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Centers for Medicare and Medicaid Services (CMS) and Competitive Bidding

The Issue

The National Minority Quality Forum issued a report at the American Diabetes Association 75th Annual Scientific Sessions in 2015 – National Minority Quality Forum Report on CMS Competitive Bidding Program. The Forum detailed the results of a competitive bidding program (CBP), implemented by the Centers for Medicare and Medicaid Services (CMS) in nine test markets in 2011. Competitive bidding affects retail channels, which see significant reductions in reimbursements for diabetes testing supplies. As a result, pharmacies (especially independent ones) have less incentive to sell BGM supplies to people on Medicare.

Some Medicare patients have to pay out of pocket if they want to keep using the BGM prescribed by their doctor. In 2011, the CBP disrupted access to necessary blood glucose monitoring supplies, and correlated to more hospitalizations and deaths in these nine test markets. The CBP went national in 2013.  Here is the NMQF Press Release that accompanied their original report NMQF Report Press Release_12 01 2015.

The DLC’s Stance

Effective diabetes management requires that therapy be personalized to the unique needs of each patient. The CBP has not only disrupted beneficiary access to the tools they need to manage their diabetes but has violated the sacrosanct relationship between physicians and their patients.

Given these troubling findings that show the suffering of Medicare beneficiaries, it is our position that CMS be compelled to suspend the CBP until adequate safeguards are in place to monitor the true impact of the program, preserve the integrity of physician-patient relationships, and protect beneficiaries from potential further harm.

Our Activism

We’ve taken a strong position on the “unintended consequences” of the CMS’s Competitive Bidding Program, and will continue to monitor its effects.  Here are highlights of our actions to date on this important issue for seniors with diabetes:

 

 

 

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