CGM limits are said to set bad precedent

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Despite the fact that the Food and Drug Administration approved its third continuous glucose monitoring device and incorporated a mobile app in March, Medicare beneficiaries still can't take full advantage of this convenient technology because of a policy that also threatens to restrict coverage of future remote patient-monitoring technologies.

At issue, experts say, is a Medicare rule that prohibits beneficiaries from using an FDA-approved mobile app to send results from a glucose-monitoring device to their doctors, families and caregivers. The Centers for Medicare & Medicaid Services covers such devices for patients with “intensively managed diabetes,” but the agency states that patients still must see their doctor to have any data downloaded for interpretation in order for the device to be covered.

According to the CMS ruling, “if a beneficiary uses a non-DME device (smart phone, tablet, etc.) as the display device, either separately or in combination with a receiver classified as DME, the supplies shall be denied as non-covered by Medicare.” Remote data transmission could be particularly helpful in nursing homes, where physicians aren't always on site for days at a time.

James Scott, president and CEO of the health policy and reimbursement consulting group Applied Policy, told the online newsletter service Inside Health Policy that the CMS glucose monitoring policy also sets a bad precedent for other telehealth advancements.

Others representing providers and diabetics have written to CMS asking the agency to allow benecfiiaries to use FDA-approved apps.

“Families [and] caretakers along with providers and diabetes educators are key players in the team of people who assist the person with diabetes,” said Leslie Kolb, chief science and practice officer for the American Association of Diabetes Educators. “The ability to link the patient's glucose data is critical.”