Lost in Translation: A Disconnect between the Science and Medicare Coverage Criteria for Continuous Subcutaneous Insulin Infusion

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

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Numerous studies have demonstrated the clinical value and safety of insulin pump therapy in type 1 diabetes and type 2 diabetes populations. However, the eligibility criteria for insulin pump coverage required by the Centers for Medicare & Medicaid Services (CMS) discount conclusive evidence that supports insulin pump use in diabetes populations that are currently deemed ineligible. This article discusses the limitations and inconsistencies of the insulin pump eligibility criteria relative to current scientific evidence and proposes workable solutions to address this issue and improve the safety and care of all individuals with diabetes.

Original languageEnglish (US)
Pages (from-to)715-725
Number of pages11
JournalDiabetes Technology and Therapeutics
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2021

Keywords

  • AID
  • CSII
  • Centers for Medicare & Medicaid Services
  • HCL
  • Insurance coverage
  • LGS
  • PLGS
  • Type 1 diabetes
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Medical Laboratory Technology

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