Committee advances amendment to let Medicaid cover continuous glucose monitors for gestational diabetes amid agency concerns over eligibility language

Representative Seabolt asked a committee to approve an amendment to House Bill 352 (LC570223) that would ensure Medicaid covers continuous glucose monitoring (CGM) when prescribed for people diagnosed with gestational diabetes and would remove a textual requirement that the patient receive “at least 1 daily administration of insulin.”

“This amendment ensures that Medicaid will cover continuous glucose monitoring for pregnant women that are diagnosed with gestational diabetes if their physician prescribes it,” Representative Seabolt said. He argued the change would close an unintended coverage gap.

Brandy Sylvan, director of government relations at the Georgia Department of Community Health, told the committee the department supports adding gestational diabetes to the list of qualifying conditions but objects to striking the “daily administration” language on line 21. Sylvan said the department’s prior-authorization process relies on clinical guidelines from the American Diabetes Association and the American Association of Clinical Endocrinology and that removing the daily-insulin criterion would make automated prior authorization difficult and would require manual reviews.

“We do not have concerns with the gestational diabetes language,” Sylvan said. “However, we do have concerns with removing the requirement that insulin be administered daily… that change would make it very difficult for us to administer an automated prior authorization requirement, and it is not in line with the clinical guidelines.”

Members asked questions about how the department’s automation works and whether the language would expand eligibility to people who receive infrequent injections. Representative Oliver, Representative Sharper and Representative Reese queried DCH officials about the impact on prior authorization workload and clinical appropriateness for CGM use when insulin is not administered daily. Representative Breeze and others noted that clinical practice generally ties CGM to insulin-dependent patients but asked DCH to clarify exceptions.

The committee voted to move the bill out of committee with a do-pass recommendation. Before the final voice vote, members agreed to let the legislative counsel correct the bill’s effective-date language on line 12 to read July 1, 2025. The chair called for the ayes, and “the ayes have it.” The record does not include a roll-call tally.

Committee discussion recorded the department’s preference to leave line 21 unchanged and asked DCH to provide additional clinical detail from its pharmacy team; the committee did not adopt a textual fix for line 21 during the hearing. An event announcement followed the vote: Quest Diagnostics will host an on-site screening trailer offering colorectal cancer screening kits and hemoglobin and blood-sugar testing on a forthcoming Thursday.