Use of Smartphone and Medicare Patients

I am sure I missed this, but why are Medicare patients not allowed to use a smartphone with the Dexcom G5. What is the medical or technical reason behind this decision or is it just another dumb decision based on like a smartphone not being a medical device?

Thanks

Use xdrip, and I have to go with them just making life difficult - which is their lifeblood

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I was talking with my Endo and his Decom rep said that they should have the problem straighten out by year end
Dom

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Not sure anyone really knows, but Medicare’s rules blow chunks.

I suspect Medicare’s thinking went something like this. In order for any medical equipment system to qualify for “durable medical equipment” or DME status, at least one component of the systems has to considered and deemed “durable.” Medicare selected the Dexcon G5 receiver as the durable component of the system.

They further reasoned that if Medicare members do not use the component designated as “durable,” in this case the Dex receiver, then Medicare will not be able to defend its decision to designate the Dex G5 system as eligible for Medicare coverage. So, in the interest of being able to defend Medicare’s decision to designate the G5 system as DME, they adopted the policy that members must use the G5 receiver and never use any alternate means like a smartphone.

I’m not defending their logic or policy but I’m glad that at least one CGM is eligible and covered by Medicare. I think they will come to their senses when the reality of sharing BG status via a smartphone with a caregiver finally sinks in as a crucial safety component for their members. I’m grateful that they’re busying themselves with this issue rather than whether a CGM qualifies for DME status.

I hope Medicare comes to its senses soon and chooses to be smart about their evolution!

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There was no reasoning (AFAIK) released. Strictly the decision.

AFAIK - everything else is conjecture.

A couple more conjectures…

  • only the system with the Receiver was certified by the FDA. A system based on a software app is inherently insecure.
  • they did not want any argument to be possible for Medicare to reimburse for smartphone purchase

The Dexcom mobile app is FDA approved.

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Terry is right. If a cell phone can be considered a “durable medical device,” it could be covered.

Weirdly, I am banned also. It all has to do with insurance coding, but Medicare, as secondary, won’t cover CGM supplies. I had to sign paperwork to only use the receiver, but Medicare denies claims.