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Re: [IP] Re:(IP) Medicare-Dexcom-Smartphones



I think the bureaucratic backstory is that because accuracy of the CGM with a
smartphone may be either off warranty or not fully reviewed during the review
process, that could be part of the problem. This kind of stuff sounds like
when you have medication that is known to work for a secondary disease, while
the FDA approval is for a primary disease, that could be the issue. For
example if you look at Gabapentin, which I take for my neuropathy in my
fingers, the main approved usage is for fibromyalgia. Lot of drugs work very
well for stuff that they are not explicitly tested for. But that's just a
guess.


I'm on NJ Family Care, which is basically state run Medicaid and after six
years of using a CGM with the 530G, these bozos denied me the CGM for the
630G, even though they are still covering my sensors. They are idiots and one
day I may go low and wind up in the Emergency Room with no margin for error
because of this nonsense. I usually have to call paramedics once a month but
they don't care.


David Jones
freelance journalist
https://davidjones.contently.com
862-264-8346


________________________________
From: email @ redacted
<email @ redacted> on behalf of Pam Brown
<email @ redacted>
Sent: Sunday, August 27, 2017 5:00 PM
To: email @ redacted
Subject: [IP] Re:(IP) Medicare-Dexcom-Smartphones

I few months I sat in on a conference call that CMS had about the new
coverage
for the Dexcom. When they said that the smartphone app couldn't be used even
as a secondary monitor, a bunch of people including a very articulate guy
from
JDRF challenged that premise and tried to explain why that made no sense. The
CMS guy just kept repeating the same thing about smart phones not being DME
and only DME and supplies related to it were allowed to be covered by
Medicare. He kept reading some language from the statute about DME and saying
that using anything at all in conjunction with DME devices that wasn't a DME
item itself or part of the original bundle would invalidate the entire device
being considered DME. Everyone kept saying that no one would expect Medicare
to pay for the smartphone. The guy was clearly stuck in his bureaucratic role
and couldn't get past that. I'm sure that Dexcom, JDRF and others are
lobbying
like crazy to make CMS understand, so hopefully one day the smartphone app
will be allowed. Pam

<Maybe someone can explain this to me.I don't get the smartphone
restriction.Dothey think that PWD's with CGM's are gonna expect Medicare to
pay for their
smartphones?I mean, the connection doesn't cost anything. It goes against
common
sense.I understand that a person can't expect Medicare to pay for a smart
phone,
but not to allow use of an app?>
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