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Capitol Correspondence - 05.28.19

Important Senate Committee Asks CMS About Price of Insulin

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The Chair and Ranking Member of the Senate Finance Committee, which oversees Medicaid, wrote a letter to the Centers for Medicare and Medicaid Services (CMS) requesting information on the cost of insulin, and its effect on federal spending for health programs. The Chair is Senator Chuck Grassley (R-IA) and the Ranking Member is Senator Ron Wyden (D-OR). ANCOR is sharing this letter because diabetes, which insulin treats, is a frequent challenge for people with intellectual / developmental disabilities. Additionally, the majority of supports for people with disabilities are funded by Medicaid.

As written in the letter:

“Accordingly, we are seeking your assistance in gathering data to better understand how

insulin price increases have affected costs for federal healthcare programs and the patients that

use them. 5 Please answer the following and provide the requested information no later than May

30, 2019:

1. For each of the following programs, please provide the total amount of federal spending that CMS paid in reimbursements for each insulin product with a unique National Drug Code (NDC) on an annual basis for each fiscal year from FY2010 to the present (including partial year totals for the current fiscal year), and the amount that the federal government has received in rebates, including mandatory, supplemental, and other relevant rebates:

a. Medicare Part D

b. Medicare Part B

c. Medicaid6

d. Children’s Health Insurance Program

2. For each of the following programs, please provide the average out-of-pocket insulin costs for patients on an annual basis for each fiscal year since FY2010 to the present:

a. Medicare Part D (stand-alone and Medicare Advantage)

b. Medicaid

c. Children’s Health Insurance Program

[…]

6. For each of the following programs, please provide the total amount of federal spending on diabetes-related costs beyond insulin, including spending that resulted from comorbid conditions and complications ( e.g. amputations, renal disease, retinopathy), spending on equipment and supplies, and non-insulin medications. Please provide a breakdown of the spending data by reason (e.g. comorbid condition, equipment, supplies) from FY2010 to the present (including partial year or estimates for the current fiscal year) and include a description of the data source.

a. Medicare Part D

b. Medicare Part B

c. Medicaid

d. Children’s Health Insurance Program

[…]

8. Please provide all data and records, to include memoranda and reports, relating to CMS’ examination of the impact of rising insulin costs to federal spending in Medicare, Medicaid, and the Children’s Health Insurance Program, and the health outcomes of people enrolled in Medicare, Medicaid, or Children’s Health Insurance Program.”