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



 My endo found out that POMCO covers Dexcom CGMS. I started with it a month ago.
It is a lifesaver. I am on Medicare...


James S Durr
email @ redacted




-----Original Message-----
 From: jsmith93_rochester.rr.com
<email @ redacted>
To: ip <email @ redacted>; daveg2 <email @ redacted>
Sent: Wed, Sep 9, 2015 11:24 pm
Subject: [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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