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Committee moves to align coverage for continuous glucose monitors with standards of care
Summary
Senate Bill 11-32 would require a health plan (Access) to provide continuous glucose monitors via pharmacy and durable medical equipment benefits and to align coverage criteria with standards of care; staff said Access already provides most of the bill's provisions.
A health-policy bill would codify insurer practice for continuous glucose monitoring and give prescribing providers flexibility to select the appropriate benefit channel.
Senate Bill 11-32, summarized by staff, directs Access to require its contractors to provide members with continuous glucose monitors (CGMs) through both a pharmacy benefit and a durable medical equipment benefit and to update coverage criteria "to align with the current standards of care." The bill would also allow a member's prescribing provider to determine the appropriate option for the member. Staff said the item was on the third-read consent calendar.
Why it matters: Chairwoman Bliss said the bill largely "falls in line with the legislative intent" to codify Access's current practice. She reported Access testified it is "doing 90% of the things that are in this bill" and characterized the bill as a codification of existing practice.
Discussion and next steps: Committee members had no substantive questions in this session. Staff noted the bill needs codification of Access practice and that it had largely unanimous committee support; two nay votes occurred in appropriations but staff did not review those videos in session. No committee vote occurred during this session.
Ending: The bill remains on the committee calendar to reach further legislative consideration.
