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CMS to Allow Smartphones to Connect With CGM for Medicare Beneficiaries

Mary Caffrey
The ban on letting people in Medicare connect their continuous glucose monitor (CGM) to a smartphone drew ire from patients, advocates, and even the Government Accountability Office.
People in Medicare who wanted a continuous glucose monitor (CGM) to manage their diabetes will now be allowed to link it with their smartphone, allowing users to share data with caregivers and family members.

The reversal of a CMS ban on smartphone use with CGM for those who wanted Medicare reimbursement will end one of the most head-scratching rules ever. The original ban brought outcry from patient and clinician groups as well as the Government Accountability Office, which last summer cited the rule as an example of how CMS needed to do more to embrace technological advance in its durable medical equipment (DME) programs.

The rule change itself has not appeared, but its forthcoming arrival was announced Tuesday in a notice on CMS’ website.

“CMS heard from numerous stakeholders who shared their concerns that Medicare’s CGM coverage policy limited their use of CGMs in conjunction with their smartphones, preventing them from sharing data with family members, physicians, and caregivers,” the notice reads.

“After a thorough review of the law and our regulations, CMS is announcing that Medicare’s published coverage policy for CGMs will be modified to support the use of CGMs in conjunction with a smartphone, including the important data sharing function they provide for patients and their families.”

According to the notice, the DME Medicare Administrative Contractors (MACs) will put out “a revised policy article in the near future, at which time the published change will be effective.”

The American Association of Diabetes Educators heralded the change, saying it would bring better monitoring, better care, and expanded coverage, as private insurers would see CMS action and “follow their lead.”

While many diabetes patients and advocates were celebrating on social media, one longtime CGM user said the fact that the rollout remains in the hands of the MACs leaves him concerned, because their track record thus far has been poor. Dan Patrick, who has lived with type 1 diabetes for more than 50 years, said the MACs offered beneficiaries a rocky roll out of the Dexcom G5 in 2017, followed by delays in getting patients the Omnipod after CMS announced approval for reimbursement.

“They’re 2 for 2,” Patrick said. ““I’m not going to jump up and down yet.”

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