LEGISLATIVE  »  FEDERAL ISSUES

DME Competitive Bidding: H.R. 5235, the Medicare Access to Diabetes Supplies Act
Recently introduced by Reps. Welch (D-VT) and Mike Rogers (R-MI). This legislation would exclude diabetic supplies provided by small pharmacies from DME competitive bidding. The bill defines small pharmacies using the SBA definition of $7 million or less in annual sales. Excluding these supplies from competitive bidding is important for small pharmacies because they will unlikely be able to effectively participate in the competitive bidding program. That will reduce beneficiaries' access to diabetes testing supplies, particularly in rural or other underserved areas.

The PBM Audit Reform and Transparency Act of 2010 (H.R. 5234)
Recently introduced by Reps. Weiner (D-NY) and Jerry Moran (R-KS). This legislation expands the new Pharmacy Benefit Manager transparency requirements included in the health care reform bill to all plans both public and private plans. It also would restrict PBMs' ability to steer patients to mail order and it is the first federal legislation to try and reform abusive PBM auditing practices.

Health Care Reform
Overview: Kaiser Foundation Summary of HCR Provisions

Centers for Medicare and Medicaid

Point of Sale Facilitated Enrollment (POS FE) & Other Resources

Medicare Part D Fraud, Waste, and Abuse (FWA) FAQ

Medicaid Dispensing Fees by State (June, 2009)

Research

Grant Thornton's "Cost of dispensing study"