WASHINGTON (AP) — Medicare begins a major change next month that could save older diabetics money and time when they buy crucial supplies to test their blood sugar — but it also may cause some confusion as patients figure out the new system.
On July 1, Medicare opens a national mail-order program that will dramatically drop the prices the government pays for those products but patients will have to use designated suppliers. The goal is to save taxpayers money but seniors should see their copays drop, too.
Don't care about the convenience of mail delivery? Just over half of the 4.2 million diabetics with traditional Medicare coverage used mail-order last year, but starting July 1 beneficiaries also can get the new lower price at drugstores enrolled in the Medicare program.
"Those who like the face-to-face interaction with the pharmacist have that choice," stressed Jonathan Blum, Medicare deputy administrator. "We want to preserve both options."
It's the biggest expansion yet of a larger, and somewhat controversial, initiative that's predicted to save taxpayers nearly $26 billion over the next decade by cracking down on waste and fraud in the medical equipment industry. Diabetics aren't the only Medicare patients affected.
Depending on where they live, patients who rent home oxygen gear and hospital beds, or who need power wheelchairs, walkers and certain other equipment also could see changes in their suppliers and lower prices as a pilot test of this so-called competitive bidding program expands from nine metro areas to a total of 100 on July 1. Medicare is supposed to apply the lower pricing nationally by 2016.
The diabetes initiative is the first to go nationwide — and Blum said it should put an end to unscrupulous practices such as shipping cartons of supplies to diabetics who haven't run out yet and billing Medicare for the cost.
The concern: Potentially hundreds of thousands of older patients may have to switch mail-order suppliers. The American Diabetes Association worries they won't get the word before their supplies run short — or might be pressured to switch to a cheaper brand of blood-sugar monitor and the matching supplies even though that's against the rules.
"We're sort of torn, truthfully," said Krista Maier, the association's associate director of public policy. "It will save the Medicare program money, which is good for its sustainability. The challenge is ensuring that beneficiaries' testing of their blood glucose isn't disrupted."
Here are some questions and answers about the program:
Q: What's the big change?
A: Until now, hundreds of mail-order companies could bill Medicare for the test strips, lancets and other supplies that diabetics use to measure and track their blood sugar. Under the new national program, Medicare patients can order from only 18 mail-order companies that won government contracts and will be subject to more oversight. (The change doesn't apply to Medicare Advantage patients.)
