Medicare Putting More Diabetics at Risk

A new survey from the American Association of Diabetes Educators (AADE) found that Medicare’s Competitive Bidding Program (CBP) significantly reduced beneficiary choice and access to commonly used diabetes testing supplies. The lack of choice forces beneficiaries to switch to unfamiliar or unsuitable testing systems, and can have dire health consequences.

AADE’s survey is the latest in a continuous round of reports by AADE and others pointing out the inherent problems with the CBP. Last year, a National Minority Quality Forum report showed a direct link to increases in mortality and complications, inpatient admission and supplier costs. The unintended consequences from switching testing supplies results in diminished or ceasing altogether of blood sugar testing, leading to an increased risk for complications such as blindness, kidney damage, cardiovascular disease and lower-limb amputations.

The new survey reinforces AADE secret shopper surveys done in 2011 and 2013 showing the same downward trend in availability and access.

“Evidence continues to show that the competitive bidding process is failing people with diabetes and putting them at unnecessary risk,” said Kellie Antinori-Lent, a diabetes clinical nurse specialist at the University of Pittsburgh Medical Center. “Patient safety and choice must come first.”

Key findings from the survey include:

• The number of manufacturers making diabetes testing supplies (DTS) available under National Mail Order (NMO) has fallen 50 percent since the start of the Competitive Bidding Program (CPB)
• The number of diabetes testing systems available under NMO is less than half the number available in 2009 before the CPB started
• Many suppliers do not offer models covering 50 percent of the market share of the DTS
• Suppliers do not provide consistent information about inventory to customers

The Centers for Medicare and Medicaid Services (CMS) established the competitive bidding program for mail-order suppliers of diabetes testing equipment in January 2011. Soon after, widespread anecdotal reports suggested that the suppliers were denying access to the specific brands and types of equipment promised to be available on Medicare.gov. The most recent study showed some improvements, finding fewer discrepancies between the information provided on Medicare.gov and what is available to consumers.

To ensure beneficiary safety and well-being, a complete review of the program is necessary. AADE applauds the recent announcement by CMS to delay Round 2019 of the Competitive Bidding Program in hopes that the process can be overhauled to reflect evidence based data and best practices. Beneficiaries should have access to their preferred testing supplies, directed by their healthcare team.