Medicare CGM Access Act of 2015

Well we can do a few things.

  1. send different letters, JDRF’s DPACs, etc
  2. We can send those repeatedly I all for monthly.
  3. We can modify the letters in 1) and send them again
  4. We can set up a calling program
  5. a Tweet-in
  6. lots more.
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Even in the midst of the DC craziness letter get counted and maybe (OK wishful thinking) [rant] it helps DC remember we the people care more about getting stuff done than their stupid intramural squabbles. [/rant]


So, after almost three years of fighting Medicare for CGM coverage, this is where it ends. Despite having won at least six Administrative Law Judge decisions, unless I continue on to Federal District Court, I have lost. Apparently all of the ALJ’s who ruled fully favorable on my behalf, have made “mistakes of the law”! The Medicare Appeals Council agrees with the Administrative Qualified Independent Contractor and despite a Federal Court case which was won in Wisconsin to cover the CGM, unless I go to Federal Court my fight is over. It will cost upwards of $30,000. To fund a Federal Court case and since I am not rich, the fight ends. It makes me angry that in this land of the free, you can’t go to federal court without huge fees. I want to thank everyone for your support along the way!:heart:️ There are still bills in Congress S804 in the Senate and HR1427 in the House-to amend Medicare to cover CGM’s. This is life saving Durable Medical Equipment that needs to be covered. I urge every one to please contact your Senators and Congressmen and ask them to co-sponsor and support these bills. Thank you!


@SueL, you fought a long and courageous legal battle. It doesn’t seem like justice to me when the opposition has access to an unlimited pot of money. For $30k you could simply buy the D-tech you need. I wonder if the JDRF, ADA, or a consortium of diabetes tech companies might like to finance your case.

We all need to redouble our citizen efforts and keep punching away with letters, phone calls, and emails. We will win this issue. The only thing uncertain is when and how many lives will be lost in the meantime.


@SueL, I reluctantly “liked” your post, because I am thankful for your efforts, but sad to see the results.

I have to wonder what is the point of having ALJ’s if they are either so prone to “mistakes of the law”, and/or their respective agency can override an ALJ decision in a seemingly cavalier fashion, and/or the ALJ procedures are so broken to create these mistakes. Damn and double damn (maybe triple damn)!

I guess instead of cursing the darkness …

I say this because if CMS will not bend because of “mistakes of the law”, the clear solution is to change the law and specifically direct CMS to cover CGMs.

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