Tag Archives: CMS

Advocacy Works.

I suppose we’ve all become jaded a bit over the years. When you ask for intelligent changes to policy or rules, you get used to having your concerns ignored, sometimes validated, and mostly not acted upon.

But a recent announcement flies in the face of that argument, and before any more time goes by, I think it’s important to talk about it.

The news, which you may have heard: the U.S. Centers of Medicare and Medicaid Services (CMS) has agreed to allow seniors on Medicare to view CGM data on their smartphones.

As Diabetes Patient Advocacy Coalition noted, this is pretty big news, and it’s thanks to advocacy of this organization and others, as well as individual advocates across the country, that this injustice has been righted.

There are a couple of reasons why I wanted to talk about this.

To begin with, this is how advocacy is supposed to work. In this instance, people saw that seniors on Medicare were being denied the right to use their smartphones as a medical device. Those advocates banded together and took their message to CMS, who were empowered to consider the advocacy message and act on it. And they did.

Second, I wanted to talk about this win because it’s a win. So often, we advocate for causes, and our causes remain causes for years until some movement happens on them (and that’s the most times I’ve written “causes” in one sentence in my life). Once our cause is helped along by a decision or a product launch or something else, we move on to the next cause so quickly that we almost forget the fact that real progress was actually made.

I don’t want that to happen here. Let’s stop and smell the lithium ion of our cell phone batteries and recognize that something pretty great happened here. And you and I had a hand in making it happen.

Let’s take a moment and remember that advocacy works. And let’s remember to thank all those responsible for making it work.

My Diabetes Platform for the election.

Welcome to Diabetes Awareness Month. And since this is also a big election year (and we generally elect candidates and vote on issues in November), let’s merge those two together for the sake of this post.

Oh yeah, I’m going there. For the sake of myself and my friends with diabetes, I’m going there.

I fully recognize that there is more than one way to get things done, and I’ve seen countless examples over the past eight years that there is more than one way to not get things done. Rather than going down party lines, I thought I would lay out my own framework for a more perfect diabetes union. My own policy statement that outlines issues I stand for during this very important election cycle. Here are my thoughts:
– Any talk of a rework or repeal of the Patient Protection and Affordable Care Act must include a guarantee of coverage for every Amercian, regardless of what they’re living with today and in the future. And an undertaking like this must not take place until all sides can agree that this provision stays in place. If you don’t support that, I won’t even think about voting for you, and should you get elected, I might even go to Washington to protest your stance. Loudly.
Note: they don’t want to “repeal and replace”… they want to take away your right to coverage, and deny it forever. If you’re okay with that, and you’re okay with any coverage you might be lucky enough to get costing more anyway (because they never said it would ever cost less), then go ahead and vote for your candidate(s).

– The Competitive Bidding program set up by the Center for Medicare and Medicaid Services (CMS) must end. As soon as possible. I have friends being harmed by this program today, I will have friends being harmed by this program in the near future, and if it continues, I’m a little over ten years from being harmed by this program myself. People who really know, know this program is wasteful. Make them stop it. Now.

– The cost of drugs and devices necessary to keep us alive is too much. Consider the fact that having to pay extra just for the right to stay alive is asking far too much. Having what is considered to be good coverage that costs me thousands of dollars out of pocket every year is a ridiculous way to say “good coverage”. The cost of staying alive should be significantly reduced. Make it happen. My friends and I will help show you how.

– Patients require a seat at the table. Notice I didn’t say “want”… I said require a seat at the table. When our well-being and overall health are being discussed by Congress, by policy makers, by local and state legislatures, it is unthinkable to exclude patients from weighing in on the very issues that affect us. Trust me: you’re going to hear from us anyway. Don’t let it be while you’re backtracking from an ill-informed decision. Let it be when you’re discussing the very thing that we’re experts at living with. There’s a reason we’re experts at diabetes. We live with it every single day. Help us help you.

– In all you do, remember: People With Diabetes are worthy of your respect, consideration, and empathy. If you don’t yet possess empathy, it’s not too late to get some. Trust me, it will come in handy. All great leaders throughout our history have not only possessed empathy, they have displayed it often in executing the duties of office. All poor leaders in our nation’s history have lacked empathy. It is a necessary component of accepting the responsibility of any public office.

– Finally: if it’s not too much trouble, I’d like a slice of pie on my Diaversary this year. Anything that doesn’t contain marshmallow, meringue, or pudding.
I’m Stephen Shaul, and I approve this message.

Vote for Diabetes this November. To make your voice heard, PLEASE VOTE. Diabetes Patient Advocacy Coalition makes it easy to share your concerns to all the candidates right now: CLICK HERE.


I’m not going to sugar-coat this for you, even though this is a diabetes blog.

We’re at the point where this is untenable.

For the past five years, the Centers for Medicare and Medicaid Services (CMS) has been conducting a grand experiment, opening up competitive bidding on a wide range of necessities for People With Diabetes who have Medicare as their primary healthcare partner (hint: that’s 11 million U.S. citizens over the age of 65). They have been told as far back as three years ago by nurses, educators, and patients themselves that competitive bidding endangers the lives of senior citizens with diabetes, but they keep ignoring the warnings.

There’s a new publication in Diabetes Care, the peer-review journal of the American Diabetes Association, that shows that competitive bidding is an abject failure at all levels.

Wait… why is competitive bidding bad, you may ask? Isn’t it better if we get the best price for the products we need?

Let’s answer the second question first, and the first question second: It is imperative for seniors living with diabetes to pay the lowest price possible for the healthcare, devices, and drugs that will help them live the best they can through their golden years. To answer the first question, yes, competitive bidding is very bad, and there is proof it is bad, and that proof is being ignored by CMS, and that must stop.

Let me give you a simple example: I use a BG meter made by Ajax Corporation (not a real BG meter maker—remember, this is an example). It works pretty well, pretty accurate, and I’m nearly out of test strips for my existing meter. But now, Ajax lost out on the latest round of competitive bidding, and I now have to use a meter made by Acme Corporation. That means, as a senior on Medicare, I have to go get a prescription for the new meter, find the new meter and test strips, pay for them, and learn how to use the new meter. Immediately.

What do you think the chances are that 11 million people are going to be able to do that easily?

Let’s face it: they aren’t.

Which means some of them won’t, which means some of them won’t be checking their BGs, which means some of them will wind up in the hospital or a skilled nursing facility with hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar), where a best-case scenario is a stay of days in the facility, costing Medicare thousands, maybe hundreds of thousands, more than the continued cost of strips for a meter the patient was comfortable with in the first place. All because of the competitive bidding process.

And that’s only one example. Pissed off yet?

Good. Here’s what you can do: Use the Easy button.
CLICK HERE NOW and go to the Diabetes Patient Advocacy Coalition to help add your voice to the growing #suspendbidding chorus demanding an end to competitive bidding until CMS is called to answer for this destructive practice before a congressional hearing.

I promise you, it will take less than1 minute for you to let your House representative and both your Senators know that the CMS competitive bidding process is dangerous and deadly.

CLICK HERE NOW. I will be Medicare eligible in 11 years. Let’s end this process before I’m eligible in 10.

If you have any questions, please let me know by using the E-mail Stephen link in the upper left corner of this page.

Living with diabetes or not, we… I… don’t want your help with this. I need it.


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