A new Centers for Medicare and Medicaid Services (CMS) policy update will enhance benefits for the roughly 300,000 Medicare-eligible individuals who are qualified to use continuous glucose monitors (CGMs) to manage their diabetes, a policy change pushed for by U.S. Reps. Tom Reed (R-NY) and Mike Bishop (R-MI).
Reps. Bishop and Reed this week celebrated the policy change after advocating for Medicare to permit coverage of costs for CGMs by patients who track their glucose data using smartphones, tablets and other personal electronic devices.
The CGM technology for diabetes management “has real potential to provide peace of mind and independence to patients and families living with this disease,” said Rep. Bishop, who along with several colleagues on the U.S. House Ways and Means Committee and U.S. House Energy and Commerce Committee sent a bipartisan April 11 letter to CMS Administrator Seema Verma seeking the policy change.
Initial guidance released in January 2017 by CMS had extended Medicare coverage to therapeutic CGMs, but “did not allow beneficiaries to utilize their smartphones in conjunction with these devices, in conflict with how many use their CGMs,” Rep. Bishop said.
“This announcement means patients will be able to use their mobile devices to share data and alerts with caregivers and loved ones – without the fear of losing Medicare coverage,” he said.
Previously, Medicare patients were disqualified from using personal electronic devices with CGMs because they weren’t considered to be Durable Medical Equipment (DME), which are covered under Medicare, according to a statement from Rep. Reed’s office. That designation has been updated, according to CMS, and the policy change also has been extended to permit Medicare coverage for CGM supplies that are linked to non-DME devices, according to the statement.
“People with diabetes who keep their caregivers and loved ones up to speed via their cell phones and tablets now no longer have to worry that this convenience will cost them their Medicare coverage,” said Rep. Reed in a June 13 joint statement released with U.S. Rep. Diana DeGette (D-CO), who are co-chairs of the Congressional Diabetes Caucus.
Medicare’s published coverage policy for CGMs will be modified to support the use of CGMs in conjunction with a smartphone, including the data-sharing function, according to CMS, which noted that the modification follows “a thorough review of the law and our regulations.”
Additionally, according to CMS, the published change will become effective once the Durable Medical Equipment Medicare Administrative Contractors issues “a revised policy article in the near future.”
“Continuous glucose monitoring shouldn’t have to mean being connected to only one kind of device to transmit data and alerts,” said Reps. Reed and DeGette. “This welcome change in policy means freedom from needless worry for all involved.”