Final Medicaid Bulletin on Continuous Glucose Monitoring Systems

The Michigan Department of Health and Human Services issued a final Medicaid Policy Bulletin May 1 with revisions to the Continuous Glucose Monitoring Systems (CGMS) Policy.

In response to the proposed policy issued April 1, the MHA submitted a comment letter, offering seven recommended changes. Three of the seven changes the MHA suggested were adopted in the final policy:

  • Removal of a daily blood glucose testing requirement.
  • Removal of provider documentation requirements for the daily number of finger-stick tests prescribed.
  • Changing the requirement for diabetes self-management education from annual to bi-annual. This requirement became optional.

The additional suggestions not adopted include:

  • Removal of the provider documentation requirement for daily frequency of insulin administered.
  • Removal of the provider documentation requirement for beneficiary treatment plan and compliance.
  • Update the 90-day provider documentation requirement to align with the bi-annual monitoring requirement for CGMS.
  • Add Type II diabetes as a condition where prior authorization is not required.

This policy will go into effect June 1, 2023.

Members with questions may contact Kelsey Ostergren at the MHA.