Medicare Announces Criteria Covering Dexcom G5 Mobile CGM for All People with Diabetes
March 24, 2017
Medicare Announces Criteria Covering Dexcom G5 Mobile CGM for All People with Diabetes on Intensive Insulin Therapy
SAN DIEGO--(BUSINESS WIRE)-- DexCom, Inc. (NASDAQ:DXCM), the leader in continuous glucose monitoring (CGM) for people with diabetes, is pleased to announce that the U.S. Centers for Medicare & Medicaid Services (CMS) has published an article clarifying criteria for coverage and coding of the Dexcom G5 Mobile system, the only therapeutic CGM under this CMS classification. People covered by Medicarewho have either Type 1 or Type 2 diabetes and intensively manage their insulin will now be able to obtain reimbursement.
"This is a new era and a huge win for people with diabetes on Medicare who can benefit from therapeutic CGM," said Kevin Sayer, President and Chief Executive Officer, Dexcom. "This decision supports the emerging consensus that CGM is the standard of care for any patient on intensive insulin therapy, regardless of age."
According to CMS, therapeutic CGM may be covered by Medicare when all of the following criteria are met:
- The beneficiary has diabetes mellitus; and,
- The beneficiary has been using a home blood glucose monitor (BGM) and performing frequent (four or more times a day) BGM testing; and,
- The beneficiary is insulin-treated with multiple daily injections (MDI) of insulin or a continuous subcutaneous insulin infusion (CSII) pump; and,
- The patient's insulin treatment regimen requires frequent adjustment by the beneficiary on the basis of therapeutic CGM testing results.
In order to be included in this category, the system must be defined as therapeutic CGM, meaning you can make treatment decisions using the device. Dexcom G5 Mobile is the only system approved by the FDA to meet that criteria.
A diabetic boy’s parents ‘didn’t believe in doctors.’
Now they’re guilty of his murder.
from the Washington Post
Alexandru Radita’s first medical crisis began when he was on the verge of turning 3. His parents brought him — thirsty, feverish, vomiting and suffering from abdominal pain — to a hospital in British Columbia in December 2000. Lab tests confirmed that young Alex had Type 1 diabetes.
A doctor spoke to Alex’s mother to explain her son’s diagnosis and how they would need to treat him at home. Type 1 diabetes is a lifelong condition in which a person’s pancreas does not produce enough insulin. People with it need regular blood tests and insulin injections to moderate blood-sugar levels.
According to court documents, “Mrs. Radita . . . made it clear that in her view the diagnosis was incorrect and she would prove that the doctors were wrong.”
The entire article can be found here.