Increase Access, Reduce Disparities: Recommendations for Modifying Medicaid CGM Coverage Eligibility Criteria-Reference-Cited by-同舟云学术

Increase Access, Reduce Disparities: Recommendations for Modifying Medicaid CGM Coverage Eligibility Criteria

Published:2022-12-16 Issue: Volume: Page:193229682211440
ISSN:1932-2968
Container-title:Journal of Diabetes Science and Technology
language:en
Short-container-title:J Diabetes Sci Technol

Author:

Galindo Rodolfo J.¹²³^ORCID,Aleppo Grazia⁴^ORCID,Parkin Christopher G.⁵^ORCID,Baidal David A.⁶,Carlson Anders L.⁷⁸⁹¹⁰^ORCID,Cengiz Eda¹¹^ORCID,Forlenza Gregory P.¹²^ORCID,Kruger Davida F.¹³,Levy Carol¹⁴¹⁵^ORCID,McGill Janet B.¹⁶,Umpierrez Guillermo E.¹⁷¹⁸^ORCID

Affiliation:

1. Emory University School of Medicine, Atlanta, GA, USA

2. Center for Diabetes Metabolism Research, Emory University Hospital Midtown, Atlanta, GA, USA

3. Hospital Diabetes Taskforce, Emory Healthcare System, Atlanta, GA, USA

4. Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

5. CGParkin Communications, Inc., Henderson, NV, USA

6. Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA

7. International Diabetes Center, Minneapolis, MN, USA

8. Regions Hospital & HealthPartners Clinics, St. Paul, MN, USA

9. Diabetes Education Programs, HealthPartners and Stillwater Medical Group, Stillwater, MN, USA

10. University of Minnesota Medical School, Minneapolis, MN, USA

11. Pediatric Diabetes Program, Division of Pediatric Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA

12. Barbara Davis Center, Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Denver, Denver, CO, USA

13. Division of Endocrinology, Diabetes, Bone & Mineral, Henry Ford Health System, Detroit, MI, USA

14. Division of Endocrinology, Diabetes, and Metabolism, Icahn School of Medicine at Mount Sinai, New York, NY, USA

15. Mount Sinai Diabetes Center and T1D Clinical Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA

16. Division of Endocrinology, Metabolism & Lipid Research, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA

17. Division of Endocrinology, Metabolism, Emory University School of Medicine, Atlanta, GA, USA

18. Diabetes and Endocrinology, Grady Memorial Hospital, Atlanta, GA, USA

Abstract

Numerous studies have demonstrated the clinical value of continuous glucose monitoring (CGM) in type 1 diabetes (T1D) and type 2 diabetes (T2D) populations. However, the eligibility criteria for CGM coverage required by the Centers for Medicare & Medicaid Services (CMS) ignore the conclusive evidence that supports CGM use in various diabetes populations that are currently deemed ineligible. In an earlier article, we discussed the limitations and inconsistencies of the agency’s CGM eligibility criteria relative to current scientific evidence and proposed practice solutions to address this issue and improve the safety and care of Medicare beneficiaries with diabetes. Although Medicaid is administered through CMS, there is no consistent Medicaid policy for CGM coverage in the United States. This article presents a rationale for modifying and standardizing Medicaid CGM coverage eligibility across the United States.

Funder

Abbott Diabetes Care

Publisher

SAGE Publications

Subject

Biomedical Engineering,Bioengineering,Endocrinology, Diabetes and Metabolism,Internal Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/19322968221144052

Reference119 articles.

1. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020: estimates of diabetes and Its burden in the United States. Date unknown. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed February 29, 2020.

2. Socioeconomic Position and Health among Persons with Diabetes Mellitus: A Conceptual Framework and Review of the Literature

3. Medicaid.gov. August 2022 Medicaid & CHIP enrollment data highlights. Date unknown. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html. Accessed May 20, 2022.

4. Centers for Medicare & Medicaid Services. 2020 Medicaid and CHIP beneficiary profile: characteristics, health status, access, utilization, expenditures, and experience. https://www.medicaid.gov/medicaid/quality-of-care/downloads/beneficiary-profile-2021.pdf. Published 2021. Accessed May 23, 2022.

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