The AAFP is calling on CMS to simplify the Medicare requirements for prescribing diabetic supplies by allowing physicians to use more generic terms when writing prescriptions for the items and to write open-ended prescriptions.
In a letter to CMS Administrator Marilyn Tavenner(3 page PDF), M.A., AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash., said physicians should be able to use the term "diabetic supplies" when prescribing the products, a change in regulatory requirements that would benefit both patients and physicians without compromising the integrity of the Medicare program. It would lead to better patient outcomes and lower costs, according to Stream.
"Family physicians simply want to be able to efficiently and effectively prescribe what their diabetic patients need to help manage their condition in a way that maintains their health," said Stream in the letter. "Unfortunately, the current Medicare rules surrounding prescription of diabetic supplies impede this goal and add no discernible value to the care of such patients."
Stream listed the lengthy requirements for Medicare glucose testing supplies and acknowledged that glucose testing and other diabetic supplies are an area often cited for processing errors. "Physicians have a role to play in fraud prevention," said Stream. "However, the related requirements have become overly burdensome with little to no value added to the actual care of the diabetic patient."
For example, said Stream, many physicians interpret instructions to provide a detailed description of items being prescribed to mean that they need to specify the exact brand of machine, test strips and lancets needed by patients. This information typically is immaterial, and it becomes a burden on the physician to collect such information.
Stream also questioned the requirement to specify the length supplies will be needed. "Diabetes is a chronic disease with no known cure," said Stream. "Patients with diabetes need glucose testing supplies for as long as they are able to care for themselves in their own home. Asking physicians to specify length of need for such equipment and supplies puts them in an untenable position of predicting a future that is not knowable."
Stream also described the reporting requirements as onerous, noting they do not contribute to patient care. "Family physicians' time is better spent helping patients manage their diabetes, not providing additional paperwork to justify what the patient needs for such a basic service in diabetes."
CMS recently has been looking for opportunities to streamline rules and regulations to benefit patients and physicians without comprising the integrity of the Medicare program. Changing regulations related to diabetes supplies would provide such an opportunity, said Stream. "We expect that by streamlining this process, patients will have better outcomes at a lower cost to the program," he noted.