Letter to The Honorable Richard A. Stone. M.D. USAR (Ret.)
NAVAPD President, Dr. Samuel V. Spagnolo, M.D., recently reached out to Dr. Stone, Acting Undersecretary for Health at Veterans Health Administration, regarding the recent changes to Medicare coverage that affect veterans covered by Veterans Health Administration (VHA.)
Dear Dr. Stone,
On behalf of the National Association of Veteran Affairs Physicians and Dentists (NAVAPD), I am writing today to urge the Department of Veterans Affairs to review recent changes to Medicare coverage criteria for Continuous Glucose Monitor Systems (CGMs), and to consider whether similar changes would be warranted for veterans covered by Veterans Health Administration (VHA).
As you well know, VHA and Medicare CGM coverage policies closely align with requirements that must be met to cover usage of CGMs, including frequent blood glucose monitoring (r.e.2-4 times or more per day). On June 3rd, Medicare announced that it will update its local coverage determination (LCD) policy removing the frequent testing requirement on July 18, 2021.
As you will note, Medicare's Durable Medical Equipment Administrative Contractors concluded, "there is no evidence to support that frequent SMBG (>4 times per day) as a prerequisite for initiating CGM use is predictive of improved health outcomes." The DME MACs cited consensus clinical practice guidelines and consistent clinical evidence found through its literature analysis of randomized controlled trials and systematic reviews with meta-analyses to support this decision. NAVAPD values the importance of reforming the VA health care system to further improve quality and access in the 21st century.
Given this change in Medicare policy and the clinical indications supporting it, we recommend that YHA consider a similar step to provide the veterans we serve with comparable access to important and beneficial healthcare technologies.
Sincerely,
Samuel V. Spagnolo, M.D.
President - National Association of Veteran Affairs Physicians and Dentists
Serving Those Who Serve Our Veterans Since 1975