The National Association of Chain Drug Stores has given federal lawmakers focused on deficit reduction a heads-up when it comes to diabetes testing supplies for Medicare patients.


National Association of Chain Drug Stores, NACDS, super committee, diabetes testing supplies, diabetes care, deficit reduction, Medicare, Congressional Joint Select Committee on Deficit Reduction, cost of health care, retail pharmacy, Medicare competitive bidding program, reimbursement, Patty Murray, Jeb Hensarling, diabetes patients, Medicare Part B, Medicare Part D, durable medical equipment, Centers for Medicare & Medicaid Services, CMS, Chain pharmacies, prescription medications, pharmacist counseling, diabetes supplies


































































































































































































































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NACDS to committee: Take care with diabetes care

October 18th, 2011

ALEXANDRIA, Va. – The National Association of Chain Drug Stores has given federal lawmakers focused on deficit reduction a heads-up when it comes to diabetes testing supplies for Medicare patients.

NACDS on Tuesday sent a letter to the bipartisan co-chairmen of the Congressional Joint Select Committee on Deficit Reduction, known as the "super committee," urging them to resist limiting access to diabetes testing supplies in a way that would result in poorer health outcomes and hike the cost of health care.

Specifically, NACDS warned against moving any segment of retail pharmacy into the Medicare competitive bidding program and against reducing reimbursement for diabetes testing supplies obtained at a retail pharmacy to below-cost levels.

"We understand the Joint Select Committee on Deficit Reduction must make difficult choices in order to find savings and rein in spending. However, we are concerned that the committee may consider changes that would impact access to diabetes testing supplies for Medicare beneficiaries," NACDS wrote to Sen. Patty Murray (D., Wash.) and Rep. Jeb Hensarling (R., Texas).

Instead, NACDS cited preventive services that diabetes patients encounter in their retail pharmacies and pointed to alternative approaches, such as moving coverage of diabetes testing supplies from Medicare Part B to Medicare Part D, which would yield savings for Medicare without compromising patient access and health.

The association explained that although diabetes testing supplies are deemed as durable medical equipment (DME) under the Medicare, the Centers for Medicare & Medicaid Services (CMS) has excluded diabetes testing supplies furnished by retail pharmacies from competitive bidding — a move hailed by NACDS.

"Without this exclusion, it is highly unlikely that retail pharmacies would be able to furnish diabetes testing supplies in Medicare, since competitive bidding reimbursement rates are below diabetes testing supplies product costs for retail pharmacies," NACDS stated in the letter. "Chain pharmacies, which make up 66% of retail community pharmacies, are a vital access point for both diabetes testing supplies and prescription medications. Maintaining access to diabetes testing supplies at local pharmacies allows seniors to access to all of the equipment and prescription drugs they need to manage their disease from a single source."

NACDS also noted in the letter that below-cost reimbursement cuts for retail pharmacies would "hurt access to care and severely limit the valuable role of pharmacist-patient interactions in reducing overall program spending."

"Reduced access and the elimination of face-to-face pharmacist counseling will lead to under-testing, decreased medication adherence, poorer outcomes, and increased overall costs," the association stated.

NACDS suggested moving diabetes testing supplies from Medicare Part B to the Part D program. "Prescription drugs related to diabetes, such as insulin, are provided to Medicare beneficiaries through Part D," the association explained. "However, durable medical equipment such as diabetes monitors, testing strips and lancets are provided to Medicare beneficiaries through Part B. This results in difficulties coordinating care."

In the letter, NACDS went on to say that "diabetes supplies should be covered through the Part D benefit."

"This would mirror commercial practices, would allow beneficiaries with diabetes to access necessary medications and supplies from the same provider if they chose, and would reduce costs by moving products to the more efficient Part D program, which continues to operate below Congressional Budget Office (CBO) projections," NACDS said. "Conversely, proposals to expand the competitive bidding program to include retail pharmacy-provided diabetes testing supplies are inherently flawed, as they fail to take into account that fragmenting care for Medicare beneficiaries with diabetes will inevitably result in increased costs."

Last month, NACDS had sent a letter sent to the 12-member super committee that highlighted the accessibility of local pharmacists and noted that improving medication adherence via community pharmacists is key to improving health and cutting costs.

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