Four congressmen are urging the Centers for Medicare and Medicaid Services (CMS) to keep prices for its national Competitive Bidding Program (CBP) for Medicare Part B mail-order diabetes testing supplies separate from similar supplies offered by retail pharmacies.


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NCPA: CMS urged to ensure local access to diabetes supplies

August 27th, 2010

ALEXANDRIA, Va. – Four congressmen are urging the Centers for Medicare and Medicaid Services (CMS) to keep prices for its national Competitive Bidding Program (CBP) for Medicare Part B mail-order diabetes testing supplies separate from similar supplies offered by retail pharmacies.

The National Community Pharmacists Association said Thursday that Reps. Mike Rogers (R., Mich.), Zack Space (D., Ohio), Lee Terry (R., Neb.) and Peter Welch (D., Vt.) have sent a letter to CMS administrator Donald Berwick about the issue. The lawmakers noted that the CBP pricing model could negatively impact patient access.

"CMS recently released a proposed rule that would exclude retail pharmacies from participation in a proposed mail-order competitive bidding program to occur sometime after 2010. This is a step in the right direction, since a significant number of Medicare beneficiaries have diabetes and often obtain all of their necessary prescriptions and diabetic supplies from their local community pharmacy," the legislators wrote in the letter. "The proposed rule serves the important role of maintaining a non-mail-order retail pharmacy option for Medicare beneficiaries with diabetes.

"Despite the likely benefits of the proposed rule, we remain concerned about the possibility of applying mail-order competitive bidding prices to retail pharmacies," the congressmen added. "This would eventually drive patients away from utilizing their local community pharmacies, jeopardizing both patient health and access to invaluable face-to-face interaction with pharmacy professionals."

In addition, NCPA pointed out, the lawmakers contended that retail pharmacy — especially independent community pharmacies located in underserved areas — would incur significant financial losses under any sort of CBP pricing model that could force pharmacies to stop selling diabetes supplies to seniors. The association said the lack of clarification about how and when future CBP pricing might be applied to retail pharmacy raises concern. 

"We commend Reps. Rogers, Space, Terry and Welch for their leadership and foresight in heading off a potential problem that could see millions of seniors lose access to diabetes testing supplies at their local pharmacies," Douglas Hoey, NCPA acting executive vice president and chief executive officer, said in a statement.

"This is not only a matter of convenience but of adherence, as pharmacists have the expertise to ensure the supplies are being used correctly," Hoey noted. "Planning for future contingencies is what every successful entrepreneur faces, and that is why this full-court press to garner an ironclad commitment from CMS is occurring. CMS must keep mail-order and pharmacy pricing separate."

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