NCPA Backs Bill to Preserve Seniors' Access to Diabetes Supplies at Community Pharmacies

Alexandria, Va. - May 07, 2010

The National Community Pharmacists Association (NCPA) praised Representatives Peter Welch (D-VT) and Mike Rogers (R-MI) for introducing the Medicare Access to Diabetes Supplies Act. The bill removes diabetes supplies (i.e., test strips, monitors, lancets, glucose control solutions) furnished by small community pharmacies from the Centers for Medicare and Medicaid Services' (CMS) final competitive bidding program for Medicare Part B DMEPOS (durable medical equipment, prosthetics, orthotics and supplies). Small community pharmacies are currently classified by the Small Business Administration's definition as having annual sales of $7 million dollars or less. 

"This legislation allows seniors to continue obtaining essential medical supplies like diabetes testing strips from their local community pharmacy," said Bruce T. Roberts, RPh, NCPA executive vice president and CEO. "The current competitive bidding program favors larger health care providers at the expense of smaller ones like community pharmacies. As a result many seniors who get these supplies from community pharmacies could be forced to travel many miles or go through mail order without the face-to-face consultation that helps maximize health outcomes." 

"Representatives Welch and Rogers offer a common-sense legislative solution by exempting pharmacies of a certain size from this requirement, which is why we call on Congress to roll up its sleeves and pass it as soon as possible," added Roberts. 

Competitive bidding requires DMEPOS suppliers to submit a bid to be awarded a contract. Medicare uses the bids to determine payments. Previous rounds of competitive bidding were problematic enough that Congress intervened to halt, reshape and restart the process again. One of the primary concerns was that small suppliers like community pharmacies, particularly those in underserved rural and urban areas, would be underbid, and ultimately forced out of the program by larger suppliers that have no local presence but could always offer Medicare a better price, even if the quality was questionable. Consequently, community pharmacies and other comparably sized providers have problems winning contracts. 

While 73% of community pharmacies sell DMEPOS, it constitutes only a small fraction of their total sales. As a consequence, many community pharmacies will either limit the amount of or stop offering DMEPOS, rather than completing the time-consuming and expensive competitive bidding process. This undercuts the relationship pharmacists develop with seniors. For example, seniors with diabetes get valuable advice for taking prescription drugs and properly monitoring their blood glucose levels. For seniors no longer able to purchase DMEPOS, especially in underserved rural or urban areas without many other health care options, the ramifications of this are not only inconvenience, but potentially health compromising. 

In addition, competitive bidding is supposed to reduce fraud and lower costs, but the available evidence suggests that the inclusion of diabetes supplies sold by small community pharmacies will not achieve that objective. Not only are all pharmacies regulated and licensed at the state level, but the operators responsible for fraudulent DMEPOS-related crimes are not known to be pharmacies. 

The National Community Pharmacists Association (NCPA®) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40% of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.

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