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[IP] WHITCOMB v. BURWELL Case No. 13-CV-990



 I have been in contact with JDRF advocacy in Washington, DC. I asked for
comments on the case Dave Guyer posted yesterday at I-P. The reply I received
was as follows:

 "Medicare allows beneficiaries multiple opportunities to appeal services that
have been denied under the program. The Whitcomb case is an example of a
beneficiary appeal that reached the highest level, which is District Court. In
the Whitcomb case, the ruling by the Court requires Medicare to revisit the
denial and to do a proper analysis of the issue. Medicare has 90 days to comply
with the Court's ruling. That time window does not expire until October. The
outcome of Ms. Whitcomb's efforts - either positive or negative - will affect
only her access to continuous glucose monitoring (CGM). It does not have an
impact on our effort to secure Medicare coverage for CGM more broadly."

 To Dave: I live in Rochester, NY, and was very fortunate to find a Medicare
Advantage HMO that offered CGM coverage as an extra benefit. The plan is offered
by Excellus BC/BS which is only available in this area. As Pam Brown has pointed
out, it is very rare for a public Medicare HMO to offer CGM coverage. If you are
eligible as a retiree for Medicare, there might be some better options available
through your former employer, which could include CGM coverage.

Jerry Smith
.
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