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Committee advances bill requiring Access to clarify and align CGM coverage
Summary
Senate Bill 11‑32, which would require Access (AHCCCS) contractors to provide continuous glucose monitors under pharmacy and durable medical equipment benefits and to publish clear coverage criteria, received a due‑pass recommendation after stakeholder testimony; Dexcom and patient advocates supported the measure.
The Senate Appropriations Committee advanced Senate Bill 11 32, which would require Medicaid contractors (Access/AHCCCS) to provide continuous glucose monitors (CGMs) under the pharmacy benefit and durable medical equipment benefit and to publish an accessible, standalone coverage policy for CGMs.
Sponsor Senator Kevin Payne, who said he is diabetic, described difficulties patients face when benefit details change and urged transparent, navigable rules so providers and patients can obtain CGMs without unexpected disruption. Diane McAllister, representing Dexcom, said the bill “does not change what coverage is for the CGMs that the agency already has,” but would make the coverage clearer and easier to find; she said Access had moved the policy into a lengthy prior‑authorization document and that a standalone policy would aid providers and patients.
Access staff were present and the agency reported no anticipated fiscal impact for the bill. Committee members had no further questions and recorded 9 ayes, 0 nays and 1 not voting on the due‑pass recommendation.
The bill’s text focuses on transparency and parity between pharmacy and DME coverage routes and on allowing prescribing providers to choose the appropriate benefit pathway for the patient. No substantive changes to clinical eligibility criteria were presented during the hearing.
