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Senator Collins Proposes Improved CGM Coverage For Medicare Patients

WASHINGTON, D.C. – U.S. Senator Susan Collins spoke from the Senate floor today regarding the introduction of the Medicare CGM Access Act. This legislation would create a separate benefit category under Medicare for the continuous glucose monitor (CGM) and would require coverage of the device for individuals meeting specified medical criteria.

A CGM is a physician-prescribed, FDA-approved medical device that can provide real-time readings and data about trends in glucose levels every five minutes, thus enabling someone with insulin-dependent diabetes to eat or take insulin and prevent dangerously low or high glucose levels.

Currently, however, insulin-dependent Medicare beneficiaries are being denied coverage for CGMs because the Centers for Medicare and Medicaid Services (CMS) has determined that they do not meet the Medicare definition of durable medical equipment and do not fall under any other Medicare category.

In her floor speech Senator Collins said, “The continuous glucose monitor is a potential life-saving device because it prevents dangerously low and high blood glucose levels by alarming the wearer when glucose levels fall outside of a safe range….Still, even though 95 percent of private insurers cover CGM technology, Medicare does not. There are thousands of seniors with type 1 diabetes who are denied access to the CGM technology that would keep them healthy and safe.”

Senator Collins is the founder and co-chair of the Senate Diabetes Caucus. This legislation is supported by a broad coalition of organizations, including the American Association of Clinical Endocrinologists, the American Association of Diabetes Educators, the Endocrine Society and the JDRF.