Medicare’s Competitive Bidding program negatively impacts insulin pump users

Last year Bennet Dunlap and a group of committed DOC (Diabetes Online Community) advocates created a social movement called StripSafely. It was the raising of voices of those with diabetes to encourage the FDA to put a post market survey in place to ensure our test strips and meters meet safety standards and the ISO requirement for blood glucose testing.

The movement was a roaring success. Dunlap went to Washington to present to the FDA. The FDA did develop a post-market surveillance testing program. As background, this movement was prompted by Medicare’s program of competitive bidding for meter and strip manufacturers, increasing the odds that products would be chosen by price, not quality. I was a part of that movement as were thousands of people who wrote letters and it was satisfying indeed to see we could affect such change.

Now, however, the problem continues, or perhaps progresses. A survey conducted by the American Association of Diabetes Educators (AADE) finds that suppliers participating in Medicare’s Competitive Bidding program are failing to provide access to insulin pumps and related supplies. This can critically impact the health of patients either being denied a pump and supplies or being forced to use one not of their choosing. Many suppliers only offer one brand.

Of Medicare’s 29 suppliers, only 17 carry insulin pumps, and only 18 offer replacement supplies. Many suppliers are not meeting their obligation to even offer a pump and Medicare members are having difficulty finding suppliers who do, I know as I am often asked by those on Medicare how can they get an insulin pump? Restrictions also make it difficult if not downright impossible for pump users to switch pump systems. Of course the competitive bidding program was initiated to contain costs, but at what price to members and people with diabetes?

The AADE hopes the survey will help initiate positive change. One would be to move pumps and supplies from their current billing product category to a new product category, “Continuous Insulin Infusion Systems and Supplies.” This would require suppliers to stock pumps and supplies, helping to ensure patients would have access.

Another call is for Medicare to enforce the requirements that suppliers make available pumps and supplies to all Medicare members as indicated through the Healthcare Common Procedure Coding System.

Facing turning 62 this year I can only hope by time I get to Medicare the AADE and other impact organizations will have had their way. While I do not wear a pump, I cannot bear the thought that instruments I do use to remain healthy would be limited and or restricted to me. To think I could not get these items is frankly unthinkable and I’d go so far as to say criminal.

4 thoughts on “Medicare’s Competitive Bidding program negatively impacts insulin pump users

  1. Thanks for the kind words. Thank you more for joining the campaign and conversation.

    I am coming to see advocacy as a chronic condition much like diabetes. It is never finished, there is always more to do and so it feels daunting.

    But there are successes. And as in diabetes care, we should be willing to learn from successes. We as a community stepped up. We can and will do more but I very much think that our success in coming together was an achievement and a path forward. Thanks for seeing that.

  2. Pingback: Medicare’s Competitive Bidding program negatively impacts insulin pump users | Diabetes Advocates

  3. I know two women who had difficulties getting their pump supplies this winter. One managed not to run out before the new supplies arrived, but the other woman had to borrow supplies because she ran out. I thought that the CGM issue was going to be my biggest problem with Medicare but stories like this demonstrate that life with Type 1 is going to be rocky on Medicare. Ugh:-(

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