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The basis for your appeal is that the cgms is covered pursuant to the General Laws. The State of Rhode Island where I live. 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?

Last I checked 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.

For discussion on this topic click here.