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Committee advances bill to restore dual reimbursement pathway for continuous glucose monitors after DHS cites lost rebates
Summary
The Senate Public Health, Welfare and Labor Committee passed House Bill 1255 to require Medicaid to maintain both pharmacy and durable medical equipment (DME) reimbursement pathways for continuous glucose monitors, after the Division of Medical Services told lawmakers the change would reduce rebate revenues and cost the state about $2 million.
The Senate Public Health, Welfare and Labor Committee on Thursday passed House Bill 1255, a measure requiring the Division of Medical Services at the Department of Human Services (DHS) to maintain a dual reimbursement pathway for continuous glucose monitors (CGMs) as both a pharmacy benefit and a durable medical equipment (DME) benefit.
The bill arose after legislators and stakeholders said a previous change moved CGMs into pharmacy billing only and produced an “unintended consequence” limiting choices for providers and affecting how rebates are handled. Representative Jeremy Wooldridge, the bill sponsor, told the committee the dual pathway would restore access in counties that lack DME providers…
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