DMEPOS is ridiculous

by Caleb Reading

At our drugstore, we sell diabetic testing supplies even though we lose money on them.  We do this because we’re the only store in town and we live in the type of climate where getting things through mail order isn’t always reliable (extreme cold, extreme heat, high humidity and precipitation).  We know our delivery guys.  We know the meds and medical supplies go directly from the temperature/moisture-controlled warehouse to the temperature/moisture-controlled van to our back door, where we store them how they need to be stored ASAP.  Nothing is sitting in a mailbox for 7 hours in humid 98 degree heat while somebody is at work.  Nothing is sitting in a soggy box in the rain.

Anyway, we’re probably going to have to stop selling test strips.  Why?  Because the government is going to make us pay almost $4000 every three years for DMEPOS accreditation.  We already lose money when we fill test strips; now we have to pay for the privilege.  Huge mail order testing supply companies can afford that because they do thousands of test strip orders a week and get better prices from the manufacturers than we do.  They actually turn a profit on this stuff.  How are we supposed to pay over a thousand bucks a year to provide a SERVICE to our patients that already costs us $2 to $4 every time we fill for test strips?  Are we just supposed to tell all our diabetic patients to go mail order, regardless of the weather or quality of care, or to drive 80 miles one-way to some huge chain store that can still afford to bill test strips through medicare?

Sidenote:  many mail-order companies are owned by insurance companies.  So how is it not price-fixing, racketeering, a monopoly, or whatever else when insurance companies force patients to go mail-order or give them cheaper copays for doing so?  Oh, and I love it when mail-order patients expect us to give them free pills when their mail order doesn’t show up on time or come to us for free consultations when they call the mail-order place with a medication question and nobody will answer it (and how is THAT legal?  The pharmacy inspector would be halfway up to our pancreas if we “answered” medication questions by putting our patients into an endless phone loop of customer service reps who barely speak English and have no pharmacology knowledge.)