Sign the CGMS Denial Campaign Petition

For Immediate Release
July 14, 2008

Media Contact:
Gina Capone

gcapone1@optonline.net

Diabetic Community Continues Its Fight Against Insurance
Providers for Repeated Denials of Life Saving Device

NEW YORK, NY: July 14, 2008 – On Tuesday, July 1, Diabetes Talkfest (http://www.diabetestalkfest.com) sponsored the first-ever CGMS Denial Day online rally to raise awareness about how insurance companies are repeatedly denying claims for continuous glucose monitors. http://diabetestalkfest.com/blog/?p=189 . In association with Tudiabetes.com.

Due to the overwhelming positive response to this effort Diabetes Talkfest is launching the CGMS Denial Campaign. The first part of the campaign is an online petition (http://www.ipetitions.com/petition/CGMSdenial/) that will be sent to all major health insurance providers. We want to get at least 2000 signatures for the first round of this campaign by November 9, 2008.
“After a recent week-long trial with a CGMS, during which time my blood sugars were significantly better, I was once again denied by my health insurance provider,” said Diabetestalkfest.com founder Gina Capone. “This problem isn’t going away and neither are we. And this petition is going to let health insurance companies know we are going to continue this fight. We have come together as a community and will continue to raise our voices until we are heard.”

The CGMS can be a life saving device for people with diabetes by preventing and reducing complications and alarming users who are no longer sensitive to hypoglycemia of approaching low blood sugars, especially during bed time hours. The device allows people to greatly reduce the number of times they have to check finger sticks, and has the ability to constantly monitor glucose levels by showing trends in blood sugars for people that experience hyperglycemia (high blood sugars). CGMS have been proven to help people with diabetes control their blood sugar levels, and quality of life.

There are currently three Real-Time CGMS manufacturers in the US:

Dexcom, DexCom STS CGM system; Abbott, FreeStyle Navigator®; and Medtronic, Guardian RT CGM system.

For more information please visit: www.diabetestalkfest.com

About Diabetestalkfest.com
Diabetestalkfest.com is the first online diabetes website dedicated to live chats. It was created by Gina Capone and Jon Schlaman, who first met on a diabetes message board in February of 2001.

Over the past six years the site has united thousands of people living with diabetes in its online diabetes chat room and social network DIABETEStalkfest (www.diabetestalkfest.com). The DTF live chats provide members with cutting edge information from leaders in the field of diabetes. Diabetes Talkfest partnered with Tudiabetes.com, a community for people touched by diabetes, in March of 2008.

I signed the petition. Although my coverage was approved last summer, and I’ve been using it for the last 10 months with great success, my insurance company has recently decided that CGMS is “investigational” and therefore they will no longer cover the sensors. Based on the petition letter, I’m assuming only people who’ve actually been denied coverage should sign it - is that a correct assumption? If not, I’d be able to have my husband and mom sign it, and attest to how helpful its been to me.

everyone can sign it i edited the bottom part of the petition so that people that dont have it can support us.

everyone please support this…http://www.ipetitions.com/petition/CGMSdenial/index.html

I signed & thanks for helping it push forward!

no problem! pass it to everyone you know

I just got the link for the petition in my email from my amazing Animas Clinical Manager and came here to post about it but you already have! This petition is a GREAT thing and I will be passing it along for sure!

The petition will soon hit 700 signatures.

738 signatures!

My insurance “covers” my Dexcom CGM however it is classified and durable medical equipment which means they will only pay for my sensors after I have met my $1500 deductible. Then they pay 70%. I’m using 2 sensors per month which adds up to $1440 per year just shy of my deductible. So the truth is even if it’s “covered” you still pay… Insurance companies are like casinos. They always win.

It really depends on the plan though, and if you get it through your job, it’s your employer that negotiates deductibles. I don’t know what my DME deductible is, but as long as I get my equipment and supplies from an in-network DME supplier, the deductible doesn’t apply, and they cover DME at 100%. When I got my CGMS last August, I got it from Minimed, an in-network DME supplier, so it was covered. I never paid a penny for the start-up kit or sensors.

I initially wanted a DexCom, but you can only get a DexCom CGMS from the DexCom manufacturer. DexCom doesn’t wholesale them to other DME suppliers. DexCom isn’t considered an in-network DME supplier, so if I was only willing to use a DexCom CGMS, I would have had my deductible applied, and I would have had to pay some percentage once the deductible was met. Horizon Blue Cross Blue Shield said they would cover the MM Guardian though, so of course I went with that instead of the DexCom.

It wasn’t until recently that Horizon changed their policy for covering the CGMS. They decided it’s “investigational” so they’re refusing to cover them at all. I’ve submitted an appeal, and there’s not anything else I can do beyond that at this point. I had been changing sensors every 6 days because I just could never get any more than that out of them. I would get Cal Error after Cal Error until I changed it. I can’t afford to pay for 5 sensors a month myself. So now I have my CGMS monitor and all the accessories sitting in a drawer, and I’m waiting to hear about my appeal.

Gina,

I’ve been reluctant to sign mainly b/c I haven’t been denied one b/c I’ve never tried to get one but if you think my siganture would help in anyway please let me know!!

doris, the good thing about the wording of the petition is that you can just support the people that want one.

this is the last paragraph of the petition text:

“Even if I have not been directly affected by diabetes or CGMS denial, I am signing this petition as an indication of my support for patients with diabetes to be given the opportunity through insurance coverage, to improve the quality of their lives with CGMS technology.”

OK I’ll sign it then!!! Uph give me sometime to figure this one out!!!

The CGMS online petition started by Gina Capone is getting close to 1,000 signatures now.

If you haven’t signed it, please take a minute to read through the details and help raise awareness about this very important matter:
http://www.ipetitions.com/petition/CGMSdenial/

Thanks so much for doing this !!!

I too am a long-time Type I diabetic with the strong opinion that CGMS
is required for the best health result that is needed to sustain us,
especially as we get older. Moreover, the more that these devices get
used throughout our community, the more that product companies will
invest in making and improving them.

My stand is that allowing health insurance companies to "just say no"
is no longer acceptable.

-Kevin Pammett
http://www.DigitalMediaMagik.com/

I signed and put the info on my blog. Keep up the great work!

Rich

I just signed and forwarded the link to all my friends.

I signed the petition and I would like to hear from anyone who is on Medicare with a supplemental

Insurance plan in MA who has applied for coverage and has been denied or has been approved. I would like to know what supplemental plan that you have. I have the HMO Medicare Blue from BC/BSMA.

I signed the petition and I would like to hear from anyone who is on Medicare with a supplemental

Insurance plan in MA who has applied for coverage and has been denied or has been approved. I would like to know what supplemental plan that you have. I have the HMO Medicare Blue from BC/BSMA.