The Florida Legislature passed a bill during this year’s session that will help diabetics in the state by providing greater access to continuous glucose monitors (CGMs).
House Bill 967 requires the Florida Agency for Health Care Administration to provide coverage for continuous glucose monitors for Medicaid patients who have been diagnosed with Type 1 or Type 2 diabetes (or any other type of diabetes treated with insulin) if their provider writes a prescription. More than 2.1 million Floridians, or 12.5 percent of the adult population, have been diagnosed with diabetes.
Veronica De La Garza, director of state government affairs at the American Diabetes Association (ADA), discussed HB 967 and the impact it will have on diabetic Floridians with State of Reform in this Q&A.
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State of Reform: Has the ADA heard from the Floridians it represents that the provisions included in HB 967 are needed there?
Veronica De La Garza: “Yes, we have heard from Floridians that better access to CGMs is needed. Per the House of Representatives’ bill analysis, the Medicaid program in Florida has not been covering CGMs for adults over the age of 20 despite the clinical benefits that can be obtained.”
SOR: Does the ADA have any idea how many Floridians this will impact?
VD: “In federal fiscal year 2021-2022, 43,924 Medicaid recipients required diabetic supplies. The legislation will now make available CGMs for those children and adults who are insulin-dependent and wish to utilize a CGM to improve their glucose control.”
SOR: The glucose monitors eliminate the need for diabetics to draw blood with a lancet to test their blood sugar levels. What other features do glucose monitors offer that help diabetics?
VD: “CGMs continually monitor blood glucose (blood sugar), giving the user intermittent or real-time updates through a device that is attached to their body. CGMs provide significant, potentially life-changing benefits for diabetes management, and are recommended because they:
- Help [patients] avoid or delay serious, short- and long-term diabetes complications.
- Potentially save money through improved diabetes management and fewer events, like hypoglycemia (low blood glucose) leading to emergencies.
- Offer people with diabetes and their healthcare team more details about glucose levels than traditional blood glucose meters, giving [them] the opportunity to analyze the data more precisely than ever before.
- Provide biofeedback to allow people with diabetes to modify their dietary pattern or insulin dose based on trends as directed by their healthcare provider. CGMs can improve glucose management and reduce risk for hypoglycemia and hyperglycemia (high blood glucose).”
SOR: Has the ADA noticed a recent trend of states implementing laws to make glucose monitors more available to diabetics? Are there other initiatives that the ADA has recently noticed that states are implementing to help diabetics?
VD: “The ADA is playing a leading role in advocating for state Medicaid programs to improve their coverage policies for CGMs so beneficiaries can improve their diabetes management. By doing so, beneficiaries can lower their risk for the costly and serious complications of diabetes that include heart attack, stroke, kidney disease, blindness, and lower limb amputation.
In addition to leading efforts on CGM legislation, the ADA also advocates for insulin copay caps at both the state and federal levels to improve insulin affordability. Twenty-five states and Washington, D.C., have passed such laws to improve insulin affordability for those on state-regulated health insurance plans. And the federal government has also capped Medicare copays for insulin.”
This Q&A has been edited for clarity and length.