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Bridging the Gap: Addressing Medicare Coverage for Diabetes Technology

Bridging the Gap: Addressing Medicare Coverage for Diabetes Technology

The Looming Challenge in Diabetes Care

With an estimated one-third of the 66 million Medicare beneficiaries grappling with diabetes, the intersection of technology and Medicare coverage remains a significant hurdle. As the Baby Boom generation enters Medicare, projections indicate a surge in diabetes diagnoses.

Despite healthier habits among this generation, including reduced smoking rates, the prevalence of diabetes is notably higher. Please fill out the form if you or a friend would like more information on continuous glucose monitoring devices.

Medicare’s Struggle to Embrace Technological Advancements

The landscape of diabetes technology has evolved, yet Medicare’s adaptation to these innovations has been sluggish. Continuous glucose monitors, despite their early entry into the market and extensive patient usage, faced delayed coverage by Medicare until 2017. Present coverage policies fail to adequately accommodate the integration of these devices with patients’ smartphones.

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Unraveling Medicare’s Coverage Dilemma

A prime example lies in the automated insulin delivery system, approved by the FDA and consisting of three integral components. While Medicare covers the initial components as durable medical equipment, the regulatory framework fails to address the inclusion of the algorithm—a vital element for seamless functioning.

Advocating for Inclusive Coverage Policies

There’s a pressing need for Medicare to encompass crucial components like the algorithm, pivotal for the proper operation of covered technologies. Analogous to coverage for test strips used with blood glucose monitors and oxygen in canisters, the algorithm should be recognized as an essential component deserving separate coverage.

Also, read about the Miniature Continuous Glucose Monitor

Collaborative Efforts for Change

Industry players are actively engaging with federal bodies and Congress to bridge these coverage gaps. While initiatives like the Centers for Medicare and Medicaid Services’ Transitional Coverage for Emerging Technologies (TCET) are steps in the right direction, there’s a collective push for stronger policies to ensure a streamlined path to national Medicare coverage for evolving medical devices, especially in diabetes care.

Patient-Centric Perspectives

Patients frequently testify to the transformative impact of cutting-edge diabetes monitoring technologies on their lives. As we observe National Diabetes Month, these advancements stand as a beacon of hope. Personal experiences, like that of a father witnessing the life-changing effects of technology on his daughter managing Type 1 diabetes, underscore the urgency for faster Medicare coverage.

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Urgent Call for Action

National Diabetes Month serves as a poignant reminder of the imperative need for expedited Medicare coverage of diabetes medtech. Millions of Medicare beneficiaries deserve access to these life-altering advancements today, not tomorrow. The call to recognize the critical role of technology in enhancing their quality of life echoes resoundingly.