Medicare announced it is continuing the National Mail-Order Program for Diabetes Testing Supplies (part of the Medicare Competitive Bidding Program). New mail-order supplier contracts go into effect on July 1, 2016.
How will this affect your patients?
- If your patients with Original Medicare (fee-for-service) have been getting their diabetes testing supplies through the mail and would like to continue to do so, they may need to choose a new supplier starting July 1, 2016.
- If a beneficiary’s current mail-order supplier was given a new contract with Medicare, he/she will be able to continue receiving diabetes testing supplies from that supplier after July 1, 2016.
- If a beneficiary’s current mail-order supplier was not given a new contract with Medicare, he/she will need to choose a new Medicare mail-order supplier for diabetes testing supplies.
- If your Medicare patients encounter new difficulties after July 1, 2016 obtaining their mail order diabetes testing supplies, they should check if their mail order supplier still has a contract with Medicare.
Medicare beneficiaries still also have the option to pick up their testing supplies from a local store (local pharmacies and storefront suppliers) enrolled in Medicare.
Resources for your patients
Beneficiaries can call 1-800-MEDICARE or visit medicare.gov/supplier to get a list of mail-order contract suppliers for diabetes testing supplies.
Medicare will only pay claims for Durable Medical Equipment, including diabetes testing supplies, if the ordering physician or non-physician practitioner is actively enrolled in Medicare through the Medicare Provider Enrollment, Chain and Ownership System (PECOS). If the ordering provider is not enrolled in PECOS on the date the prescription is filled or re-filled, Medicare will not pay the submitted claims.
It is also important to tell your patients who are Medicare beneficiaries if you are not participating in Medicare before you order Durable Medical Equipment for them. All providers enrolled with Medicare must revalidate their enrollment on a periodic basis, usually every 5 years. If you do not have an active record, learn how you can enroll, revalidate your enrollment and/or make a change:
Updated June 22, 2016