05/21/2020    

RESPONSES/COMMENTS (DME)

RE: Medicare Therapeutic Shoe Program/ COVID-9

From: Michael J Marcus, DPM

 

Medicare has placed multiple hurdles in place for physicians to dispense and prescribe DM shoes to our patients. Over the last two years, the paperwork produces a burden to both doctor and patient. Often restricting coverage unfortunately leads to less compliance and further foot and ankle problems in our most fragile DM neuropathic patients. Now with the Covid crisis, I fear that the paperwork burden will further escalate progressive loss and amputation rates in this population. The methods of obtaining the required paperwork involves greater patient risk, more visitations, as well as more stress to our patients as well as our office staff. It further increases the use of PPE. 

 

Has Medicare made any modifications or revisions that would help us help these patients during these trying times? If not, shouldn’t we through APMA with the ADA begin to ensure that methods are in place that would reduce patient exposure and allow appropriate dispensing. Perhaps utilize their PMH. As far as I know PMHs don’t change - if you have a history of a disease - you have a history of the disease for life. We rarely cure disease. The very fact that we are forced to provide paper work yearly on chronic diabetics with persistent neuropathy with a history of previous amputations is totally ridiculous.

 

Michael J Marcus, DPM, Montebello/Irvine, CA