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Discussion in 'Continuous Glucose Sensing' started by MReinhardt, Mar 11, 2010.

  1. MReinhardt

    MReinhardt Approved members

    Dec 29, 2007
    Over two years ago Chell was approved by Illinois Medicaid for the cgms & sensors. Iowa Medicaid per-say has also approved Chell for the cgms & sensors BUT medicaid its self is not paying for her cgms & sensors, read on. . . .

    I have a letter in front of me from the State of Iowa stating:

    The request for an exception to Rule 441 Iowa Administrative Code 78.10 for MR to receive a Continues Glucose Monitor and sensors has been review. (M, age 19) has a diagnoses of type 1 diabetes and multiple problems. The letter goes on to say "It is not covered by the Medicaid Program".

    Continue on with the letter:

    Bases upon the Information, it has been determined that a continuous glucose monitor and sensors would meet M's medical needs. Therefore, I have agreed to approve a request for the exception to policy to Rule 441 Iowa Administrative Code 78.10 (2) for her to receive a continuous blood glucose monitor and sensors from Date xxxxxxx to Date xxxxxxx.

    Then is goes on to how MM is suppose to be billing the cgms and sensors.

    To continue on with the letter:

    The Iowa Mediciad Enterprise is directed to pay for these services using Federal finanacial participation under the EPSDT provision of OBRA '89

    end of letter

    Link to OBRA '89 http://www.dpw.state.pa.us/PubsFormsReports/NewslettersBulletins/003673169.aspx?BulletinId=1301

    If you do a search on EPSDT OBRA '89 there is lots more info available
  2. rickst29

    rickst29 Approved members

    Jun 2, 2006
    um, Davidson ....

    Michelle was speaking of Medicaid, not Medicare.

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