According to American Diabetes Association, continuous glucose monitors (CGMs) are the standard of care for treating people with type 1 diabetes and people with type 2 diabetes on insulin pumps or multiple daily insulin injections, and a recommended tool for people with type 2 diabetes on any form of insulin.
Studies demonstrate that CGMs can improve clinical quality and health outcomes, reduce health care costs, and support health equity efforts. However, there is no consistent Medicaid CGM coverage policy in the U.S. ― with 40 states and the District of Columbia providing some level of CGM fee-for-service coverage with wide variations in coverage and 10 states offering no fee-for-service CGM coverage.
With support from The Leona M. and Harry B. Helmsley Charitable Trust, this paper explores the current CGM coverage landscape in Medicaid, highlights state approaches to CGM coverage, and identifies state opportunities to expand coverage. It also provides recommendations to the diabetes community on how to support increased CGM access and coverage across the country.