By Michael Rule, Manager of Public Affairs and Grassroots Advocacy
With the July 1 implementation of the national mail order (NMO) program rapidly approaching, Representative Mike McIntyre (D-NC) became the 44th member of the House of Representatives to raise concerns with the Centers for Medicare and Medicaid Services (CMS). If implemented, the NMO would ban independent pharmacists from providing home delivery of diabetes testing supplies (DTS) to Medicare Part B beneficiaries.
In his letter, Representative McIntyre noted that “I am concerned that implementation would negatively impact the quality of care in rural areas like those in my district, and that is simply unacceptable. It is essential that we ensure adequate access of care for those in need.” He further requested CMS to provide information to his office surrounding their decision and whether a review would take place prior to implementation.
His letter follows a joint letter to CMS signed by 43 members of the House, which questioned CMS’ reasoning for the rule. Those lawmakers wrote, “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. We ask that you expeditiously consider allowing small retail pharmacies to continue home delivery and not prevent these crucial face-to-face counselling and adherence services from being available to Medicare patients.”
In addition, patient stories are beginning to emerge indicating the potential inconvenience and harm that this policy change may have on patients. South Dakota’s Keloland TV recently profiled a senior husband and wife who both have diabetes. Neither can drive so they rely on their independent community pharmacy, Lewis Drug pharmacy, for delivery of their testing supplies and medication. The husband, Herb Grogan, told the station of the value he places on trusting his health needs to someone local who “understands me and my medical condition.”
With bipartisan pressure mounting, it is prudent for CMS to reexamine this delivery prohibition decision to ensure patients maintain access to their testing supplies through a provider they know and trust. In the absence of CMS action, bipartisan legislation, H.R. 2375, has also been introduced that would delay the implementation of the NMO by six months to give Congress time to study the potential negative impact on patient care.
Visit the NCPA Legislative Action Center to look up the contact information for your members of Congress and call to urge them support this legislation and act where CMS has thus far failed to do so.