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Old 05-12-2007, 07:11 PM
Tony Tony is offline
Administrator
I am a: Type 1
 
Join Date: Feb 2002
Location: Rhode Island
Posts: 4,181
Appealing the cgms

As you know from another thread I started a month ago I was denied coverage for the continuous glucose monitoring system (cgms). I am now in the process of appealing and I am pretty confident that I will win my appeal. Here's why,

The basis for my appeal is that the cgms is covered pursuant to the General Laws of the State of Rhode Island, 1956, as amended, §27-18-38(a)(b), entitled “Diabetes Treatment” which states, in part “Upon the approval of new or improved diabetes equipment and supplies by the Food and Drug Administration, all policies governed by this section shall guarantee coverage of new diabetes equipment and supplies when medically appropriate and prescribed by a physician.”

Now your probably asking yourself, does my state have a similar law?

46 states have some type of laws requiring health insurance coverage to include treatment for diabetes and the four states that do not included coverage are Alabama, Idaho, North Dakota and Ohio.

I have found California and Texas have a similar law to Rhode Island where health plans must provide coverage for new or improved diabetes equipment and supplies approved by the FDA when determined by a physician to be medically necessary and appropriate.
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Tony
Administrator of Diabetesforums.com

"Weeding my way through Diabetes, and taking all of you along for the ride." - archimeech

Last edited by Tony : 05-15-2007 at 04:40 PM.
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