U.S. Rep. Schock champions diabetic care for seniors
Congressman Aaron Schock (R-IL) has introduced legislation known as the Medicare Access to Diabetes Supplies Act, H.R. 1936, aimed at preserving the ability of the nation’s seniors to continue receiving their diabetic testing supplies from their neighborhood pharmacist. As the Centers for Medicare and Medicaid Services (CMS) prepares to implement the second round of the competitive bidding program, Schock stresses that it’s imperative for Congress to exclude these local pharmacies in order to prevent a reduction in diabetes testing supplies, higher prices, and the possibility of reduced essential services that seniors currently rely on. His legislation would permanently exempt these testing supplies furnished by small community pharmacies from CMS’s competitive bidding program.
CMS included diabetic testing supplies in round one of the competitive bidding program, a program created by Congress for the purpose of reducing the excess price Medicare has been known to pay for durable medical equipment, prosthetics, orthotics, and supplies. The program requires sellers of such products to submit bids for their products and have their bids be accepted by CMS before they can sell their products to beneficiaries. If a provider fails to do so or their bid is rejected by CMS, the provider will be unable to sell his or her product to a Medicare beneficiary. As CMS continues to implement and expand the program to cities across the U.S., there is growing concern that local pharmacies will be unable to compete with larger providers. If this happens, thousands of local pharmacies would be barred from selling their products to Medicare beneficiaries.
“Without help 97 percent of local pharmacies would be impacted by this change,” said Schock. “This comes down to ensuring that the decisions made in Washington don’t adversely affect neighborhood pharmacies and the seniors who rely on them on a regular basis for many of their health care needs.”
While Schock’s legislation exempts small pharmacies, defined as those with 10 or fewer stores, from future rounds of the competitive bidding program, these pharmacies would still be subject to the Medicare Part B fee schedule for durable medical equipment, so no pharmacy will be able to arbitrarily raise prices. The bill would also exempt retail pharmacies that provide home delivery of such supplies as diabetic testing supplies to their patients who are unable to leave their home due to health reasons.
“We commend Reps. Schock and Welch for introducing this vital legislation,” said National Community Pharmacists Association (NCPA) Executive Vice President and CEO B. Douglas Hoey. “This bipartisan bill would help ensure that seniors can continue to rely on their independent community pharmacy for these essential diabetes supplies and the expert counseling needed to effectively manage their condition.”
“The in-person counseling provided by pharmacists is critical to helping many patients properly use glucose monitors,” Hoey added. “Without face-to-face counseling, seniors may incorrectly interpret glucose readings, triggering either a false alarm or a mistaken sense of security. Under either scenario, Medicare costs may increase as patients could unnecessarily seek more expensive treatment from physicians or hospitals or ultimately suffer costly diabetes complications.”
Under the Medicare Modernization Act, the Health and Human Services Secretary, was required to begin a program of competitive bidding. However, because of concerns, the program was not fully implemented and in fact only lasted a couple of weeks. Included among the many reasons for delaying the program was that there were suppliers without an actual location in or near the bid area who thus would be unable to provide their equipment and services to Medicare patients, the providers were unlicensed which is a violation of state standards, and some of the bidders included companies who had no experience in providing the items they were bidding on.
After halting the program, the Health and Human Services Secretary began a revised rebidding process again this year, but concerns still exist as many independent pharmacies will not be able to meet the competitive bidding requirements to serve an entire Metropolitan Statistical Area.
“I have heard from many local and independent community pharmacists in my district, as well as seniors who are worried, and they have expressed their concern that what in theory might seem to be good for business will in fact do more harm than good,” said Schock. “I support the purpose of the competitive bidding program, but after learning more I believe that we need to take action so that this problem is stopped before it continues and no financial blow is felt by seniors.”