The number of Medicare beneficiaries who received durable medical equipment (DME) items generally fell after Round 2 of competitive bidding program (CBP) and the national mail-order program for diabetes testing supplies were implemented July 1, 2013, according to a Government Accountability Office (GAO) report issued this fall. Specifically, from 2012 to 2014, the number of beneficiaries receiving covered items in Round 2 competitive bidding areas (CBAs) decreased 17 percent, compared with a 6 percent decrease in non-CBAs. Likewise, the number of beneficiaries who received diabetes testing supplies through the national mail-order program decreased 39 percent between 2012 and 2014, compared to a 13 percent increase the number of beneficiaries receiving these items through retail locations. Despite these decreases, CMS argued that “its routine monitoring of beneficiary access has not identified access issues.” On the other hand, four out of five beneficiary advocacy groups interviewed reported that their members experienced access issues related to competitive bidding (e.g., delays in delivery of CBP-covered DME items and trouble locating contract suppliers to provide specific DME items). Furthermore, discharge planners and state hospital associations echoed these concerns, with discharge planners and referral agents from the Florida and California hospital associations stating that delays in delivery of needed DME resulted in an increase in the length of hospital stays for some beneficiaries.
Separately, the HHS Office of Inspector General (OIG) issued a Congressionally-mandated report on Medicare market shares of mail order diabetes test strips for the period of April to June 2016. This market share data helps CMS determine if competitive bidding contract suppliers meet the statutory requirement that they provide at least 50 percent, by volume, of the types of diabetes test strips provided to Medicare beneficiaries. According to the OIG, two types of test strips accounted for about half of the mail order market during this period, five types accounted for 81 percent of the market, and 10 types accounted for 93 percent of the market.