36-2903.17. Administration; continuous glucose monitors; benefit status; coverage criteria; posting

The administration shall:

1. Require contractors to provide to members continuous glucose monitors through both a pharmacy benefit and a durable medical equipment benefit and to allow a member's prescribing provider to determine the appropriate option for the member.

2. Update the coverage criteria for continuous glucose monitors to align with the current standards of care.  The criteria for coverage shall be consistent regardless of whether a member receives the continuous glucose monitor as a pharmacy benefit or a durable medical equipment benefit.

3. Post the criteria for the coverage of continuous glucose monitors as a standalone document that is easily accessible on the administration's public website.