CMS: Medicare to cover smartphone apps used with CGM

Joanne Rinker
Joanne Rinker

Medicare will soon cover smartphone apps used in conjunction with approved continuous glucose monitors for people with diabetes, according to a statement released by CMS.

The rule change follows a push from lawmakers, diabetes advocates and stakeholders, who have called for coverage of connected smartphone apps since CMS first announced CGM devices would be categorized as “durable medical equipment” in January 2017. The policy in place currently restricts beneficiaries from using a smartphone app to share data and alerts from their otherwise coverable CGM.

In a statement posted online by CMS’ Durable Medical Equipment Center, the agency said the change is consistent with its approach of putting patients first and “incentivizing innovation and use of e-technology.”

“CMS heard from numerous stakeholders who shared their concerns that Medicare’s CGM coverage policy limited their use of CGMs in conjunction with their smartphones, preventing them from sharing data with family members, physicians and caregivers,” CMS said in the statement. “After a thorough review of the law and our regulations, CMS is announcing that Medicare’s published coverage policy for CGMs will be modified to support the use of CGMs in conjunction with a smartphone, including the important data-sharing function they provide for patients and their families.”

In an interview with Endocrine Today, Joanne Rinker, MS, RD, CDE, LDN, FAADE, director of practice and content development for the American Association of Diabetes Educators, called the change an “amazing step” for the ability to share knowledge with the people that matter to those with diabetes.

“When it first came out that [apps for CGM] weren’t covered, everyone was scratching their heads,” Rinker said. “It just didn’t make sense. So now, everyone is rejoicing. And we’re hearing this change will go into effect in about 10 days.”

Rinker said the change is especially important for parents of children with diabetes, who can now remotely monitor blood glucose levels while children are at school, and for caregivers of older adults with the disease.

“People with diabetes have a support team, and this helps that support team be able to rally around that person and help them in times when they’re not in the same vicinity,” Rinker said.

In a statement released Tuesday, AADE said the new change will allow better monitoring, particularly for children and older adults with diabetes, as well as the ability for health care providers to make improved treatment decisions by using apps to interpret data from meals, exercise, medications and insulin boluses. The change will also allow expanded coverage for people with diabetes, the organization said.

“Medicare beneficiaries will only be covered initially, but private insurers often follow their lead, opening up expanded coverage for many more,” the association said in the statement.

On March 29, the co-chairs of the Senate Diabetes Caucus and House Diabetes Caucus — U.S. Sens. Susan Collins, R-Maine, and Jeanne Shaheen, D-N.H., and U.S. Reps. Tom Reed, R-N.Y., and Diana DeGette, D-Colo. — sent a letter to CMS Administrator Seema Verma, urging the agency to review the app coverage policy, noting that the rule restricted beneficiaries’ access to the full spectrum of use for innovative diabetes therapies.

“Many innovative technologies work in tandem with smartphone applications and current Medicare coverage policies do not support this usage,” the caucus members wrote. “We urge CMS to revise its decision to support the full spectrum of use.”

A revised policy article will be issued soon, at which time the change will be effective, according to CMS. – by Regina Schaffer

For more information:

Durable Medical Equipment Center announcement. Available at: https://www.cms.gov/Center/Provider-Type/Durable-Medical-Equipment-DME-Center.html.

Statement from Senate and House Diabetes Caucus. Available at: https://www.collins.senate.gov/newsroom/senators-collins-shaheen-urge-cms-provide-coverage-glucose-monitoring-smartphone-apps.

Disclosure: Rinker is director of practice and content development for AADE.

 

Joanne Rinker
Joanne Rinker

Medicare will soon cover smartphone apps used in conjunction with approved continuous glucose monitors for people with diabetes, according to a statement released by CMS.

The rule change follows a push from lawmakers, diabetes advocates and stakeholders, who have called for coverage of connected smartphone apps since CMS first announced CGM devices would be categorized as “durable medical equipment” in January 2017. The policy in place currently restricts beneficiaries from using a smartphone app to share data and alerts from their otherwise coverable CGM.

In a statement posted online by CMS’ Durable Medical Equipment Center, the agency said the change is consistent with its approach of putting patients first and “incentivizing innovation and use of e-technology.”

“CMS heard from numerous stakeholders who shared their concerns that Medicare’s CGM coverage policy limited their use of CGMs in conjunction with their smartphones, preventing them from sharing data with family members, physicians and caregivers,” CMS said in the statement. “After a thorough review of the law and our regulations, CMS is announcing that Medicare’s published coverage policy for CGMs will be modified to support the use of CGMs in conjunction with a smartphone, including the important data-sharing function they provide for patients and their families.”

In an interview with Endocrine Today, Joanne Rinker, MS, RD, CDE, LDN, FAADE, director of practice and content development for the American Association of Diabetes Educators, called the change an “amazing step” for the ability to share knowledge with the people that matter to those with diabetes.

“When it first came out that [apps for CGM] weren’t covered, everyone was scratching their heads,” Rinker said. “It just didn’t make sense. So now, everyone is rejoicing. And we’re hearing this change will go into effect in about 10 days.”

Rinker said the change is especially important for parents of children with diabetes, who can now remotely monitor blood glucose levels while children are at school, and for caregivers of older adults with the disease.

“People with diabetes have a support team, and this helps that support team be able to rally around that person and help them in times when they’re not in the same vicinity,” Rinker said.

In a statement released Tuesday, AADE said the new change will allow better monitoring, particularly for children and older adults with diabetes, as well as the ability for health care providers to make improved treatment decisions by using apps to interpret data from meals, exercise, medications and insulin boluses. The change will also allow expanded coverage for people with diabetes, the organization said.

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“Medicare beneficiaries will only be covered initially, but private insurers often follow their lead, opening up expanded coverage for many more,” the association said in the statement.

On March 29, the co-chairs of the Senate Diabetes Caucus and House Diabetes Caucus — U.S. Sens. Susan Collins, R-Maine, and Jeanne Shaheen, D-N.H., and U.S. Reps. Tom Reed, R-N.Y., and Diana DeGette, D-Colo. — sent a letter to CMS Administrator Seema Verma, urging the agency to review the app coverage policy, noting that the rule restricted beneficiaries’ access to the full spectrum of use for innovative diabetes therapies.

“Many innovative technologies work in tandem with smartphone applications and current Medicare coverage policies do not support this usage,” the caucus members wrote. “We urge CMS to revise its decision to support the full spectrum of use.”

A revised policy article will be issued soon, at which time the change will be effective, according to CMS. – by Regina Schaffer

For more information:

Durable Medical Equipment Center announcement. Available at: https://www.cms.gov/Center/Provider-Type/Durable-Medical-Equipment-DME-Center.html.

Statement from Senate and House Diabetes Caucus. Available at: https://www.collins.senate.gov/newsroom/senators-collins-shaheen-urge-cms-provide-coverage-glucose-monitoring-smartphone-apps.

Disclosure: Rinker is director of practice and content development for AADE.