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Committee advances measure to codify CGM coverage transparency for Access members
Summary
Senate Bill 11-32 would require Access contractors to provide continuous glucose monitors (CGMs) via pharmacy and durable medical equipment benefits and publish updated coverage criteria; the committee gave it a due pass after stakeholders said Access already covers CGMs and the bill clarifies transparency.
The House Appropriations Committee on March 26 recommended a due pass for Senate Bill 11-32, which directs Access to require its contractors to provide continuous glucose monitors (CGMs) to members through both pharmacy and durable medical equipment (DME) benefits and to update coverage criteria to align with current standards of care.
Stakeholders including device manufacturers and patient advocates supported the measure as clarifying access and improving patient safety. Diane McAllister (Dexcom) told the committee the bill does not change coverage benefits but adds transparency; she said Access’s coverage policies were not previously published in one place and that has created confusion for patients and prescribers. Julie Hoffman from the American Diabetes Association said the pharmacy route matters in practice because CGMs and their sensor components have temperature limits in shipment and patients in rural areas often rely on pharmacists for in-person help with device setup.
Access testified it is neutral and that contractors already provide CGMs through pharmacy and DME and that Access has released a FAQ and will publish standalone coverage criteria. Access indicated it expects no fiscal impact because current practice covers the devices.
After public testimony, the committee recorded a vote of 15 ayes, 2 noes and 1 not voting; SB 11-32 received a due-pass recommendation.
