The co-chairs of the House and Senate Diabetes Caucuses have recently voiced their concerns to CMS about proposed changes that could impact how the agency pays for diabetes devices. In a letter addressed to CMS Administrator Dr. Mehmet Oz, caucus leaders emphasized the potential negative effects of the proposed rule, which includes insulin pumps and continuous glucose monitors in a competitive bidding program and changes payments to a monthly rental system.
The proposed changes have raised alarms among diabetes tech companies, including insulin-pump manufacturers Tandem Diabetes Care and Insulet. While these companies initially did not anticipate a significant impact on their businesses, the potential implications of the CMS proposal have become a cause for concern.
Sens. Jeanne Shaheen, D-N.H., and Susan Collins, R-Maine, along with Reps. Diana DeGette, D-Colo., and Gus Bilirakis, R-Fla., highlighted the potential consequences of the proposed policy. They expressed worries that limiting the number of suppliers responsible for providing durable insulin pumps and CGMs to beneficiaries could lead to reduced choices and access to essential diabetes technology. The current system, where manufacturers are responsible for support, could be replaced by a model that may not adequately meet the diverse needs of beneficiaries.
The legislators also underscored their support for enabling individuals to switch to newer technologies more frequently than every five years. However, they suggested that there are alternative approaches the CMS could explore to achieve this goal without compromising access and choice for beneficiaries. Additionally, they pointed out that there is an ongoing national coverage determination request to align Medicare coverage of insulin pumps with the standard of care.
AdvaMed, a leading medtech lobbying group, echoed the concerns raised by the caucus leaders. AdvaMed CEO Scott Whitaker emphasized the importance of ensuring that patients have sufficient access to diabetes technology that could significantly improve their health. Whitaker stated that any policies that impede access rather than enhance it are heading in the wrong direction.
In response to the proposed rule, AdvaMed recommended that the CMS address the significant issues before moving forward with its competitive bidding program for durable medical equipment. By taking into account the feedback from stakeholders and addressing the potential drawbacks of the proposal, the CMS can ensure that Medicare beneficiaries have continued access to essential diabetes devices and technologies.
