In July, I received a letter from my insurer that said, “Effective July 1, 2013, Carefirst has selected LifeScan’s One Touch test strips as the ONLY preferred diabetic test strip on our Preferred Drug List.” In other words, anything else is an out-of-pocket expense for me. I have many problems with this policy, but I know where it’s coming from and I don’t like it one bit!
There has been a lot of diabetes news on meter accuracy and the Strip Safely campaign to push the Food and Drug Administration (FDA) to reconsider test strip accuracy. I couldn’t agree more with the need for this campaign. If test strips are allowed continue to have a 20 percent inaccuracy rate, that means a 300 blood sugar is actually somewhere between 240 and 360. These discrepancies are too big when it involves treating diabetes with injected insulin.
Enroll in a Humana Medicare Plan Today
But under the Affordable Care Act, a new system called the “competitive bidding program” has been set up to reduce costs for Medicare patients. The program changes the amount Medicare pays suppliers for certain durable medical equipment and also changes who can supply these items.
According to the Medicare.gov website, “the Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare-contract suppliers."
But there is a wrinkle in this cost-savings idea. It may reduce the cost, but it also may influence the accuracy of meters in the wrong direction. A study at the Institute for Diabetes-Technologie, at the University of Ulm in Germany, gave a stunning glimpse at the problem of test strip accuracy. Out of five meters tested, only two systems fulfilled the criteria: Accu-Chek Aviva and Accu-Check Freestyle Lite. Among the poorest performers was OneTouch Verio. In other words, all failed to meet the FDA accuracy standards except for Accu-Chek. Two other studies showed almost identical results.
I’ve always had a little beef with One Touch policies on meter accuracy. They hold the most shelf space in the marketplace, but behind their marketing effort is a device that I feel doesn’t deserve the front-and-center attention.
While I’m not a Medicare patient, Medicare sets the price for much of our medical supplies, drugs and other health care costs, so BlueCross BlueShield based their decision on what Medicare will pay.
So, what to do...
I walked across the hall to speak to my health insurance agent (also known as my husband) and I asked him, “Do I have any recourse to fight this?” He said if I get my doctor to write a letter of appeal, then I can submit that to BlueCross BlueShield for consideration.
I think it’s worth the fight, don’t you?