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Spence Clairmont, Walhalla, N.D., column: Policy pushes pharmacies out of Medicare Part B

By Spence Clairmont WALHALLA, N.D. -- Medicare is making some significant changes that will impact many of our Medicare-eligible patients. Starting Jan. 1, 2013, no pharmacy will be able to deliver or mail Medicare Part B supplies such as blood g...

By Spence Clairmont

WALHALLA, N.D. -- Medicare is making some significant changes that will impact many of our Medicare-eligible patients.

Starting Jan. 1, 2013, no pharmacy will be able to deliver or mail Medicare Part B supplies such as blood glucose testing supplies or nebulizer solutions.

In an effort to lower costs, Medicare is putting all of these supplies out on bid. Medicare expects that over time, these supplies will become mail-order items that'll be supplied by a few large vendors.

But I believe that this is a mistake, especially in the rural areas of our country.

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While it's good for Medicare to try to save money, the trouble is that these are temperature-sensitive items that must be stored between 50 degrees and 70 degrees -- and that will be an issue in rural states, as well as any other areas where mail is left in mail boxes in temperature extremes.

Add to that the impending reduction in mail service, and you can predict supply problems. Meanwhile, local pharmacies will be unable to meet the low-bid pricing, and that will result in supply problems, too.

At present, local pharmacies are billing blood glucose testing supplies and nebulizer solutions to Medicare B, leaving patients liable for a maximum of 20 percent of the Medicare authorized price (or $0 if the patient has a Medicare supplement policy).

We make enough profit on diabetes-testing supplies to cover losses we take on nebulizer solutions. My pharmacy continues to supply test strips and nebulizer solutions because the profit on diabetes-testing supplies balances the loss we take on nebulizer solutions.

But after this year, it looks like the testing supplies will be transferred to mail-order businesses, leaving only the low- to negative-margin nebulizer solutions available to local pharmacies.

We therefore are contemplating discontinuing all Medicare Part B billing after this year.

This is not good patient care -- but Medicare is driving small businesses out.

Please remember: This is an issue with Medicare Part B only. We will continue Medicare Part D billing.

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If this concerns Medicare-eligible residents, they should contact their senators and representatives, who have not yet addressed this issue. Ask the congressmen to cosponsor or support HR 1936, the Medicare Access to Diabetes Supplies Act.

Clairmont is a pharmacist at Walhalla Prescription Shop.

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