Increase Access, Reduce Disparities: Recommendations for Modifying Medicaid CGM Coverage Eligibility Criteria

Rodolfo J. Galindo, Grazia Aleppo, Christopher G. Parkin*, David A. Baidal, Anders L. Carlson, Eda Cengiz, Gregory P. Forlenza, Davida F. Kruger, Carol Levy, Janet B. McGill, Guillermo E. Umpierrez

*Corresponding author for this work

Research output: Contribution to journalComment/debatepeer-review

3 Scopus citations

Abstract

Numerous studies have demonstrated the clinical value of continuous glucose monitoring (CGM) in type 1 diabetes (T1D) and type 2 diabetes (T2D) populations. However, the eligibility criteria for CGM coverage required by the Centers for Medicare & Medicaid Services (CMS) ignore the conclusive evidence that supports CGM use in various diabetes populations that are currently deemed ineligible. In an earlier article, we discussed the limitations and inconsistencies of the agency’s CGM eligibility criteria relative to current scientific evidence and proposed practice solutions to address this issue and improve the safety and care of Medicare beneficiaries with diabetes. Although Medicaid is administered through CMS, there is no consistent Medicaid policy for CGM coverage in the United States. This article presents a rationale for modifying and standardizing Medicaid CGM coverage eligibility across the United States.

Original languageEnglish (US)
JournalJournal of Diabetes Science and Technology
DOIs
StateAccepted/In press - 2022

Keywords

  • Medicaid
  • continuous glucose monitoring
  • insulin
  • type 1 diabetes
  • type 2 diabetes

ASJC Scopus subject areas

  • Bioengineering
  • Internal Medicine
  • Biomedical Engineering
  • Endocrinology, Diabetes and Metabolism

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