Following Bipartisan Effort Led by Senator Collins, Medicare Proposes Coverage Expansion of Continuous Glucose Monitors
Washington, D.C. — U.S. Senator Susan Collins (R-ME), the founder and co-chair of the Senate Diabetes Caucus, applauded the Centers for Medicare & Medicaid Services’ (CMS) proposed rule change that would expand Medicare Part B coverage and payment for continuous glucose monitors (CGMs).
The proposed changes to Medicare Durable Medical Equipment, Prosthetics, Orthotic Devices and Supplies (DMEPOS) coverage and payment policies would classify all CGMs (not just limited to therapeutic CGMs) as durable medical equipment (DME) and establish payment amounts for these items and related supplies and accessories. If finalized, the proposal would build on Medicare’s decision in 2017 to provide coverage for certain CGMs following advocacy by Senators Collins and Jeanne Shaheen (D-NH).
“As the Chairman of the Aging Committee, I have heard from numerous seniors who, when transitioning from employer-provided insurance to Medicare, were shocked to learn that the technologies they have relied upon for years to manage their diabetes are no longer covered,” said Senator Collins. “Following a push Senator Shaheen and I led, Medicare provided coverage for certain continuous glucose monitors in 2017, which transformed the lives of the millions of Americans who rely on these devices to successfully manage diabetes. This proposed rule builds on that successful policy by providing better coverage for CGMs to help keep patients healthy and provide relief from high out-of-pocket costs.”
According to CMS, “With one in every three Medicare beneficiaries having diabetes, this proposal would give Medicare beneficiaries and their physicians a wider range of technology and devices to choose from in managing diabetes. This proposal will improve access to these medical technologies and empower patients to make the best healthcare decisions for themselves.”
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As co-chairs of the Senate Diabetes Caucus, Senators Collins and Jeanne Shaheen (D-NH) have worked together to increase awareness of the threats posed by diabetes, invest in research, and improve access to treatment options. In response to the Senators’ bipartisan effort, CMS first approved the use of continuous glucose monitors (CGMs) in January 2017 and allowed Medicare beneficiaries to use smartphone apps in conjunction with continuous glucose monitors (CGMs) in June 2018. In order for Medicare coverage to continue to keep pace with innovation, Senators Collins and Shaheen introduced legislation last November that would create a special task force at the Department of Health and Human Services (HHS) to examine and address barriers that seniors face in accessing the latest diabetes management technologies.
Last year, the Senators introduced a bill to roll back more than a decade of insulin prices hikes, and they have consistently pressed to hold insulin manufacturers, insurers, and PBMs accountable for the skyrocketing cost of life-saving insulin.
Additionally, Senators Collins and Shaheen introduced a bill to expand access to diabetes self-management training and they led the bipartisan push in the Senate to ensure continued support for the Special Diabetes Program.
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