California Children’s Services (CCS) has made a policy change to reflect the current Medicare coding process for CGM at a significantly lower reimbursement rate, which will kick thousands of kids with diabetes off their CGMs. CCS made this policy change without asking for public comment or making a clinical evaluation– the impact to patients was not considered.
Taking away a child’s CGM has negative consequences.
As anyone who has had a CGM can tell you, diabetes management is drastically changed when a patient uses a CGM. CGMs are medical devices that measure, report, and track glucose levels and trends in real time. FDA has approved modern CGMs to make diabetes care adjustments. Scientific evidence shows CGM usage can improve diabetes management, alarming individuals of dangerous glucose levels so immediate and proactive action can be taken.
Published clinical studies have shown that when patients go off CGM, their HbA1c values increase. Higher HbA1c values are associated with increased hospitalizations, higher overall healthcare costs, and increased absenteeism from school.
Further, CGM systems are not interchangeable, especially for children. Based on FDA product labeling, only Dexcom systems are approved for kids as young as 2 years. If CCS switches a child to a less expensive CGM system, they’d be encouraging off-label use. Off-label use may pose risks or have unintended consequences for the patient.
CGMs help reduce risks associated with taking insulin. A recent JAMA article estimates that insulin, a self-administered survival drug, puts 97,000 Americans in the emergency room annually. CGMs provide an extra layer of safety and protection by showing the patient’s blood glucose. Additionally, some CGMs have a ‘sharing’ capability that allows a caregiver to see a patient’s blood glucose remotely. This lets parents keep an eye on their children’s health while the child focuses on other things, like enjoying their childhood.
Take action now!
Patients, especially children, MUST have access to the products best suited for them to help manage their diabetes! Treatment decisions should not be based on a financial, arbitrary internal policy. Click below to write a letter to officials in the California Department of Health Care Services asking them to reverse this policy and focus on patients for future policy decisions!