Re: [IP] Medicare & CGM Coverage GOOD NEWS
Thank you for sharing. I would urge all IPers to continue pushing for the
Medicare CGM access act of 2015. If it's in the law it will be a lot harder to
undo via regulation.
Don't relax and ease up now! Write your senators and reps.
Sent from my iPhone
> On Feb 29, 2016, at 9:04 AM,
<email @ redacted>
<email @ redacted> wrote:
> 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
> contractor, and the Center for Medicare Services (CMS) that used Policy
> 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
> 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
> to try you may use this case when your claim is denied by Medicare and/or
> 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
> reading or at least skimming if you are interested in Medicare CGM coverage.
> Happy Leap Year Day to all. Don't forget to change your lancet.
> Jerry Smith
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