Committee advances bill to expand insurance coverage for continuous glucose monitors

Representative Fiona Nave opened the hearing on House Bill 947, describing continuous glucose monitoring devices and arguing insurers should cover them earlier in a patient’s care. "A continuous glucose monitoring device is an alternative to finger sticks to help manage type 1 or type 2 diabetes," Nave said, explaining the device measures glucose every five minutes and can transmit data to a provider or caregiver.

The bill’s sponsor told the committee she had carried a similar bill two years earlier and that Medicare policy changes and insurer coverage updates have reduced the fiscal concerns that sank the measure previously. Nave said she found no fiscal note this session and urged the committee to approve the bill: "If companies would pay for the monitors when the diabetes provider determines it's medically necessary, they would save money and keep patients healthier," she said.

Clinical and industry witnesses supported the measure. JJ Carmody, representing Billings Clinic/Logan Health, called CGMs "the gold standard in managing diabetes" and said registered dietitians and clinicians expect cost savings over time. Jessie Fernandez, a section supervisor in the Department of Public Health and Human Services who oversees the Montana Diabetes Program, described the clinical value: continuous data increases "time in range" for blood glucose and can help prevent vascular and renal complications.

Drew Cziok, government relations director for Blue Cross Blue Shield, appeared to answer insurer questions and explained the state reimbursement (sometimes called a "defray") process insurers use when a state mandates new coverage. Cziok said changes in medical policy and a narrower bill scope contributed to a lower estimated fiscal impact this year. "We cover everything that's currently required in the bill, which is why we don't have any additional defray costs," he told the committee.

Committee members pressed for cost analyses and asked how preventive benefits and medical inflation were folded into fiscal estimates. Sponsor Nave and Jessie Fernandez cited clinical measures such as hemoglobin A1c and "time in range" to explain how CGMs can improve management and, the sponsor argued, avoid more expensive therapies later. Nave highlighted her personal experience to illustrate that a CGM changed her medication management during session and helped detect stress‑related glucose changes.

After testimony and questions, the sponsor asked for a do‑pass recommendation. The committee moved to concur on HB 947; the motion passed in committee and the bill will move to the Senate floor for further consideration.