Diabetic Test Strips: Round Two

For those of you that think what happens to Medicare won’t impact you, stop and think about how many people you have seen say that their insurance company follows Medicare guidelines. If you use a local supply store and that store closes because of what is going on with Medicare, that impacts you. Even if you mail order your supplies from a company and that company has to close up shop, you will need to find another supplier. The way Medicare is implementing this program is causing a lot of suppliers to go out of business. When you have to wait weeks or months to get what you need because there are not very many suppliers to choose from, that impacts you.

I first wrote about the Medicare Competitive Bidding Program back in December. That program went into place January 1st in nine areas of the country. Since the program started, there have been numerous problems reported. Medicare however seems oblivious to those problems and is moving forward with round two. At this point, it will not matter whether or not you live in one of the affected areas, if you are diabetic and use test strips, with round two you need to get them from one of the suppliers chosen by Medicare.

If you are using a brand named meter, you can forget about using those test strips. I have already seen numerous stories of people in the 9 areas not able to get the test strips that they had been using. All meters are NOT created equal – here is just one study done on meters. I don’t know about you, but there is a huge difference between my meter saying I am 70 as opposed to my real reading of 40. I have been down that road before. I have also woke up to EMTs over me and that is not something that I ever want to go thru again. I need an accurate meter. Medicare saving money on test strips will only increase the trips to the ER because I don’t know that my blood sugar is low and I am forced to use a meter that can’t tell me that I am low.

picture of Aviva meter with blood sugar of 13

I don’t think anyone would disagree that Medicare needs to put price limits on and they should not be paying $200 for something that costs $50. Most insurance companies have agreements with the suppliers that they work with to accept a set fee for that particular supply. What Medicare is doing with the competitive bidding process is opening up bids for an item. The lowest bidder will be the only ones allowed to sell that particular item. What was seen in round one was the bids were going to companies with bad credit and companies that had never even sold the items that they bid on. You are handed a list of suppliers and only have a couple choices. Some supply stores in the first round of the bidding program areas have already had to close.

It is not just test strips being impacted. Things like oxygen, wheelchairs, walkers and even wound supplies are on this list. If someone lands in the hospital and needs to have these items before they can go home, they have to spend extra time in the hospital because instead of a local supply store being at their home when they get home from the hospital with the items they need, it is now being shipped from across the country. How is that saving money? You are shifting the savings in DME to an increase in medical. That does nothing to solve the overall problem.

The big surgery on my foot was scheduled for 1 PM on a Friday afternoon. Prior to my going into surgery, my doctor did not know what the outcome of surgery would be until he opened my foot. Besides having a wound, I broke my foot and he could not tell from the MRI what was damage from the infection or swelling from the break. There was no way to make plans for what I would need when we did not even know what I would need. On Monday morning, the decision was made that I would be discharged from the hospital. Everyone had to scramble to make the arrangements that I would need in order to go home. I was able to get a wheelchair from a local supply company and that wheelchair was waiting for me when I got home from Pittsburgh that afternoon. We had to have the ambulance crew come get me from the car to the wheelchair and then help get me into the house. Had I not been able to get the wheelchair, I would have had to either stay a couple extra days in the hospital or go to into some kind of nursing care. Any savings for having that wheelchair shipped from California would have been eaten alive by the extra hospital/nursing days that I was not able to go home.

My case was a “what would have happened” if this program had been in place when I went thru my foot wound. Unfortunately, this exact scenario has been playing out over and over again in the nine areas of the country under Medicare’s Competitive Bidding program. As I stated above, increasing medical costs to save money on DME supplies is not the answer. Putting supply companies out of business is not the answer. Setting fair prices is a much better answer and letting companies decide if they want to sell those items at a fair price is a much better answer.

I have written several other articles about the competitive bidding process. I setup a Medicare menu on the lower left hand side of my blog if you want to look at the other articles – the Medicare menu is under the grey-haired lady shaking her head!

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6 thoughts on “Diabetic Test Strips: Round Two

  1. Thanks for your comment back. I had a few occasions when my BG dropped and i treated it with High carb juice and it seemed to be heading back up-only a few points though-and then it would drop lower! I remember once when I had to drink four bottles of juice-10 oz. each. I will have to look up gastroperisis.

    I saw the pictures of your foot in the beginning…Oh my gosh! Having been in nursing for so many years I saw and treated my share of wounds. It is amazing your foot recovered from that. Somehow my feet are in good condition but I work hard to keep it that way. I was however, wearing sandals much of the summer with no ankle socks. Suddenly both heals were really bothering me-very sore-half numb. Uh oh! I got worried so now I wear no footwear without ankle socks or full socks. All is improved! We Diabetics have to be so darn mindful and vigilant all the time.

    Again thanks for this helpful blog and your comment back to me.

    • Thanks Kathleen! Gastroparesis is from a type of neuropathy & is nerve damage to the stomach – food basically just sits there instead of going thru the digestion process.

      I was very fortunate with my foot and had some very good doctors. The ones in the beginning weren’t so good, but I found good ones in time. Mine actually started as dry-cracked skin. I called my doctor on day one. I call it a comedy of errors that happened, but it really wasn’t funny! I try to encourage people to take very good care of their feet. I have seen what happens even when you do the right thing. Better safe than sorry. I used to be a sandal person also, but can’t do that anymore.

  2. Superb post!! I am a Diabetic on two insulins, who has had many struggles with drops in my blood sugar. When I saw your meter that gave a reading of 13, I was flabbergasted. My lowest has been 21. I finally took matters into my own hands. I eat right, my A1c’s have been 5.8-5.8 and the last was 6.1. But I kept suffering drops. Most of them in the evening or in the middle of the night. How it is that I wake up is beyond me. My doctor was not adjusting my insulin correctly so I decided to adjust my own sugar levels and insulin myself. I now keep my sugars a bit higher and I lowered my insulin. Honestly, I was afraid I was going to go into a coma. I live alone.

    Your info about test strips is scary. I use Free Style Lite as my meter-there is no better one. I have two identical ones-one for home and one I carry in my bag each day, in case. I also never leave home without having eaten and without a high carb juice. My meter is small, compact and simple, except when I am delirious with a low, low sugar. Then I can’t even function. Luckily I have an RX premium that covers my strips for the most part, leaving me with a modest co-pay. But that too could change. My Rx plan has been known to suddenly decide not to cover this or that, leaving me high and dry. With an illness as deathly serious as Diabetes, the Gov and Medicare need to mind their own business. They don’t pay for my strips anyway!

    Your post is very excellent and insightful and helpful. i do wish you well and hope to hear more from you. Can I subscribe? I’ll check and see!

    • Thank you Kathleen! I have gastroparesis, so that really plays havoc with ones blood sugar. Even if you know you are going low and treat the low, what you use to treat the low sits in your stomach and your blood sugar keeps going lower. When I was in the hospital, the nurses were always flabbergasted because they would come back to test my BS and it would be even lower.

      I am glad that you have a meter that you can trust – I think that is very important. I know that just because I like a meter and it works for me doesn’t mean that it will work for everyone. I know someone that had a meter that was not accurate for her, yet it was the most accurate meter for her husband. That is why I always like to say that not all meters are created equal! I think a lot of us live in fear that what we have now will change. Unfortunately the people making those decisions are not the one that has to live with them.

      I saw that you figured out how to subscribe before I was able to get to this message – my neighbor popped in early this morning and threw me off schedule!

  3. I actually think they would have no compunctions about discharging you with no thought to what your needs might be. The new attitude seems to be “just get ’em outta here!”. When I was discharged to a rehab hospital/Alzheimer’s home, it was on a Friday afternoon. Therefore, no hospitalist until the following Monday, correct insulin orders did not follow me, and they had omitted writing down that I needed Omeprazole (A PPI for severe heartburn, or GERD). So I sat or laid around with my tongue stuck to the roof of my mouth, relapsed into hallucinations and delirium from high BGs, and was in excruciating pain from my esophagus. “Sorry, we can’t do anything for you, it’s not time for your insulin (which wasn’t adequate, anyway), and you can’t have any more Tums, because you’ve had the maximum dose.” I could have been out of there in a week at most if they hadn’t allowed me to relapse, so I was in for THREE miserable weeks. Do you REALLY think they saved any money by discharging me from the hospital on a Friday night, when if they had kept me till Monday, on appropriate treatment, I might have been able to go straight home? (You shouldn’t have got me started — I’m more scared of Medicare than almost anything else in the world except an earthquake or a Republican president!)

    • I do agree with some of what you say, but on one hand, sending you to another medical facility isn’t quite the same as sending someone home. They could at least have thought that you would be cared for or figured they were shifting the problem to someone else to worry about. What happened to you was not right and that scares the crap out of me than Medicare! I am terrified of going into any kind of nursing home.

      There have been people that were not able to go home from the hospital because of these new regulations. I know they do send people home too soon, but if someone needs to have oxygen before they can leave the hospital, they have to have that set up.

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