[Congressional Record Volume 160, Number 121 (Wednesday, July 30, 2014)]
[Senate]
[Pages S5137-S5138]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
By Ms. COLLINS (for herself and Mrs. Shaheen):
S. 2689. A bill to amend title XVIII of the Social Security Act to
specify coverage of continuous glucose monitoring devices, and for
other purposes; to the Committee on Finance.
Ms. COLLINS. Mr. President, as the founder and co-chair of the Senate
Diabetes Caucus, I have learned a great deal about this devastating
disease affecting nearly 29 million Americans. Fortunately, due to the
Special Diabetes Program and increased investments in diabetes
research, we have seen some encouraging breakthroughs and are on the
threshold of a number of important new discoveries.
This is particularly true for the estimated 3 million Americans
living with type I diabetes. Advances in technology, like continuous
glucose monitors, are helping patients control their blood glucose
levels, which is key to preventing costly and sometimes deadly diabetes
complications. We are also moving closer and closer to our goal of an
artificial pancreas, which would control blood glucose levels
automatically and revolutionize diabetes care.
The National Institutes of Health and the Food and Drug
Administration have been extremely supportive of these innovations in
diabetes care. I was therefore surprised and extremely troubled to
learn that insulin-dependent Medicare beneficiaries are being denied
coverage for continuous glucose monitors, or CGMs, because the Centers
for Medicare and Medicaid Services, CMS, has determined that they do
not meet the Medicare definition of durable medical equipment and do
not fall under any other Medicare category. As a consequence, we are
seeing situations--similar to what we saw with insulin pumps in the
late 1990s--where individuals with type 1 diabetes have had coverage
for their continuous glucose monitor on their private insurance, only
to lose it when they age into Medicare.
A CGM is a physician-prescribed, FDA-approved medical device that can
provide real-time readings and data about trends in glucose levels
every five minutes, thus enabling someone with insulin-dependent
diabetes to eat or take insulin and prevent dangerous low or high
glucose levels. As demonstrated by extensive clinical evidence, adults
using a CGM have had improved overall glucose control and have reduced
rates of hypoglycemia or low blood glucose levels. Professional medical
societies, including the American Association of Clinical
Endocrinologists and the Endocrine Society, recognize this clinical
evidence and have published guidelines recommending CGM be used in
appropriate patients with type 1 diabetes. Today, about 95 percent of
commercial insurers provide coverage for CGM devices.
The ironic thing is that it is only because of advances in diabetes
care like the continuous glucose monitor that people with type 1
diabetes can expect to live long enough to become Medicare
beneficiaries. I am particularly concerned given the implications that
this coverage decision will have for future decisions regarding
artificial pancreas systems, which will combine a continuous glucose
monitor, insulin pump, and sophisticated algorithm to control high and
low blood sugar around the clock.
I am therefore joining my colleague from New Hampshire and my Co-
Chair
[[Page S5138]]
of the Senate Diabetes Caucus in introducing the Medicare CGM Access
Act of 2014 to create a separate benefit category under Medicare for
the continuous glucose monitor and require coverage of the device for
individuals meeting specified medical criteria.
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