04/30/2024

HHS Surveying CGM Suppliers on Acquisition Costs & Prices

Source:  AAHomecare Alert 4/29/24

Last week, the HHS Office of Inspector General (OIG) began sending emails and letters to a select group of continuous glucose monitor (CGM) suppliers as part of an evaluation for their study "Medicare Payments Compared to the Prices Available to Consumers and Suppliers for Continuous Glucose Monitors and Sensors." This study aims to determine the cost-effectiveness of Medicare payments in comparison to the supplier’s acquisition costs and other prices available to consumers. 
 
The OIG's request for information on acquisition costs by suppliers will identify potential areas where Medicare can optimize savings. In the announcement of the report originally posted in the OIG’s Work Plan in November 2023, the OIG noted CMS allowed more than $1.1 billion in Medicare Part B payments for CGMs and sensors in 2022. If the OIG identifies opportunities for Medicare to realize cost savings, CMS has the authority to either introduce CGMs into the competitive bidding program or exercise their authority of inherent reasonableness to adjust Medicare payments accordingly.
 
CGM suppliers who are recipients of the OIG requests have likely been notified via email. AAHomecare recommends suppliers to diligently monitor their email and mail correspondence for any communication from the OIG. It is imperative for suppliers who have received such requests to promptly respond within the specified timeframe to facilitate the OIG's analysis.

AAHomecare is actively monitoring the development of the study. To ensure comprehensive coverage and timely updates, we encourage CGM suppliers who have received communication from the OIG to connect with Mina Uehara, Senior Director of Regulatory Affairs at minau@aahomecare.org.