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Letter from the Editor #662: Changes in Medicare Pricing

Feb 1, 2013
One of our sources has been in touch with the Centers for Medicare & Medicaid Services (CMS) and found that new, lower Medicare prices  will go into effect this July in a major expansion of the DMEPOS Competitive Bidding Program. The CMS Office of the Actuary estimates that the program will save the Medicare Part B Trust Fund $25.7 billion and beneficiaries $17.1 billion between 2013 and 2022. Hopefully this means that more patients will be able test more often. 
Medicare beneficiaries across the country will save an average of 72 percent on diabetic testing supplies under a national mail-order program starting at the same time. The new reimbursement for 50 strips is only $10.41 for a box of 50 test strips.  This compares with a cash cost of about $50 for the same amount. For prescribers this means that there will be a lot of meter switching as some companies will not be able to survive the price reduction and more of their patients will be forced to leave the local pharmacy to get their strips. 
This is just another reason why prescribers are becoming so frustrated and leaving the practice sooner. In fact, according to a report from UBM Medica, the fee prescribers receive for existing patient visits tumbled as much as a third last year, as indicated by the Fee Schedule Survey by Physicians Practice

This could not come at a worse time as we have seen a large enough increase in the incidence of  type 2 diabetes in children that the American Academy of Pediatrics has issued guidelines for managing the disease, and one of their recommendations includes frequent follow-up visits.


With a day packed full of education, motivational tools, one-on-one sessions, and workshops, the TCOYD health fair is a great way to get your patients to take better care of their health and themselves.

Topics: From the dLife Kitchen, Chef Michel Nischan prepares a delicious day of diabetes eating. On today’s menu: Turkey Sausage Patties for breakfast; Chicken Ranch Salad for lunch; Lemon Ginger Salmon for dinner; and Nutty Chocolate Meltaways for dessert. Sundays live online at at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at

Please answer this week’s poll: What concerns your patients most when diagnosed with type 2 diabetes?
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Dave Joffe, Editor-in-chief