[IP] Medicare & CGM Coverage GOOD NEWS
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- Subject: [IP] Medicare & CGM Coverage GOOD NEWS
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- Date: Mon, 29 Feb 2016 15:03:12 +0000
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Here is some very good news. An administrative law judge (ALJ) from the
Medicare Departmental Appeals Board, Civil Remedies Division, has essentially
thrown out the CMS argument that CGM equipment is non covered because it is
PRECAUTIONARY! The case was brought against NHIC, a Medicare DME administrative
contractor, and the Center for Medicare Services (CMS) that used Policy Article
A33614 to deny CGM coverage. Judge Keith W. Sickendick, his real name, has
issued a preliminary decision which will become final when CMS fails to provide
medical documentation for the ridiculous NHIC policy article issued more than
ten years ago.
Dr. Nick Argento, an endocrinologist from Maryland, has supported several of
his Medicare patients in their efforts to obtain CGM coverage. If anybody wants
to try you may use this case when your claim is denied by Medicare and/or your
private health insurance plan. Here is the link to Dr. Nick's website which
includes several other important links.
The case itself contains 19 pages of legal decision language but is well worth
reading or at least skimming if you are interested in Medicare CGM coverage.
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