@article{e7a9e05063024d89ad2de495ff074bcb,
title = "Lost in Translation: A Disconnect between the Science and Medicare Coverage Criteria for Continuous Subcutaneous Insulin Infusion",
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.",
keywords = "AID, CSII, Centers for Medicare & Medicaid Services, HCL, Insurance coverage, LGS, PLGS, Type 1 diabetes, Type 2 diabetes",
author = "Grazia Aleppo and Parkin, {Christopher G.} and Carlson, {Anders L.} and Galindo, {Rodolfo J.} and Kruger, {Davida F.} and Levy, {Carol J.} and Umpierrez, {Guillermo E.} and Forlenza, {Gregory P.} and McGill, {Janet B.}",
note = "Funding Information: G.A. has received research support from AstraZeneca, Dexcom, Eli Lilly, Insulet, Novo Nordisk, and is a consultant for Dexcom and Insulet. C.G.P. has received consulting fees from Abbott Diabetes Care, CeQur SA, Dexcom, Inc., Onduo, Roche Diabetes Care, and Novo Nordisk. A.L.C. has received research support from UnitedHealthcare, Abbott, Dexcom, Eli Lilly, Insulet, Medtronic, Novo Nordisk, and Sanofi, and is a consultant for Medtronic and Insulet, with all financial support going to his institution. In addition, A.L.C. has a patent, Treatment of Hypoglycemia Unawareness with Intranasal Insulin, pending to HealthPartners Institute. D.F.K. has served on advisory boards and/or speaker bureaus for Dexcom and Abbott Diabetes Care, and her institution has received research support from Dexcom. R.J.G. has received unrestricted research support to Emory for investigator-initiated studies from Novo Nordisk and Dexcom, Inc., and consulting fees from Abbott Diabetes Care, Sanofi, Novo Nordisk, Eli Lilly, BI, and Valeritas. R.J.G. is partially supported by research grants from NIH/NIDDK P30DK11102 and 1K23DK123384-01. C.J.L. reports research support from Abbott Diabetes, Dexcom, Insulet, Tandem Diabetes Care, and Senseonics paid to her institution, nonfinancial device support from Dexcom, Tandem Diabetes Care, and Abbott Diabetes, service as a consultant for Sanofi, Eli Lilly and Dexcom, and Novo Nordisk outside the submitted work. G.E.U. is partly supported by research grants from the NIH/ NATS UL1 TR002378 and 1P30DK111024-05, and P30DK111024-05S and has received unrestricted research support (to Emory University) from AstraZeneca, Novo Nordisk, and Dexcom. G.P.F. conducts research sponsored by Medtronic, Dexcom, Abbott, Tandem, Insulet, Beta Bio- nics, and Lilly. G.P.F. has been a consultant/speaker/advisory board member for Medtronic, Dexcom, Tandem, Insulet, Beta Bionics and Lilly. J.B.M. reports consulting fees from Bayer, Boehringer Ingelheim, Lilly, Metavant and Salix as well as research funding grants from Dexcom, Medtronic and Novo Nordisk. Publisher Copyright: {\textcopyright} Grazia Aleppo, et al., 2021; Published by Mary Ann Liebert, Inc. 2021.",
year = "2021",
month = oct,
day = "1",
doi = "10.1089/dia.2021.0196",
language = "English (US)",
volume = "23",
pages = "715--725",
journal = "Diabetes Technology and Therapeutics",
issn = "1520-9156",
publisher = "Mary Ann Liebert Inc.",
number = "10",
}
