CMS Updates Beneficiary-Owned CGM Supplies Policy

WASHINGTON—The Centers for Medicare and Medicaid Services (CMS) issued a revised policy (CR 13049) that seeks to update documentation requirements for replacement supplies of beneficiary-owned continuous glucose monitors (CGMs), the American Association for Homecare (AAHomecare) wrote in a newsletter to members.

According to the policy, which will go into effect Tuesday, Feb. 18, contractors reviewing CGM supplies claims will no longer be required to verify that the CGM receiver’s original requirements were met. The policy states that once Medicare has paid for the CGM receiver, medical necessity for the receiver is considered established. Additionally, a supplier will only need to provide medical necessity documentation for on-going supplies. 

CMS said this policy seeks to align CGM policies with other durable medical equipment (DME) items, such as CPAP devices. The updated policy change aims to streamline coverage for beneficiaries and reduce the administrative burden on suppliers.

AAHomecare said it thanks CMS for recognizing the challenges faced by suppliers and for listening to industry feedback in making this important change.