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ARIZONA HOUSE OF REPRESENTATIVESFifty-seventh Legislature First Regular Session |
Senate: HHS DP 6-0-1-0 | APPROP DP 9-0-1-0 | 3rd Read 26-2-2-0 |
SB 1132: AHCCCS; continuous glucose monitors
Sponsor: Senator Payne, LD 27
Committee on Health & Human Services
Overview
Directs the Arizona Health Care Cost Containment System (AHCCCS) to require its contractors to provide members with continuous glucose monitors through both a pharmacy benefit and a durable medical equipment benefit. Prescribes requirements regarding coverage for continuous glucose monitors.
History
AHCCCS is Arizona's Medicaid program that oversees contracted health plans for the delivery of health care to individuals and families who qualify for Medicaid and other medical assistance programs. Through contracted health plans across the state, AHCCCS delivers health care to qualifying individuals including low-income adults, their children or people with certain disabilities. Current statute outlines covered health and medical services offered to AHCCCS members (A.R.S. § 36-2907).
According to the National Institute of Diabetes and Digestive and Kidney Disease, continuous glucose monitoring means using a device to automatically estimate a person's blood glucose level throughout the day and night. A person can see what their blood glucose level is at any time and review how their blood glucose level changes over a period of time from a few hours to days. A continuous glucose monitor is the device used to monitor a person's glucose level every few minutes and to keep track of the glucose levels over time. It has three parts which include a: 1) sensor that can either be inserted under the person's skin and held in place with a sticky patch or that can be implanted under the skin; 2) transmitter that sends the glucose levels collected by the sensor; and 3) software that receives the person's glucose levels from the transmitter and is stored on a smartphone, insulin pump or a separate device known as a receiver.
Provisions
1. Directs AHCCCS to require its contractors to provide continuous glucose monitors to members through both a pharmacy benefit and a durable medical equipment benefit. (Sec. 1)
2. Allows an AHCCCS member's prescribing provider to determine the appropriate option for the member. (Sec. 1)
3. Requires AHCCCS to update the coverage criteria for continuous glucose monitors to align with the current standards of care. (Sec. 1)
4. Requires the criteria for coverage of continuous glucose monitors to be consistent regardless of whether an AHCCCS member receives the continuous glucose monitor as a pharmacy benefit or a durable medical equipment benefit. (Sec. 1)
5. Directs AHCCCS to post the criteria for coverage of continuous glucose monitors as a standalone document that is easily accessible on its public website. (Sec. 1)
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9. SB 1132
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