Last week we posted a blog titled “CMS Updates For CGM Coverage,” which on the surface seemed like very exciting, impactful changes on CMS regulations for CGM coverage during the COVID-19 pandemic.
After sharing this post, members of our community let us know that although CMS guidelines have been relaxed in writing, this hasn’t translated into better access on the ground.
To learn more we dove into the interim final rule with comment period (IFC) that was released by the Department of Health & Human Services – Centers for Medicare & Medicaid Services.
In the March 31st COVID-19 IFC, we finalized on an interim basis that we will not enforce the clinical indications for coverage across respiratory, home anticoagulation management, and infusion pump NCDs (Nation Coverage Determinations) and LCDs (Local Coverage Determinations) (including articles) allowing for more flexibility for practitioners to care for their patients. This enforcement discretion will only apply during the PHE for the COVID-19 pandemic.
The language in the IFC is vague and ambiguous regarding what it means to have less stringent and “more flexible” requirements of obtaining a CGM in the time of the COVID-19 for people with diabetes. Though we have found a few highlights from the document based on feedback by our community on what is unclear.
In this IFC, we are finalizing on an interim basis that we will not enforce the clinical indications for therapeutic continuous glucose monitors in LCDs. For example, we will not enforce the current clinical indications restricting the type of diabetes that a beneficiary must have or relating to the demonstrated need for frequent blood glucose testing in order to permit COVID-19 infected patients with diabetes to receive a Medicare-covered therapeutic continuous glucose monitor.
Overall, there is still much to learn about these changes as they apply to real-life situations. This is an unprecedented time for all of us and there is a lot of unknowing. We hope as things develop to keep you informed.
If you have any more information on these changes, please click here to visit our survey to update us.
Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer
Join Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, and ADCES 2020 Diabetes Educator of the year as she reviews these important topics. As Diabetes Specialists, we are tasked with taking a leadership role in technology and cardiovascular risk reduction. Dr. Isaacs will address these topics with clinical insight and expert knowledge during these two virtual courses.
Session 1 | CV Risk Management with Pharmacology and Intensive Insulin Therapy | Recorded & Ready for Viewing!
Session 2 | Continuous Glucose Monitoring and Insulin Pump Therapy | Recorded & Ready for Viewing!
$69 | Earn 4 CEs
These sessions are also included in our Virtual Conference.
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
April 14, 2021 – April 16, 2021
October 1 11:30 am – 12:45 pm
October 24 12:00 pm – December 7 2:15 pm
November 5 11:30 am – 12:45 pm