Cynthia Rice: Automated Insulin Delivery Coverage Is Modernizing the Medicare Program

Earlier this year, Medicare implemented a rule that allows coverage of CGM/automated insulin delivery systems without requiring a finger stick. What do you think the effect of this rule change will be?

Now this is an important rule that we applaud. It helps modernize the Medicare program.

These continuous glucose monitors (CGMs) help people with type 1 diabetes achieve better glucose control. We've long advocated for private plans to cover them and for Medicare to cover them—for public and private plans to cover them. This rule takes away sort of a burdensome test, which was requiring people to show that they were taking at least 4 finger sticks a day before Medicare would allow them to have a continuous glucose monitor. And it was not rooted in science—these modern CGMs are approved by the Food and Drug Administration that you don't have to use finger sticks with them. So it was adding a burden and costs to people with diabetes.

Frankly, there are many people who are using continuous glucose monitors before they get to Medicare, and then they age into Medicare and suddenly Medicare was saying, “well, we can't let you keep using this important tool unless you start using finger sticks again.” So it was sort of an unnecessary burden, and no reason why Medicare should pay for the cost of that, so we're pleased to see that be removed.