Thursday, November 08, 2007

CGMS approval - some hope

Recently Kevin McMahon of Diabetech started a useful site called CGMS Central.

This site's mission is
to be the resource on the web for anything about CGMS reimbursement.
And on Monday the Centers for Medicare & Medicaid Services (CMS) finally approved billing codes for continuous glucose monitor systems.

In theory this means it will become a little easier to claim for these systems from your insurance company. In reality, it's not such a slam dunk. Until there is more proof that use of a continuous glucose monitor improves blood sugar control, insurance companies are not going to cover these devices as a matter of course.

While we're waiting for better coverage, if you've got any information about insurance coverage for CGMS based on your experience, do visit CGMS Central and share the information with others.

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Monday, June 04, 2007

ADA Application with Centers for Medicare & Medicaid

The Centers for Medicare and Medicaid Services (CMS) have just published a regulation for the "Application by the American Diabetes Association (ADA) for Continued Recognition as a National Accreditation Program for Accrediting Entities To Furnish Outpatient Diabetes Self-Management Training".

The details for both the application by the ADA and submission of comments can be found in the published PDF file from CMS. The background section that starts on the bottom of the first page provides interesting details on the process including:
A national accreditation organization applying for deeming authority must provide us with reasonable assurance that the accrediting organization requires accredited entities to meet requirements that are at least as stringent as CMS’s requirements. We may approve and recognize a nonprofit or not-for-profit organization with demonstrated experience in representing the interests of individuals with diabetes to accredit entities to furnish training.
Now I know there's been some recent discussion on D-blogs about the ADA and whether they are being influenced by large drug companies.

If you're not comfortable with how the ADA is conducting their business, this may be a useful way to raise your concerns. If you have any comments about this application, you can submit them to the CMS provided you do this by 5 PM on June 25, 2007.

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