Policy must keep pace with innovation
Arkansas legislators mandated that their Medicaid program cover CGMs, protecting the state’s most vulnerable residents from dangerous and costly health complications.
To keep blood glucose levels in a safe range and avoid devastating complications like heart attacks, strokes, kidney failure, blindness, or amputations, people with diabetes must constantly adjust their care.
These devices provide real-time blood glucose readings throughout the day.
These pumps deliver insulin more precisely and flexibly than traditional methods.
AI-driven software links CGMs and insulin pumps, improving blood glucose control and helping patients avoid dangerous complications and trips to the emergency room.
These tools help patients keep their blood glucose within a healthy range for longer periods, improving health outcomes and lowering healthcare costs.
The American Diabetes Association now recommends CGMs as the standard of care for anyone with diabetes using insulin therapy, including youth and adults. It also recommends CGMs for some adults with Type 2 diabetes who use other glucose-lowering medications.
Despite these recommendations, Medicaid coverage of CGMs varies widely across states, with some covering them under prescription benefits while others classify them as durable medical equipment (DME). Across the country, coverage differentiates between people with Type 1 versus Type 2 diabetes as well as between children and adults. Some states create additional prior authorization barriers alongside prescriber and diabetes-specific requirements.
Arkansas legislators are leading the way by requiring their Medicaid program to cover CGMs for people with diabetes. This legislation helps patients access important tools to manage their disease and lower costs for the state.
Medicaid policies are shaped by federal guidelines, but individual states determine the details of benefits covered. Arkansas’s decision to cover CGMs helps patients avoid costly ER visits, hospital stays and treatment complications—driving overall cost efficiency to benefit all.
By expanding access to CGMs, Arkansas is improving health outcomes for its most vulnerable residents while managing state resources more efficiently. Other states can follow this example to reduce healthcare costs and improve care for people with diabetes.
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