Legislation does not increase Medicare costs, deserves congressional support, NCPA says
Alexandria, Va. July 29, 2013 - The Diabetic Testing Supply Access Act (H.R. 2845), legislation recently introduced by U.S. Rep. Peter Welch (D-Vt.) that would allow independent community pharmacies to provide same-day delivery services of diabetes testing supplies (DTS) to Medicare beneficiaries who are homebound or in long-term-care or assisted living facilities (ALFs), received the endorsement of the National Community Pharmacists Association (NCPA) today.
In conjunction with the "competitive bidding" program, on July 1, 2013 the Centers for Medicare and Medicaid Services (CMS) also implemented a national mail order program, which included a ban on DTS deliveries by community pharmacies to seniors and ALFs. NCPA and dozens of members of Congress have objected to the senseless ban, due to its negative impact on patients and the fact that Medicare costs are equivalent regardless of whether the DTS are provided to patients through the mail or delivery by a community pharmacy.
"Community pharmacists commend Representative Welch for his initiative in introducing this common-sense legislation," said NCPA CEO B. Douglas Hoey, RPh, MBA. "For many Medicare beneficiaries, July has been a challenging month. Some have been forced to learn to use a new glucose meter or monitor, while others have had to find a new DTS supplier. Medicare's home delivery ban imposes an additional burden on some of the most vulnerable beneficiaries—those who are homebound or in assisted living facilities.
"Many beneficiaries rely on their independent community pharmacy for their medications as well as their DTS," Hoey added. "These pharmacies offer same-day, home delivery as a service to their patients. It is part of what distinguishes independent community pharmacies from other pharmacy providers and there is no reason for Medicare to ban the practice when it doesn't cost the agency one penny."
In recent weeks, the problems triggered by the ban have begun to come to light.
"We have had over 30 complaints from patients and assisted living facilities about the new CMS diabetic strip policies," one independent community pharmacist told NCPA. "For those residents in assisted living facilities it has been especially burdensome since we deliver their regular prescriptions to them and it has caused a great inconvenience to both the patient and added extra work for the caregiver to make sure each patient has their diabetic supplies. I have had one lady call here four times asking why we could not provide her supplies. We asked her if she received a letter from Medicare about the change in July, she still did not understand it and is now completely out of supplies. We have provided her with the phone number to Medicare to voice her concerns. Unfortunately mail order suppliers are providing supplies that are not readily available in typical retail settings, so when a patient is out they can't just run down to the local store."
Another independent community pharmacist added, "My patient is a 69-year-old insulin-dependent diabetic that has had her left leg below the knee amputated. She has also recently broken her hip. She is homebound. She does not have a credit card and does not have a secondary insurance policy. We offer free delivery and she has a monthly charge account here. Because I can no longer deliver her diabetic test strips she has to go to mail order. Mail order will not accept a personal check. She must get a money order or credit card for her 20 percent copayment. She called Medicare to ask what she can do. The representative suggested that she sign a document giving me permission to pick up her test strips and bring them to her as a favor. So here is my complaint: how is this any different from what I have been doing for over 20 years with free delivery?"
Forty-three members of Congress led by U.S. Rep. Aaron Schock (R-Ill.) and Rep. Welch sent a letter to CMS in May questioning the delivery prohibition. "Now that retail and mail order suppliers receive the same level of reimbursements, we believe there is no further reason to prohibit home delivery by retail pharmacies," they asserted. "We ask that you expeditiously consider allowing small retail pharmacies to continue home delivery and not prevent these crucial face-to-face counseling and adherence services from being available to Medicare patients."
The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent an $88.5 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com/.
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