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NCPA backs Medicare diabetes supplies bill
May 24th, 2011
ALEXANDRIA, Va. – The National Community Pharmacists Association has endorsed legislation that would exempt diabetes testing supplies provided by small community pharmacies from the Centers for Medicare and Medicaid Services (CMS) competitive bidding program and pricing for Medicare Part B durable medical equipment, prosthetics, orthotics and supplies (DMEPOS).
NCPA said Tuesday that the exemption sought by the bill — the Medicare Access to Diabetes Supplies Act (H.R. 1936), introduced by Reps. Aaron Schock (R., Ill.) and Peter Welch (D., Vt.) — would enable senior citizens to continue receiving vital diabetes testing supplies and counseling on their proper use from independent pharmacies.
Besides the permanent exemption for diabetes testing supplies, the legislation also would permit small community pharmacies to continue providing home delivery of these products, without those items being subject to the future national mail-order competitive bidding program, according to NCPA.
"We commend Reps. Schock and Welch for introducing this vital legislation," B. Douglas Hoey, executive vice president and chief executive officer of NCPA, said in a statement. "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."
NCPA noted that CMS has indicated it will likely include retail diabetic supplies in future rounds of DMEPOS competitive bidding. The exemption in H.R. 1936 covers diabetes test strips, monitors, lancets, glucose control solutions and applies to community pharmacies with 10 or fewer locations.
Without the legislation, or a comparable exemption, small pharmacies would no longer be able to offer these supplies and provide face-to-face guidance to seniors, resulting in reduced access, NCPA said, explaining that most independent pharmacies won't be able to meet the competitive bidding requirement to service an entire metropolitan statistical area and to match the bids of large mail-order facilities.
"The in-person counseling provided by pharmacists is critical to helping many patients properly use glucose monitors," Hoey pointed out. "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."
In other news, NCPA on late Tuesday announced its endorsement of the Pharmacy Competition and Consumer Choice Act of 2011, introduced by Reps. Cathy McMorris Rodgers (R., Wash.) and Anthony Weiner (D., N.Y.).
The association said the bill would preserve patients' ability to go to the pharmacy of their choice, establish new protections for patient information, eliminate wasteful pharmaceutical spending and create a more level the playing field among pharmacies.
In particular, NCPA said, the legislation takes aim at "restricted network" pharmacy benefit plans and would allow "any willing provider" that agrees to accept a health plan's terms and reimbursement rates to participate in that plan, as long as the pharmacy is licensed in that state and eligible to participate in federal and state health plans.
The bill would also ensure that private plans provide pharmacies with timely reimbursement, as required under Medicare Part D, instead of delaying the payments to generate interest from those funds, according to the association. The measure, too, would give pharmacies basic information about how a pharmacy benefit manager determines reimbursement rates (for example, maximum allowable costs, or MACs) and require those rates to be updated frequently to reflect changes in drug costs.
"This bipartisan legislation would implement some badly needed reforms to give consumers new rights, reduce wasteful pharmaceutical spending and level the pharmacy playing field," stated NCPA president Robert Greenwood.
NCPA's endorsement of the Medicare diabetes supplies and pharmacy competition bills come amid its 2011 Legislative Conference in Washington, D.C., where independent pharmacists are meeting with elected officials and their staff to discuss priorities for community pharmacies and their patients.