Alexandria, Va. - Sept. 15, 2010
The National Community Pharmacists Association (NCPA) today submitted a statement for the U.S. House of Representatives Energy and Commerce Health Subcommittee hearing, "Medicare's Competitive Bidding Program (CBP) for Durable Medical Equipment (DME): Implications for Quality, Cost and Access." Seniors could lose access to items like diabetes testing supplies (DTS) and the accompanying, adherence-strengthening consultation that they receive at community pharmacies because of how the Centers for Medicare and Medicaid Services (CMS) might apply the CBP.
In its statement, NCPA noted that during the aborted first round of this program, "less than two percent of the suppliers submitting bids were independent pharmacists, despite the fact that community pharmacies hold one-third of all, and one-half of the active, DME supplier numbers." That experience demonstrates how any future efforts to include community pharmacies, directly or indirectly, in competitive bidding would likely see individual community pharmacies stop offering these services because they "do not have the volume of testing supply business to be able to submit successful competitive bids."
NCPA's statement offered three legislative recommendations:
While CMS exempted retail pharmacies from the latest round of mail order competitive bidding, Congress should pass H.R. 5235, the Medicare Access to Diabetes Supplies Act, which permanently exempts from the DTS sold by community pharmacies;
Congress must introduce and pass legislation that exempts community pharmacies from any pricing resulting from competitive bidding. Otherwise, pharmacies might be forced to "terminate sales of diabetes testing supplies and hinder beneficiary access if the prices established under such a program are applied to the community pharmacy market" in the future; and
In enacting legislation to address the points above, Congress should also clarify the ability of community pharmacists to deliver these products to homebound seniors and, on a temporary basis, to "snow bird" seniors who spend colder months in warmer climates. CMS' proposed present definition in this instance of "mail order" as "any item... shipped or delivered to the beneficiaries' home regardless of the method of delivery," would block community pharmacies from providing these patient services.
NCPA has worked constructively with CMS ever since the CBP program was announced. Those efforts will continue. However, the focus on seeking remedies through Congress results from its ability to write the laws that CMS implements though regulatory guidelines. The current guidelines are cause for concern and must be addressed to ensure that "Medicare Part B beneficiaries continue to have access to the high quality DTS and other DME supplies at their local community 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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