States Focus on Patient Access & Outcomes
Recent legislative efforts aim to improve preventive medical care
By Meg Herndon
Arkansas Act Protects Patient Access to CGM
Arkansas Governor Sarah Huckabee Sanders signed Act 857, which amends the coverage of continuous glucose monitors (CGMs) in the state’s Medicaid program into law. This industry legislation protects CGM access by:
- Requiring Medicaid coverage as a durable medical equipment (DME) benefit without requiring a national drug code as part of claim submission
- Mandating that reimbursement should be no less than Medicare under applicable HCPCS codes
- Ensuring consistent approval requirements, whether through pharmacy or DME
The American Association for Homecare (AAHomecare) said its Diabetes Council members and Arkansas Medical Equipment Providers (AMEP), which was initially formed to address this issue, were instrumental in passing the legislation.
“AMEP is incredibly grateful for the work of our sponsors to ensure that DME and their patients were taken care of this legislative session,” said Caitlyn Hiland, AMEP executive director. “We are excited to continue this momentum into the summer to carefully craft the rules with the intention of keeping patients our first priority. This is a huge win for our current members and we hope it inspires other DMEs operating in Arkansas to reach out to us with the intention of helping their business and patient base.”
New York City Establishes Sleep Apnea Screening Pilot Program
The New York City Council voted to establish a sleep apnea screening pilot program. The program will seek to expand access to preventive medical care and improve health outcomes by providing screenings to New Yorkers at no cost, prioritizing individuals without insurance.
Introduction 1047-B, sponsored by Council Member Shaun Abreu, would require the New York City Department of Health and Mental Hygiene (DOHMH), or another agency designated by the mayor, to establish a three-year pilot program that provides access to sleep apnea screenings at no cost, as well as access to home sleep apnea tests, if deemed appropriate. The bill would require DOHMH to prioritize individuals without insurance.
Untreated sleep apnea can lead to serious health complications, including cardiovascular issues, diabetes and cognitive problems, potentially decreasing life expectancy.
