Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

JUNE GIBBS BROWN 

Inspector General 

JUNE 2000 

OEI-03-98-00231 

Blood Glucose Test Strips: 

Marketing to Medicare Beneficiaries 
OFFICE OF INSPECTOR GENERAL 

The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, is to 

protect the integrity of the Department of Health and Human Services programs as well as the 

health and welfare of beneficiaries served by them. This statutory mission is carried out through a 

nationwide program of audits, investigations, inspections, sanctions, and fraud alerts. The 

Inspector General informs the Secretary of program and management problems and recommends 

legislative, regulatory, and operational approaches to correct them. 

Office of Evaluation and Inspections 

The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 

Inspector General. It conducts short-term management and program evaluations (called 

inspections) that focus on issues of concern to the Department, the Congress, and the public. The 

inspection reports provide findings and recommendations on the efficiency, vulnerability, and 

effectiveness of departmental programs. 

OEI's Philadelphia Regional Office prepared this report under the direction of Robert A. Vito, 

Regional Inspector General, and Linda M. Ragone, Deputy Regional Inspector General. Principal 

OEI staff included: 

REGION 

Robert Katz, Project Leader

Nancy Molyneaux, Program Analyst

Cynthia Hansford, Program Assistant

Lauren McNulty, Program Analyst

Dave Tawes, Program Analyst

Amy Sernyak, Program Analyst

REGION IV 

John Mejia, Office of Audit Services 

HEADQUARTERS 

Stuart Wright, Program Specialist

Barbara Tedesco, Mathematical Statistician

Linda Moscoe, Technical Support Staff

Scott Horning, Technical Support Staff

To obtain copies of this report, please call the Philadelphia Regional Office at (800) 531-9562. 

Reports are also available on the World Wide Web at our home page address: 

http://www.dhhs.gov/progorg/oei 
EXECUTIVE SUMMARY 

PURPOSE 

To examine how marketing practices affect Medicare beneficiaries who use diabetic 

testing supplies. This report serves as a companion to a recently issued draft report, 

“Medicare Payments for Blood Glucose Test Strips” (OEI-03-98-00230). 

BACKGROUND 

In conjunction with an inspection which examined the propriety of Medicare payments 

for blood glucose test strips, we gathered information relating to the marketing of these 

supplies. This information encompassed marketing practices targeted to the diabetic 

Medicare population as well as the diabetic community in general. 

We obtained marketing information from a 1997 sample of Medicare beneficiaries and the 

suppliers who provided the diabetic supplies to these beneficiaries. The information was 

obtained from the beneficiaries through telephone interviews. We mailed survey forms to 

the suppliers which included questions relating to their marketing practices. In addition, 

we collected current examples of diabetic supply advertisements in four metropolitan 

areas. 

Marketing of diabetic testing supplies to the Medicare population is of vital interest 

because of sharply increasing payments. Medicare allowances for test strips more than 

doubled between 1994 and 1997, increasing from about $102 million in 1994 to $220 

million in 1997. Allowances exceeded $314 million in 1998. The full impact of an 

expansion of eligibility requirements, which took effect in 1998, could lead to an even 

greater increase in payments in future years. 

FINDINGS 

Diabetic supply advertisements offer inducements and can be misleading. 

Coinsurance information in diabetic supply advertisements can be misleading and we found that 

suppliers did not always collect coinsurance from beneficiaries. Diabetic supply advertisements 

also offer inducements and beneficiaries reported receiving incentives such as free monitors. 

Beneficiaries receive test strips automatically from mail-order suppliers. We found 

that many beneficiaries received their test strips from suppliers automatically even after the 

guidelines issued on July 1, 1998 prohibited automatic shipping. 

Marketing of Blood Glucose Test Strips 1 OEI-03-98-00231 
RECOMMENDATIONS 

To address the vulnerabilities identified in this report, we recommend that the 

Health Care Financing Administration: 

Issue bulletins reminding suppliers who routinely waive deductibles and/or 

coinsurance or who engage in misleading advertising practices that they may be in 

violation of the Medicare and Medicaid anti-kickback law. Suppliers should be 

advised to seek legal counsel if they have any questions or concerns regarding waivers of 

deductibles and/or coinsurance or the propriety of marketing or advertising materials. 

Remind suppliers that beneficiaries must specifically request new supplies of test 

strips before they are dispensed. Suppliers must not automatically dispense new 

quantities of test strips on a predetermined basis even if beneficiaries have authorized such 

procedures previously. 

Promote supplier concurrence and cooperation with the Office of Inspector 

General’s Compliance Program Guidance for the Durable Medical Equipment, 

Prosthetics, Orthotics and Supply Industry. Suppliers who establish a compliance 

program in accordance with the guidelines should be able to maintain an ethical and lawful 

business operation. 

Advise beneficiaries, as part of its outreach service, to report any instances of 

fraudulent or abusive practices (such as misleading advertising and excessive or 

unrequested deliveries of test strips) involving their home blood glucose monitors, 

test strips, or related supplies to their DMERCs. 

AGENCY COMMENTS 

The HCFA concurred with our recommendations. As part of an intensive campaign to reduce and 

eliminate fraudulent and abusive supplier practices, including those detailed in our findings, HCFA 

cited a number of ongoing and planned initiatives. These initiatives included, (1) plans to discuss 

routine waivers of deductibles and coinsurance in addition to misleading advertising at the 2000 

Beneficiary Integrity Conference, (2) reminding suppliers in DMERC bulletins and newsletters 

that they must not automatically dispense new supplies of test strips unless specifically requested 

by beneficiaries or their caregivers, (3) working with the National Supplier Clearinghouse to 

include language in the notifications sent to suppliers awarding them billing numbers to read and 

adhere to the OIG’s Compliance Program Guidance for the Durable Medical Equipment, 

Prosthetics, Orthotics and Supply Industry, and (4) continuing beneficiary outreach efforts, which 

include tips on identifying improper practices involving home blood glucose monitors and related 

supplies. The full text of HCFA’s comments can be found in Appendix B. 

Marketing of Blood Glucose Test Strips 2 OEI-03-98-00231 
TABLE OF CONTENTS 

PAGE

EXECUTIVE SUMMARY .................................................... 1

INTRODUCTION .......................................................... 4

FINDINGS ................................................................ 8

Misleading advertising .................................................. 8

Automatic mailing of supplies ........................................... 10

RECOMMENDATIONS .................................................... 12

APPENDICES

A: Estimates and Confidence Intervals ..................................... 14

B: Health Care Financing Administration Comments .......................... 17

Marketing of Blood Glucose Test Strips 3 OEI-03-98-00231 
INTRODUCTION 

PURPOSE 

To examine how marketing practices affect Medicare beneficiaries who use diabetic 

testing supplies. This report serves as a companion to a recently issued draft report, 

“Medicare Payments for Blood Glucose Test Strips” (OEI-03-98-00230). 

BACKGROUND 

In conjunction with an inspection which examined the propriety of Medicare payments 

for blood glucose test strips, we gathered information relating to the marketing of these 

supplies. This information encompassed marketing practices targeted to the diabetic 

Medicare population as well as the diabetic community in general. 

Marketing of diabetic testing supplies to the Medicare population is of vital interest 

because of sharply increasing payments. Medicare allowances for test strips more than 

doubled between 1994 and 1997, increasing from about $102 million in 1994 to $220 

million in 1997. These allowances include the 20 percent coinsurance which beneficiaries 

are responsible for paying. Allowances exceeded $314 million in 1998. Preliminary 

figures indicate that allowances will exceed $380 million in 1999. The full impact of an 

expansion of eligibility requirements, which took effect in 1998, could lead to an even 

greater increase in payments in future years. 

Medicare Coverage of Home Blood Glucose Monitors and Test Strips 

Title XVIII of the Social Security Act prescribes coverage requirements under Part B of 

the Medicare program. Part B covers services and items including durable medical 

equipment (DME). Claims for home blood glucose monitors and test strips are covered 

under Part B within the DME benefit. Suppliers submit claims for reimbursement to 

DME regional carriers (DMERCs). The four DMERCs process all Medicare claims for 

prosthetics, orthotics, medical supplies, and other DME. They are under contract with 

the Health Care Financing Administration (HCFA), the agency which administers the 

Medicare program. 

A blood glucose monitor and the supplies needed to use it effectively are covered if the 

beneficiary meets these requirements: 1) the patient is under a physician’s care for 

diabetes; 2) the glucose monitor and related accessories and supplies have been ordered 

Marketing of Blood Glucose Test Strips 4 OEI-03-98-00231 
by the patient’s treating physician; 3) the patient (or patient’s caregiver) has been trained 

to use the required equipment in an appropriate manner; and 4) the equipment is designed 

for home rather than clinical use. 

Prior to July 1, 1998, Medicare coverage for home blood glucose monitors and test strips 

was restricted to beneficiaries with Type 1, or insulin-treated diabetes. Medicare 

expanded coverage on that date to beneficiaries with Type 2, or non-insulin treated 

diabetes. Also prior to the issuance of the new guidelines, suppliers could send shipments 

of test strips to beneficiaries automatically. The new guidelines prohibit this practice. 

Marketing Practices 

Medicare beneficiaries who utilize medical supplies on a repeated basis, such as blood 

glucose test strips, may be strongly influenced by marketing practices. Manufacturers’ 

rebates, special dealer sales, coupons, discounts, and similar financial inducements are all 

designed to sway consumer product choice. Entities interested in reaching diabetics who 

use testing supplies resort to a variety of media to promote their products, including 

radio, television, specialized periodicals, and newspapers. 

Advertising incentives which indicate or imply a routine waiver of coinsurance or 

deductible could be in violation of 42.U.S.C. 1320a-7b(b), the Medicare and Medicaid 

anti-kickback statute. According to an Office of Inspector General Medicare Fraud 

Alert (94-04), such routine waivers of coinsurance or deductibles are unlawful because 

they could result in (1) false claims, (2) violations of the anti-kickback statute, and (3) 

excessive utilization of items and services paid for by Medicare. Anyone who routinely 

waives copayments or deductibles can be criminally prosecuted and excluded from 

participating in Medicare and State health care programs. 

In addition, 42.U.S.C. 1320a-7a(a) (5) prohibits a person from offering or transferring 

remuneration to a beneficiary that such person knows or should know is likely to 

influence the beneficiary to order items or services from a particular provider or supplier 

for which payment may be made under a Federal health care program. “Remuneration” is 

defined as including a waiver of coinsurance and deductible amounts, with exceptions for 

certain financial hardship waivers, which are not prohibited. 

Beneficiaries’ choice of test strips and related supplies can also be influenced by noneconomic factors. Many advertisements stress special supplier services, such as 

overnight delivery, no paperwork, training in the use of blood glucose monitors and test 

strips, and frequent follow-up contacts to ensure that supplies are adequate and operating 

satisfactorily. 

Prior to the completion of this inspection, the Office of Inspector General issued a 

document entitled, Compliance Program Guidance for the Durable Medical Equipment, 

Marketing of Blood Glucose Test Strips 5 OEI-03-98-00231 
Prosthetics, Orthotics and Supply Industry. This document can be located on the 

Internet at http://www.hhs.gov/progorg/oig/modcomp/cpgfinl.htm. The Guidance, which 

was prepared in consultation with health care trade organizations, was designed to 

promote a higher level of ethical and legal conduct among providers of medical 

equipment and supplies. The Guidance details specific problems which we cite in this 

report, such as providing routine waivers of deductibles and/or coinsurance. 

METHODOLOGY 

Sampling 

We selected a simple random sample of 555 Medicare beneficiaries with paid claims for 

blood glucose test strips in 1997. The beneficiaries were selected from a 1 percent DME 

claims file developed from HCFA’s National Claims History File. We defined our sample 

population as those patients whose claims for test strips averaged $50 per month or 

more. In order to compute point estimates and confidence intervals for inappropriate and 

questionable claims, we treated the beneficiary sample as a single-stage cluster sample in 

which each of the beneficiaries was a cluster and their 1997 claims were the unit of 

analysis. Estimates were made only for the universe of beneficiaries with claims 

averaging $50 a month or more. 

We checked Medicare records to ascertain if any of our sampled beneficiaries were 

shown as deceased. We removed these beneficiaries from the sample. In addition, we 

removed beneficiaries from the sample whose test strips were provided by suppliers under 

investigation. The remaining sample consisted of 472 Medicare beneficiaries. In all, 310 

suppliers had submitted 2,184 claims for Medicare reimbursement for these beneficiaries. 

Since many of the 310 suppliers provided test strips for multiple beneficiaries, our unique 

supplier-beneficiary combination totaled 540. 

Data Collection and Analysis 

Our primary data collection sources for this report were our sample beneficiaries and 

their test strip suppliers. Many of the questions we asked beneficiaries and suppliers in 

our survey instruments were relevant to test strip marketing practices. Additionally, 

many beneficiaries and suppliers provided comments and information pertinent to 

industry marketing practices. We did not, as part of this inspection, contact 

manufacturers, wholesalers, distributors, or similar entities. However, we reviewed 

media sources from four metropolitan areas--Atlanta, GA; Boston, MA; Kansas City, 

MO; and Philadelphia, PA--and we obtained current examples of advertising relating to 

blood glucose test strips and accessories. 

Marketing of Blood Glucose Test Strips 6 OEI-03-98-00231 
Beneficiary information. We collected information from beneficiaries via telephone 

interviews. Questions included beneficiaries’ diabetic medical care and treatment, 

frequency of blood sugar testing, how supplies were obtained, and supplier marketing 

practices. We completed telephone interviews with 313 of the 472 beneficiaries, a 66 

percent response rate. The interviews were conducted from December 1998 to June 

1999. 

Supplier information. We mailed 540 survey forms to suppliers, one for each 

beneficiary for whom a claim was filed. In addition to asking suppliers about the types of 

equipment and supplies provided to beneficiaries, we also included questions about their 

business and marketing practices. Of the 540 surveys mailed, 469, representing 1,902 

claims, were completed and returned. 

Marketing information. We obtained marketing information from a 1997 sample of 

Medicare beneficiaries and the suppliers who provided the diabetic supplies to these 

beneficiaries. The information was obtained from the beneficiaries through telephone 

interviews. We mailed survey forms to the suppliers which included questions relating to 

their marketing practices. In addition, we collected current examples of diabetic supply 

advertisements in four metropolitan areas. 

This study was conducted in accordance with the Quality Standards for Inspections 

issued by the President’s Council on Integrity and Efficiency. 

Marketing of Blood Glucose Test Strips 7 OEI-03-98-00231 
FINDINGS 

Diabetic supply advertisements offer inducements and can 

be misleading 

Coinsurance information in diabetic supply advertisements can be misleading 

During the course of the inspection, we reviewed diabetic supply advertisements in 

Atlanta, GA; Boston, MA; Kansas City, MO; and Philadelphia, PA. Our review of 

advertisements for diabetic testing supplies revealed examples of misleading wording and 

misinformation. The two examples below suggest that beneficiaries can get their test 

strips at no cost, including no coinsurance payments. 

If you have Medicare or Private Insurance, 

You may be eligible to receive your: 

DIABETIC SUPPLIES AT 

NO 

F or mo re inf or ma tion c all 

1-800-###-##### 

DIABETIC PATIENTS!! (Type 1 & Type 2) 

COST TO YOU! 

Diabetes 

Paying for your testing supplies. 

Company name... 1-800-###-#### 

Marketing of Blood Glucose Test Strips 8 OEI-03-98-00231 
Deductibles and coinsurance, which beneficiaries are responsible for paying, were rarely 

mentioned in advertisements. Sometimes, small print carried this terse message: “Deductibles 

and co-pay may apply.” 

Suppliers did not always collect coinsurance from beneficiaries 

In our interviews with beneficiaries, we found that some, as stated in the advertisements, 

did not pay anything for their test strips. Of those who did not pay for their test strips up 

front, about 8 percent said they did not pay any coinsurance and that coinsurance was not 

paid by Medicaid or other insurance. A copayment for 100 test strips would be 

approximately $14. A few suppliers surveyed said that they did not collect coinsurance. 

Reasons suppliers gave for not collecting or billing for coinsurance included, “patient 

indigent” and “patient qualifies for financial hardship.” Two suppliers stated simply, “We 

did not bill for coinsurance.” 

Undoubtedly, cost is an important consideration for many beneficiaries, and if one 

supplier collects coinsurance and another supplier does not, the supplier who does not 

clearly has a competitive edge over rivals. One supplier complained that most of their 

patients said their previous suppliers had “...automatically waived their co-payments and 

deductibles.” The patient has “nothing to lose,” the supplier added, indicating that 

patients can simply choose a supplier who will not bill them for these amounts. 

If suppliers use advertising inducements which indicate or imply a routine waiver of a 

coinsurance or deductible they could be in violation of the Medicare and Medicaid antikickback statute, 42 U.S.C. 1320a-7b(b). This statute makes it illegal to offer, pay, 

solicit, or receive anything of value as an inducement to generate business payable by 

Medicare or Medicaid. When providers, practitioners, or suppliers forgive financial 

obligations for reasons other than genuine financial hardship of the particular patient, they 

may be unlawfully inducing that patient to purchase items or services from them. In 

addition, the Health Insurance Portability and Accountability Act (Section 1128A) 

provides civil monetary penalties for anyone offering “remuneration,” including “the 

waiver of coinsurance or deductible amounts” as an inducement to use an item or service. 

Such penalties also apply to anyone giving “false or misleading information.” 

Diabetic supply advertisements offer inducements and beneficiaries reported 

receiving such incentives 

Fifteen percent of beneficiaries reported receiving incentives from suppliers. The 

incentive most often cited by beneficiaries was a free monitor. Seven percent of supplier 

survey responses indicated that suppliers had passed on incentives to beneficiaries. The 

most prevalent inducement mentioned (77 percent) was a free monitor followed by a 

Marketing of Blood Glucose Test Strips 9 OEI-03-98-00231 
discount on the test strips (18 percent). Three suppliers responded that they passed on 

monitor rebates to beneficiaries. Another two suppliers noted that billings for test strips 

were reduced by the discounted amounts. One supplier provided a beneficiary with a free 

lancing device and control solution. 

We found that advertisements in newspapers and periodicals, leaflets and flyers located in 

pharmacies, and coupons and discount offers concentrated on putting monitors into the 

hands of diabetic patients. Since test strips are designed to be used only in monitors with 

the same brand names, these inducements obviously were crafted to generate sales of 

those test strips. 

Some inducements involving monitors may be in violation of the anti-kickback statute. A 

typical inducement relating to a test strip purchase requires the customer to buy 100 test 

strips. The monitor would then be “free.” Other inducements involve a combination 

rebate-trade-in typically ranging from $35 to $85 depending on the type and quality of 

the monitor being offered. Often, a range of monitors is offered in the inducement. With 

the trade-in along with the rebate, the monitor would then be “free” to the customer. 

Other advertisements relating to monitors included coupon offers, “free” monitors with 

purchase of 50 test strips, and a “free monitor, up to $50.” We also encountered an 

advertisement for a “diabetic care seminar” which featured “free” attendance at the 

seminar along with a “free monitor” with a purchase of 50 test strips. 

Beneficiaries received test strips automatically from mailorder suppliers 

Test strips often sent to beneficiaries automatically 

We found that many beneficiaries received their test strips from suppliers automatically 

even after guidelines were issued prohibiting automatic shipping. With the onset of the 

expanded coverage policy on July 1, 1998, the DMERCs issued instructions which 

stipulated that suppliers may not automatically furnish repetitive supplies to beneficiaries 

unless the beneficiary or caregiver specifically requested the supplies. The new guidelines 

further stated that suppliers may not initiate a refill of an order or automatically dispense 

a quantity of supplies on a predetermined basis, even if such action had been authorized 

in advance by the beneficiary or caregiver. 

During telephone interviews, we asked beneficiaries if test strips were currently being 

delivered to them automatically. At least 6 months after the implementation of the policy 

prohibiting automatic shipment of test strips, 46 percent of beneficiaries who got their 

Marketing of Blood Glucose Test Strips 10 OEI-03-98-00231 
strips in the mail stated they were currently receiving their test strips automatically. 

There was no prior authorization. This does not differ greatly from the 58 percent of 

beneficiaries who received test strips in the mail who said their 1997 supplies were also 

sent to them automatically without a preceding supplier contact to determine the need for 

more strips. 

Many beneficiaries receive test strip supplies via mail or delivery services 

More than half of the beneficiaries in our sample received new supplies of test strips in 

the mail or from delivery services such as United Parcel Service. Forty percent of 

beneficiaries picked up test strips in person while another 4 percent received delivery 

from a company employee. This information supports how suppliers characterized their 

companies on supplier survey instruments. Forty-four percent of supplier surveys 

indicated that supplies were “mail-order.” Another 16 percent used a label which did not 

imply an entity which primarily engaged in mail-order services, such as “retail pharmacy.” 

Other designations commonly cited, such as “diabetic supply company” and “medical 

supply company” typically provide both mail-order and pick-up service. 

Another indicator of the dominance of mail-order companies was revealed in a question 

on the supplier survey in which we asked suppliers how they happened to supply test 

strips to the beneficiary. Forty-four percent of suppliers replied that beneficiaries had 

called them, an indication, we believe, that beneficiaries were responding to toll-free 

telephone numbers typically used by mail-order suppliers in advertisements. According 

to the responses, only 23 percent of the beneficiaries were “walk-ins.” Suppliers had 

serviced 12 percent of the beneficiaries as a result of physician referrals. 

Marketing of Blood Glucose Test Strips 11 OEI-03-98-00231 
RECOMMENDATIONS 

This report identified a number of questionable marketing practices, including 

routine waiver of coinsurance and misleading and deceptive advertising. To 

counter these practices, we recommend the Health Care Financing 

Administration take the following steps: 

Issue bulletins reminding suppliers who routinely waive deductibles and/or 

coinsurance or who engage in misleading advertising practices that they may be in 

violation of the Medicare and Medicaid anti-kickback law. Suppliers should be 

advised to seek legal counsel if they have any questions or concerns regarding waivers of 

deductibles and/or coinsurance or the propriety of marketing or advertising materials. 

Remind suppliers that beneficiaries must specifically request new supplies of test 

strips before they are dispensed. Suppliers must not automatically dispense new 

quantities of test strips on a predetermined basis even if beneficiaries have authorized 

such procedures previously. 

Promote supplier concurrence and cooperation with the Office of Inspector 

General’s Compliance Program Guidance for the Durable Medical Equipment, 

Prosthetics, Orthotics and Supply Industry. Suppliers who establish a compliance 

program in accordance with the guidelines should be able to maintain an ethical and 

lawful business operation. 

Advise beneficiaries, as part of its outreach service, to report any instances of 

fraudulent or abusive practices (such as misleading advertising and excessive or 

unrequested deliveries of test strips) involving their home blood glucose monitors, 

test strips, or related supplies to their DMERCs. 

AGENCY COMMENTS 

The HCFA concurred with our recommendations. As part of an intensive campaign to reduce 

and eliminate fraudulent and abusive supplier practices, including those detailed in our findings, 

HCFA cited a number of ongoing and planned initiatives. These initiatives included, (1) plans to 

discuss routine waivers of deductibles and coinsurance in addition to misleading advertising at 

the 2000 Beneficiary Integrity Conference, (2) reminding suppliers in DMERC bulletins and 

newsletters that they must not automatically dispense new supplies of test strips unless 

specifically requested by beneficiaries or their caregivers, (3) working with the National Supplier 

Clearinghouse to include language in the notifications sent to suppliers awarding them billing 

Marketing of Blood Glucose Test Strips 12 OEI-03-98-00231 
numbers to read and adhere to the OIG’s Compliance Program Guidance for the Durable 

Medical Equipment, Prosthetics, Orthotics and Supply Industry, and (4) continuing beneficiary 

outreach efforts, which include tips on identifying improper practices involving home blood 

glucose monitors and related supplies. The full text of HCFA’s comments can be found in 

Appendix B. 

Marketing of Blood Glucose Test Strips 13 OEI-03-98-00231 
APPENDIX A 

Estimates and Confidence Intervals

The tables below contain statistical estimates presented in the findings section of this report. To 

calculate the point estimates and confidence intervals for the percentage of Medicare 

beneficiaries we used the SAS software package. These estimates are based on a simple random 

sample design and are reported at the 95 percent confidence level. Estimates were made only for 

the universe of beneficiaries with claims averaging $50 a month or more. 

DIABETIC SUPPLY ADVERTISEMENTS OFFER INDUCEMENTS AND CAN BE 

MISLEADING. 

Table 1. 

Beneficiaries Who Did Not Pay Coinsurance 

Point 

Estimate 

95% Confidence Interval 

Percent of Beneficiaries Who Did Not Pay 

Coinsurance 

7.66% 4.27% - 11.05% 

Table 2. 

Beneficiaries Who Received Incentives 

Point 

Estimate 

95% Confidence Interval 

Percent of Beneficiaries Who Received Incentives 

from Suppliers 

15.19% 11.02% - 19.36% 

Marketing of Blood Glucose Test Strips 14 OEI-03-98-00231 
APPENDIX A 

BENEFICIARIES RECEIVE TEST STRIPS AUTOMATICALLY FROM MAILORDER SUPPLIERS 

Table 3. 

Beneficiaries Who Received Test Strips Automatically in 1998 

Point 

Estimate 

95% Confidence Interval 

Percent of Beneficiaries Who Received Test Strips 

Automatically after July 1, 1998 

46.06% 38.44% - 53.68% 

Table 4. 

Beneficiaries Who Received Test Strips Automatically in 1997 

Point 

Estimate 

95% Confidence Interval 

Percent of Beneficiaries Who Received Test Strips 

Automatically in 1997 

58.33% 51.35% - 65.31% 

Table 5. 

Beneficiaries Who Picked Up Test Strips in Person 

Point 

Estimate 

95% Confidence Interval 

Percent of Beneficiaries Who Picked Up Test Strips 

In Person 

40.50% 35.01% - 45.99% 

Marketing of Blood Glucose Test Strips 15 OEI-03-98-00231 
APPENDIX A 

Table 6. 

Beneficiaries Who Received Strips From a Company Employee 

Point 

Estimate 

95% Confidence Interval 

Percent of Beneficiaries Who Received Strips From A 

Company Employee 

3.92% 1.74% - 6.10% 

Marketing of Blood Glucose Test Strips 16 OEI-03-98-00231 
APPENDIX B 

Health Care Financing Administration Comments

Marketing of Blood Glucose Test Strips 17 OEI-03-98-00231 
APPENDIX B 

Marketing of Blood Glucose Test Strips 18 OEI-03-98-00231 
APPENDIX B 

Marketing of Blood Glucose Test Strips 19 OEI-03-98-00231 
APPENDIX B 

Marketing of Blood Glucose Test Strips 20 OEI-03-98-00231 
APPENDIX B 

Marketing of Blood Glucose Test Strips 21 OEI-03-98-00231 
APPENDIX B 

Marketing of Blood Glucose Test Strips 22 OEI-03-98-00231