CMS Ruling on CGM

posted from: http://www.ydmv.net/2017/01/cms-ruling-on-cgm.html

The Centers for Medicare & Medicaid Services has concluded that Continuous Glucose Monitor Systems can be covered as durable medical equipment.* Specifically, those with an FDA label for the purpose of adjusting the treatment diabetes.

In practical terms currently, means the Dexcom G5. The CMS finding also established criteria for coverage that is an innovation target for other devices to achieve. Codes and coverage still need to be worked out. Still, this is great news. As one piece on the ruling observed. “Nearly 25% of patients with type I diabetes fall under Medicare.”

A lot of effort, by many, contributed to this success. The industry has maintained a rapid pace of innovation. FDA has responded with timely reviews of CGM applications, most recently with a non-adjunctive label for the G5. A majority of both houses of Congress supported legislation in the last Congress supporting coverage. Courts ruled in individual cases for coverage. We, the people with diabetes, advocated in every avenue open to us to ask for coverage.

Positive diabetes health news is great. Savor this.

*You read the CMS Ruling at https://www.cms.gov/Regulations-and-Guidance/Guidance/Rulings/Downloads/CMS1682R.pdf

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