I just received this good news from the District Manager for Tandem.
1. Medicare CGM Access Act of 2014 introduced in the Senate - Today, Co-chairs of the Senate Diabetes Caucus, Susan Collins (R-ME) and Jeanne Shaheen (D-NH), introduced the Medicare CGM Access Act of 2014 (S. 2689) – this is a big win. Though the bill is not yet posted online, it would create a Medicare benefit category for CGM and establish a payment and coding structure to go along with it. Notably, the bill has been drafted to pave the way for reimbursing future artificial pancreas technologies. There is certainly lengthy road ahead before this is passed into law, but the move is highly encouraging and desperately needed from a patient perspective. We were very encouraged to see the collaboration behind the legislation – the coalition that has worked on this issue includes JDRF, the Endocrine Society, AACE, AADE, Dexcom, Medtronic, and J&J. JDRF was out in full force on the news today, including a press release commending the bill and two advocacy asks: emailing US Senators to co-sponsor the bill and signing a petition to urge Medicare to cover CGM (the latter is at an impressive 3,845 signatures already out of a goal of 10,000). Completing both tasks takes less than five minutes! For more on this topic, including why Medicare has refused to cover CGM, see our detailed report.
This is one of the most important initiatives that is being pursued by JDRF and the Endrocrine Society. Please consider supporting this bill. Our seniors need access to this technology and under current rules having a CGM is pretty much out of the question..................................rick
Could links to a petition or the report be posted? (I did not read anything that provided a clue as to where to locate the information...)
While we're at it, what can we do to start a discussion about getting insurance carriers to reclassify CGM sensors from Durable Medical Equipment to prescription-eligible? Calling a 7-day device "DME" is grossly misleading.
Today I signed the JDRF petition that will be sent to the U.S. Senate promoting senate bill 2689, and I urge you to go to the JDRF site and sign the petition as well! I also urged my senators to co-sponsor the bill...you can do that on the JDRF site as well. We'll all be on Medicare one day...maybe now, maybe soon. We should speak up NOW! Thanks, all.
A PWD who has been using a CGM for 14 years worked her way through the Medicare appeals process. It took more than two years and some back and forth in rulings, but her case went before a federal judge who didn’t accept the argument that a CGM is “precautionary” and not “medically necessary.” That judge sent the case back to the Medicare Appeals Council for reconsideration.
So this PWD’s appeal has not come to a final conclusion, but it is movement in a positive direction.
