Beginning next week, Medicare will expand coverage of continuous glucose monitors (CGMs) for a broader group of Type 2 diabetes (T2D) patients.
The Centers for Medicare and Medicaid Services (CMS) announced an updated policy that will expand CGM coverage to insulin-treated individuals with diabetes who have traditional Medicare coverage, as well as certain non-insulin-using individuals who have a history of what’s been classified as “problematic hypoglycemia.” Experts believe this to lead to a significant increase in the use of CGMs in primary care settings, and private insurers are also likely to follow the CMS determination.
The expanded coverage for CGMs is significant for T2D patients, who can face serious health risks and need to keep their blood sugar levels under control. CGMs have been shown to be effective in achieving target glucose levels and improving quality of life for patients. By expanding coverage, the new policy is expected to help decrease health disparities in the diabetes community, especially for those facing racial, income, and geographic disparities in accessing CGMs.
The decision has been welcomed by diabetes advocates, like ADCES, and is seen as a major win for many individuals with diabetes. The expanded coverage is expected to increase access for approximately 1.5 million people with diabetes in America who currently use basal insulin treatment covered by Medicare.
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