HHS OIG Data Brief  January 2019  OEI-04-18-00440 
 
Medicare Market Shares of Mail-Order Diabetes Test Strips 
From April Through June 2018 
 
This Office of Inspector General (OIG) report provides the Medicare market shares for diabetes test 
strips (DTS) provided through the National Mail-Order Program from April through June 2018.  
A second report, anticipated in early 2019, will provide the market shares for the same timeframe for 
DTS provided via non-mail order (i.e., from local pharmacies or supplier storefronts).  These evaluations 
will inform future round(s) of the Competitive Bidding Program (CBP) for DTS.  All CBP contracts 
expired on December 31, 2018, and new contracts are not expected before the end of 2020.   
 
Why OIG Did This Review 
RESULTS AT A GLANCE  The Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (MMA) requires the Centers for 
Medicare & Medicaid Services (CMS) to phase in a CBP for 
OIG analyzed the types of 
durable medical equipment, prosthetics, orthotics, and 
strips provided through 
supplies (DMEPOS).  In 2008, mail-order DTS became part 
the National Mail-Order 
of the CBP in certain limited areas, and in July 2013, this was 
Program from April 
expanded nationally to include a National Mail-Order 
through June 2018.  We 
found that during this  Program for diabetes testing supplies. 
timeframe:    
Legislation enacted since MMA has revised the CBP.  The 
 Sampled suppliers 
Medicare Improvements for Patients and Providers Act 
provided 17 types of 
of 2008 (MIPPA) prohibits CMS from awarding contracts in 
DTS to Medicare 
beneficiaries via mail  the National Mail-Order Program to a DTS supplier if the 
order.  suppliers bid does not cover at least 50 percent, by volume, 
of the DTS types provided to Medicare beneficiaries.  (This is 
 The top two strip types 
known as the 50-percent rule.)  MIPPA requires OIG to 
accounted for 
53 percent of the  determine the market shares of the types of DTS before each 
Medicare mail-order  round of bidding to assist CMS in ensuring that bidding 
market.  suppliers meet the 50-percent rule. 
 
 The top 10 strip types 
Initially, OIG based its calculations of the Medicare market 
accounted for 
98 percent of the  shares on claims data only for DTS supplied via mail order by 
Medicare mail-order  CBP suppliers.  The Bipartisan Budget Act of 2018 amended 
market.   the 50-percent rule by requiring analysis of DTS supplied via 
mail order as well as via non-mail order. 
 
See Appendix A for information on diabetes; Medicares coverage of DTS; the CBP; and the 
National Mail-Order Program.  See Appendix B for an overview of completed OIG work on this 
topic.  OIG will conduct future reviews of the market shares of the various types of mail-order and 
non-mail-order DTS, as required by MIPPA and/or as requested by CMS.  RESULTS 
Sampled suppliers provided 17 types of DTS to Medicare 
beneficiaries via mail order; 2 types of test strips accounted 
for 53 percent of the mail-order market 
 
Our sample of claims included 17 types of DTS provided to Medicare beneficiaries from 
April through June 2018.  Two types of DTS accounted for approximately 53 percent of the 
Medicare mail-order market.  Five types of DTS accounted for approximately 88 percent of the 
market, and 10 types accounted for approximately 98 percent of the market.  
 
Exhibit 1 lists the top 10 types of mail-order DTS associated with Medicare claims for the 
3-month period of April through June 2018.  See Appendix C for a complete alphabetical listing 
of all 17 strip types.  Appendix C also provides the model, manufacturer, market share, and 
95-percent confidence interval for each type of DTS provided. 
 
Exhibit 1:  Top 10 Mail-Order DTS Types Associated With Medicare Claims for the 
3-Month Period of April Through June 2018 
Model  Manufacturer  Market Share 
Prodigy   Prodigy Diabetes Care  32.98% 
TRUEmetrix  Trividia Health, Inc.      19.82% 
Embrace  Omnis Health  18.85% 
CareSens N  i-Sens, Inc.  11.68% 
Advocate Redi-Code+  BroadMaster Bio-Tech Corp.  4.64% 
EASYMax  Oak Tree International Holdings, Inc.  3.52% 
On Call Express  ACON Laboratories  2.69% 
Unistrip1  Unistrip Technologies, LLC   1.26% 
CONTOUR NEXT  PHC Holdings Corporation  1.21% 
Easy Talk  Home Aide Diagnostics   1.15%  
     Total    97.79%* 
Source:  OIG analysis of supplier documentation and Medicare claims containing Healthcare Common Procedure Coding 
System (HCPCS) code A4253 KL for the 3-month period of April through June 2018.   
* The market shares in this column do not sum to 100 percent because these strip types are only the top 10 types, not a list of all 
strip types provided. 
 
 
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        2 
  CONCLUSION 
This report provides CMS with information on the types of DTS provided to beneficiaries via 
mail order for April through June 2018.  We found that during this timeframe, sampled suppliers 
provided 17 types of DTS to Medicare beneficiaries via mail order.  The top 2 strip types 
accounted for just over half of the mail-order market, and the top 10 types accounted for almost 
all of the mail-order market.   
 
This OIG report provides the Medicare market shares for DTS provided through the National 
Mail-Order Program from April through June 2018.  A second report, anticipated in early 2019, will 
show the market shares for the same timeframe for DTS provided via non-mail order (i.e., from local 
pharmacies or supplier storefronts).  These evaluations will inform future round(s) of the CBP for 
DTS.  The CBP contracts expired on December 31, 2018, and new contracts are not expected before 
the end of 2020.   
 
OIG will conduct future reviews of the market shares of the various types of mail-order and 
non-mail-order DTS, as required by MIPPA and/or as requested by CMS.  See Appendix B for 
an overview of OIGs completed work on this topic.   
 
 
 
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        3 
  METHODOLOGY 
Data Collection 
Using CMSs National Claims History file, we identified the population of Medicare Part B paid 
claims for DTS that were provided via mail order and had dates of service beginning between 
April 1, 2018, and June 30, 2018.  During this period, there were nine suppliers that had CBP 
contracts to provide DTS.  There were 313,704 claims for which Medicare was the primary 
payer during this period, and these claims included all 9 suppliers that had CBP contracts.1  From 
this population of claims, we selected a simple random sample of 1,210 claims.  This sample 
included all nine contract suppliers.  
 
To identify the beneficiaries associated with the claims in our sample, we matched the 
beneficiary numbers from the claims with beneficiary numbers in the CMS Beneficiary 
Enrollment Database.  We sent documentation requests to the nine suppliers associated with our 
sampled claims, asking that for each claim, the supplier (1) indicate the type (model and 
manufacturer) of DTS that it provided to the Medicare beneficiary we identified and (2) submit 
relevant documentation (such as packing slips or invoices) for the strips.  We received responses 
from all 9 suppliers documenting all 1,210 claims in our sample, a 100-percent response rate.   
 
Data Analysis 
We reviewed claims data, supplier responses, and supplier documentation to determine the 
quantity and type of mail-order DTS associated with each claim in our sample.  Each claim in 
our sample covered between 1 and 18 boxes, and data for the 1,210 claims provided information 
for a total of 5,061 boxes of strips.   
 
We categorized the DTS types by model and manufacturer.  We calculated each strip types 
share of the Medicare mail-order market by determining the total number of 50-count boxes of 
each strip type provided to beneficiaries in our sample and dividing that number by the total 
number of boxes across all strip types in our sample.  To estimate the Medicare market share of 
each type of DTS provided via mail order, we projected our sample data to the population of 
DTS provided via mail order during the timeframe we reviewed.  In our results, we present the 
market share for the top 10 types of DTS to the second decimal place.  See Appendix C for the 
market shares of the 17 strip types in our sample.   
 
Limitations  
Suppliers have 1 year to submit claims to CMS.  Our study did not include any mail-order claims 
submitted after August 3, 2018, the date we collected our Medicare claims data.  Therefore, our 
sample may not include all types of mail-order DTS reimbursed by Medicare during our 
timeframe. 
 
Standards  
This review was conducted in accordance with the Quality Standards for Inspections approved 
   
by the Council of the Inspectors General on Integrity and Efficiency.
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        4 
  APPENDIX A 
Information on Diabetes, Medicares Coverage of DTS, Beneficiaries Purchase of 
DTS, and the CBP 
 
Diabetes and Blood Glucose Monitoring.  Diabetes is a chronic disease in which a person has 
a high blood-sugar (glucose) level either because the body does not produce enough insulin, or 
because cells do not respond properly to the insulin the body does produce.2   Diabetes may be 
managed through a variety of methods, including healthy eating, physical activity, and insulin 
injections to prevent medical complications (e.g., hypoglycemia or cardiovascular disease).3   
 
A person with diabetes can use a hand-held meter to test the concentration of glucose in his or 
her blood.  To do so, the individual pricks his or her skin with a lancet and places the resulting 
drop of blood on a DTS, which is a small piece of plastic meant for one-time use.  The individual 
then inserts the strip into a meter that reads the blood samples glucose level, providing 
information necessary for the individual to manage his or her diabetes.  A person with diabetes 
may need to perform glucose tests several times a day to help maintain an appropriate glucose 
level. 
 
Medicare Coverage of DTS.  Medicare covers testing supplies, such as DTS, to help beneficiaries 
with diabetes manage their condition.4  To be eligible for Medicare coverage of DTS, Medicare 
beneficiaries with diabetes must be under the treatment of a physician for the condition.  The 
physicians order for DTS specifies the frequency at which the beneficiary should use the strips.  
Each box contains 50 strips.5  Because some beneficiaries need to test their glucose levels more 
frequently than others, the number of boxes per claim varies.6   
 
For each beneficiary, the supplier submits a single claim that can cover up to 3 months of DTS.  
The claim indicates the number of boxes provided to the beneficiary for the applicable time 
period, but it does not indicate the type of strips provided.  The modifier KL on a claim indicates 
that the DTS were provided via mail order.7   
 
Beneficiaries Purchase of DTS.  Medicare beneficiaries may purchase their DTS via mail order 
(from CBP suppliers) or via non-mail order (from local pharmacies or supplier storefronts).  CMS 
considers all DTS that are either shipped or delivered to a beneficiarys residence to be mail 
order, regardless of the method of delivery.8  Non-mail-order DTS are those that a beneficiary or 
caregiver picks up in person at a local pharmacy or supplier storefront.  For both mail-order and 
non-mail-order purchases, Medicare pays 80 percent of allowed charges for DTS (less any unmet 
Part B deductible), and the beneficiary is responsible for the remaining 20 percent.  Effective for 
dates of service on or after July 1, 2013, Medicare adjusts the fee-schedule amounts for 
non-mail-order DTS so that they are equal to the single payment amounts that the National 
Mail-Order Program establishes for mail-order DTS.9 
 
CBP.  The MMA requires CMS to phase inthrough several rounds of biddinga CBP for 
selected DMEPOS items (including DTS).10  The CBP includes high-cost and high-volume items 
or those with significant savings potential.  Suppliers submit bids that CMS evaluates based on 
the suppliers eligibility, their financial stability, and their bid prices.  Generally, CMS awards 
contracts to the suppliers that offer lower bid prices and meet applicable quality and financial 
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        5 
  standards.  The payment amounts resulting from winning bids replace the Medicare fee-schedule 
amounts for the selected items.11  Generally, contract awards and payment amounts expire every 
3 years, and suppliers must recompete to remain contract suppliers.12 
 
MIPPA added further conditions to the competition for DTS.  MIPPA required that in rounds 
subsequent to the first round, mail-order suppliers demonstrate in their bids that they can provide 
at least 50 percent, by volume, of the types of DTS provided to Medicare beneficiaries.  
Suppliers do this by attesting in their bids the types of DTS they intend to provide.  The 
Bipartisan Budget Act of 2018 amended the 50-percent rule by requiring that both mail-order 
data and non-mail-order data be used to determine the types of DTS used to meet the 50-percent 
rule.13   
 
Current Status of the CBP.  All CBP contracts expired on December 31, 2018.  In October 2018, 
CMS issued guidance stating that there would be a temporary gap in the CBP, starting January 1, 
2019, and expected to last until December 31, 2020.14  As a result, beginning January 1, 2019, 
and until new contracts are awarded under the CBP, beneficiaries may receive DTS from any 
Medicare-enrolled DMEPOS supplier.15  According to CMSs November 2018 final rule, during 
the temporary gap in the CBP, Medicare will pay for mail-order DTS at the single payment 
amount that was in effect for the last day of the CBP contract period (i.e., December 31, 2018), 
adjusted for inflation.16  For non-mail-order DTS, Medicare payment will continue to be the 
single payment amount for mail-order DTS that was in effect on December 31, 2018, and those 
amounts will not be adjusted for inflation.17  
 
 
 
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        6 
  APPENDIX B 
OIGs Past and Current Work on Medicare Market Shares of DTS 
MIPPA section 154(d)(3)(B) requires that before each new round of bidding in the CBP, OIG 
must determine the market shares of DTS types provided via mail order.   The Bipartisan Budget 
Act of 2018 amended this MIPPA section by requiring that both mail-order data and 
non-mail-order data be used to determine the types of DTS used to meet the 50-percent rule.   
 
Before each prior round of the CBP, OIG reported the market shares of different types of DTS.  
To help CMS evaluate the CBPs effect on DTS types provided to beneficiaries, OIG also 
reported additional information to CMS for the 3-month periods before and after implementation 
of new rounds.  In this January 2019 data brief, OIG is reporting the market shares for DTS 
provided via the National Mail-Order Program from April through June 2018.  A second report, 
anticipated in early 2019, will determine the market shares for the same timeframe for DTS 
provided via non-mail order.  OIG will conduct future reviews of the market shares of the 
various types of DTSprovided via mail order and non-mail orderas required by MIPPA 
and/or as requested by CMS. 
 
See Exhibit B-1 for a timeline of OIG work on the Medicare market shares of DTS. 
 
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        7 
  Exhibit B-1: OIG Work on the Medicare Market Shares of DTS  
 
Completed Before Round 2 (Contract Period January 1, 2011, to December 31, 2013) 
 
  Release Date  Report Title:  Medicare Market Shares of Mail Order Diabetic Testing Strips (OEI-04-10-00130) 
  Time period covered:  October 2009 through December 2009 
December 2010 
  Results:  75 total typestop 7 types had a 50% share of the market; top 10 types had 62% 
   
Completed Before Round 2 Recompete (Contract Period July 1, 2016, to December 31, 2018) 
 
  Release Date  Report Title: Medicare Market Shares of Mail Order Diabetes Test Strips from July-September 2013 
  June 2014  (OEI-04-13-00680)   
Results: 43 total typestop 3 types had a 59% share of the market; top 10 types had 90% 
 
 
 
Report Title: Medicare Market Shares of Mail Order Diabetes Test Strips Immediately Prior to the 
  Release Date 
National Mail-Order Program (OEI-04-13-00681)  
  June 2014  Time period covered: April 2013 through June 2013 
  Results: 62 total typestop 4 types had a 51% share of the market; top 10 types had 75% 
 
 
  Report Title: Medicare Market Shares of Mail Order Diabetes Test Strips 3-6 Months After the Start of 
Release Date 
  the National Mail-Order Program (OEI-04-13-00682)  
November 2014  Time period covered: October 2013 through December 2013 
 
Results: 41 total typestop 3 types had a 58% share of the market; top 10 types had 91% 
Completed Before 2019 (Contracts Expired December 31, 2018) 
 
  Release Date  Report Title: Medicare Market Shares of Mail Order Diabetes Test Strips from April to June 2016 
  November 2016  (OEI-04-16-00470)  
Results: 30 total typestop 2 types had a 51% share of the market; top 10 types had 93% 
 
 
 
  Release Date  Report Title: Medicare Market Shares of Mail-Order Diabetes Test Strips from July Through 
September 2016 (OEI-04-16-00471)  
  February 2017 
Results: 18 total typestop 2 types had a 60% share of the market; top 10 types had 98% 
 
 
 
Report Title: Medicare Market Shares of Mail-Order Diabetes Test Strips from October Through 
  Release Date  December 2016 (OEI-04-16-00473)  
May 2017 
Results: 19 total typestop 2 types had a 53% share of the market; top 11 types had 97% 
Completed Before Next Round (No Contracts on January 1, 2019)  
 
Release Date  Report Title: Medicare Market Shares of Mail-Order Diabetes Test Strips from April Through 
June 2018 (OEI-04-18-00440)  
January 2019 
Results: 17 total typestop 2 types had a 53% share of the market; top 10 types had 98% 
 
Anticipated  Report Title: Medicare Market Shares of Non-Mail-Order Diabetes Test Strips from April Through 
Release            June 2018 (OEI-04-18-00441) 
Results: to be determined  
Early 2019 
 
 
 
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        8 
  APPENDIX C 
Exhibit C-1:  Model, Manufacturer, and Market Share Estimates for Mail-Order 
DTS, April Through June 2018  
 
Model  Manufacturer  Market  95-Percent 
Share  Confidence Interval 
Advocate Redi-Code+  BroadMaster Bio-Tech Corp.  4.64%  3.506.13% 
CareSens N  i-Sens, Inc.  11.68%  9.7113.99% 
CONTOUR  PHC Holdings Corporation  0.12%  0.020.84% 
CONTOUR NEXT  PHC Holdings Corporation  1.21%  0.622.34% 
EASYMax  Oak Tree International Holdings, Inc.   3.52%  2.624.71% 
Easy Talk  Home Aide Diagnostics  1.15%  0.642.03% 
Embrace  Omnis Health  18.85%  16.4921.46% 
Fora G20  ForaCare, Inc.  0.12%  0.04%0.37% 
Fora V10/V12  ForaCare, Inc.  0.32%  0.11%0.94% 
GlucoCard 
ARKRAY  0.79%  0.401.57% 
Expression 
GlucoCard Vital  ARKRAY  0.12%  0.020.84% 
On Call Express  ACON Laboratories  2.69%  1.823.96% 
On Call Plus  ACON Laboratories  0.55%  0.231.33% 
Prodigy  Prodigy Diabetes Care  32.98%  29.9835.98% 
Rightest GS 300  Bionime Corporation  0.20%  0.060.64% 
TRUEmetrix  Trividia Health, Inc.  19.82%  17.3922.49% 
Unistrip1  Unistrip Technologies, LLC  1.26%  0.652.45% 
   Total    100.00%   
Source:  OIG analysis of supplier documentation and Medicare claims containing HCPCS code A4253 KL for the 3-month period 
of April through June 2018. 
 
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        9 
  Exhibit C-2.  Medicare Market Share Estimates for Top 2, Top 5, and Top 10 Types 
 
of Mail-Order DTS, April Through June 2018
Groupings of Strip Types  Combined  95-Percent 
Model Names 
with Largest Market Share   Market Share  Confidence Interval  
Prodigy 
Top 2 Strip Types  52.80%  49.6055.99% 
TRUEmetrix 
Prodigy 
TRUEMetrix 
Top 5 Strip Types  Embrace   87.97%  85.74-89.89% 
CareSens N  
Advocate Redi-Code+ 
Prodigy 
TRUEMetrix 
Embrace  
CareSens N  
Advocate Redi-Code+ 
Top 10 Strip Types  97.79%  96.6798.53% 
EASYMax 
On Call Express  
Unistrip1 
CONTOUR NEXT 
Easy Talk 
Source:  OIG analysis of supplier documentation and Medicare claims containing HCPCS code A4253 KL for the 3-month 
period of April through June 2018. 
 
 
 
 
 
 
 
 
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        10 
  ACKNOWLEDGMENTS 
 
Evan Godfrey served as the team leader for this study.  Other Office of Evaluation and 
Inspections staff from the Atlanta regional office who conducted the study include Lauren Buss 
and Margaret Naughton.  Office of Evaluation and Inspections staff who provided support 
include Kevin Farber, Christine Moritz, and Michael Novello. 
 
This report was prepared under the direction of Dwayne Grant, Regional Inspector General for 
Evaluation and Inspections in the Atlanta regional office, and Jaime Stewart, Deputy Regional 
Inspector General.   
 
   
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        11 
  ENDNOTES
 
 
1 There were 313,716 claims for DTS provided via mail order; however, 12 claims were submitted by suppliers that 
were not contracted to be in the CBP.  We did not include these 12 claims in our analysis. 
2 National Institutes of Health (NIH), What is Diabetes?  Accessed at https://www.niddk.nih.gov/health-
information/diabetes/overview/what-is-diabetes on October 24, 2018. 
3 NIH, Managing Diabetes: 4 Steps to Manage Your Diabetes for Life.  Accessed at 
https://www.niddk.nih.gov/health-information/diabetes/manage-monitoring-diabetes on October 24, 2018. 
4 Other diabetes testing supplies may include batteries, lancets, and control solution. 
5 Generally, each box of DTS contains 50 strips.  All boxes provided to beneficiaries in our sample contained 
50 strips.  There are some DTS available in the non-mail-order market, such as Accu-Chek Compact Plus strips, that 
contain 51 strips per box. 
6 CMS, MLN [Medicare Learning Network] Matters Number SE1008 Revised.  Medicare Coverage of Blood 
Glucose Monitors and Testing Supplies.  Accessed at 
http://www.cms.gov/MLNMattersArticles/downloads/SE1008.pdf on October 3, 2018.  Medicare covers up to 
100 test strips per month (i.e., two 50-count boxes) for insulin-dependent beneficiaries with diabetes and up to 
100 test strips every 3 months for non-insulin-dependent beneficiaries with diabetes.  Medicare allows additional 
test strips if they are deemed medically necessary and documented in physician records.  Medicare LCD [Local 
Coverage Determination] for Glucose Monitors (L33822 for DME MAC Jurisdictions A, B, C, and D). 
7 To receive Medicare reimbursement, suppliers submit claims using Healthcare Common Procedure Coding System 
(HCPCS) codes.  Medicare claims for DTS are billed using HCPCS code A4253.  For DTS provided via mail order, 
the HCPCS code A4253 must be followed by the KL modifier (A4253 KL).  CMS, Medicare Claims Processing 
Manual, Pub. No. 100-04, ch. 36,  20.5.4.1 and 50.6.  A modifier is a code on Medicare claim that further 
describes the services performed or supplies provided to a beneficiary. 
8 42 CFR  414.402 (defining mail-order item). 
9 American Taxpayer Relief Act of 2012, P.L. No. 112-240,  636 (added new paragraph to Social Security Act, 
 1834(a)(1)(H), 42 U.S.C.  1395m(a)(1)(H)).  See also CMS, MLN Matters Number MM8325 Revised.  July 
Quarterly Update for 2013 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee 
Schedule.  Accessed at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/downloads/MM8325.pdf on December 13, 2018. 
10 MMA, P.L. No. 108-173,  302(b)(1). 
11 CMS recently revised its CBP rules to change the processes for submitting bids, evaluating bids, and calculating 
single payment amounts.  Specifically, CMS will replace the bidding method in effect through 2018in which 
a supplier submits a bid for each item in the product categorywith what is known as lead item pricing.  Under lead 
item pricing, a bidding supplier would submit a bid for one itemknown as the lead itemin the product category.  
The maximum winning bid for the lead item would be used to establish single payment amounts for both the lead 
item and all other items in the product category. 83 Fed. Reg. 56922 (Nov. 14, 2018).  Accessed at 
https://www.gpo.gov/fdsys/pkg/FR-2018-11-14/pdf/2018-24238.pdf on November 16, 2018. 
12 CMS must recompete contracts at least once every 3 years.  Social Security Act,  1847(b)(3)(B), 42 U.S.C. 
 1395w-3(b)(3)(B). 
13 Bipartisan Budget Act of 2018, P.L. No. 115-123,  50414(a)(1).  Accessed at 
https://www.congress.gov/115/bills/hr1892/BILLS-115hr1892enr.pdf on August 17, 2018. 
14 CMS, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program:  
Temporary Gap Period.  Accessed at https://www.cms.gov/Outreach-and-
Education/Outreach/Partnerships/Downloads/DMEPOS-Temporary-Gap-Period-Fact-Sheet.pdf on December 13, 
2018. 
15 Ibid. 
16 The single payment amount for mail-order DTS that was in effect on December 31, 2018, will be increased by the 
projected percentage change in the Consumer Price Index for all Urban Consumers for the 12-month period on the 
date after the contract period ended.  42 CFR  414.210(g)(10) (as added by 83 Fed. Reg. 56922, 57071 (Nov. 14, 
2018)).  Accessed at https://www.gpo.gov/fdsys/pkg/FR-2018-11-14/pdf/2018-24238.pdf on November 16, 2018. 
17  83 Fed. Reg. 56922, 57037 (Nov. 14, 2018).  Accessed at https://www.gpo.gov/fdsys/pkg/FR-2018-11-
14/pdf/2018-24238.pdf on November 16, 2018. 
Medicare Market Shares of Mail-Order Diabetes Test Strips From April Through June 2018                        12