Today, the American Diabetes Association® (ADA) submitted a letter with the Diabetes Leadership Council, Diabetes Patient Advocacy Coalition, and nine other groups urging Congress to block or delay inclusion of continuous glucose monitors (CGMs) and insulin pumps in the Medicare competitive bidding program (CBP).
Despite the ADA sharing extensive concerns of the proposed rule , the Centers for Medicare and Medicaid (CMS) finalized a new, untested payment model for CGMs and insulin pumps in the Calendar Year 2026 Home Health Prospective Payment System rule that includes these devices in the CBP beginning in January 2028. Competitive bidding has historically limited the number of supplies and devices available to patients. Applying it to CGMs and insulin pumps could reduce choice and increase administrative burdens and barriers, ultimately reducing access to the systems that work best for patients’ individual needs and diabetes management. The CBP model would change the way these diabetes devices are managed and received, requiring them to be rented rather than owned. Under CBP, beneficiaries would have to ship old devices back to suppliers before getting a new device. It also does not include enforceable requirements for suppliers to provide the combination of devices necessary for people with diabetes, as not all CGMs and insulin pumps are able to interact with each other. CMS is only giving stakeholders six months to transition to this new model, requiring beneficiaries to switch suppliers, and potentially devices and providers, to recertify that beneficiaries meet coverage requirements for the devices leading to additional patient visits and lab tests.
CGMs and insulin pumps are critical elements of diabetes management, as stated in the ADA’s Standards of Care in Diabetes. Research and real-world data show that these devices provide significant glycemic improvements in people with diabetes and are cost-effective by reducing hospitalizations and emergency department visits.
“We are concerned that CMS is moving forward with applying the competitive bidding program to CGMs and insulin pumps without taking into consideration the barriers this may present for Medicare beneficiaries living with diabetes and the health professionals who support them,” said Catherine Ferguson, senior vice president of policy, regulatory, and federal affairs.
The ADA urges Congress to delay inclusion of CGMs and insulin pumps in the CBP until CMS can ensure that beneficiary safety and access to these critical diabetes technologies are not at risk. Read the full letter here.
###
About the American Diabetes Association
The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to end diabetes and helping people thrive. For 86 years, the ADA has driven discovery and research to treat, manage, and prevent diabetes while working relentlessly for a cure. Through advocacy, program development, and education we work to improve the quality of life for the over 155 million Americans living with diabetes or prediabetes. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (800-342-2383). Join us in the fight on Facebook (American Diabetes Association), Spanish Facebook (Asociación Americana de la Diabetes), LinkedIn (American Diabetes Association), and Instagram (@AmDiabetesAssn). To learn more about how we are advocating for everyone affected by diabetes, visit us on X (@AmDiabetesAssn).
