U.S. Sen. Susan Collins (R-ME) and U.S. Rep. Tom Reed (R-NY), co-chairs of the Senate and House Diabetes Caucus, seek to have Medicare policy cover a beneficiary’s use of smartphone apps with a continuous glucose monitor (CGM).
While the Centers for Medicare and Medicaid Services (CMS) in January extended Medicare coverage to therapeutic CGMs, “certain coverage policies exist that restrict beneficiaries’ access to the full spectrum of use for innovative diabetes therapies, including CGMs when used in conjunction with smart technology,” the lawmakers wrote in a March 27 letter to CMS Administrator Seema Verma. U.S. Sen. Jeanne Shaheen (D-NH) and U.S. Rep. Diana DeGette (D-CO), the other caucus co-chairs, also signed the letter.
“In particular, many innovative technologies work in tandem with smartphone applications, and current Medicare coverage policies do not support this use. We urge CMS to revise its decision to support the full spectrum of use,” according to the letter.
The lawmakers noted being particularly concerned that the Medicare Local Coverage Article prohibits payees from using a smartphone app to share their CGM glucose data, alerts and alarms with family members, healthcare providers and caregivers, whom could provide “an extra layer of defense” during potentially life-threatening situations.
The use of smartphone apps also would expand accessibility to a CGM device for blind and low-vision diabetics, who are unable to independently and safely use the tool, according to the lawmakers. When the mechanism is paired with a smartphone app, the CGM is accessible to everyone, they wrote.
Comparatively, the lawmakers wrote, most private payers permit people to use such smartphone apps for data sharing, but beneficiaries lose that access when they enter Medicare.
“As innovators continue to rapidly develop technologies that help individuals with diabetes manage their condition, we urge CMS to ensure that its Medicare coverage policies encourage, rather than discourage, the highest quality care and maximum accessibility,” they wrote.