Barbie gets a CGM, but will Medicare beneficiaries keep theirs?

I’m out of shape. That is, I was feeling out of shape, and out of my element, when, ahead of the July 4th holiday, I found myself trying to report and write an initial follow-up story to CMS’s proposed plans for the next round of competitive bidding.  

Bid ceilings? Remote Item Delivery? Wake me up when it’s over. 

But I’m here today to talk specifically about the proposal to include continuous glucose monitors (CGMs) in the program. Providers are, once again, not fans. For one thing, when it comes to the bid program, CGMs are a whole new territory. They’ve only been on the market for a short time, relative to glucometers and test strips, which were the hot-ticket item CMS tried to beat the profit margin out of in previous rounds of bidding. 

When you take into account that it’s only been since about mid-2023 that CMS also began covering the devices for beneficiaries with Type 2 diabetes, well, that’s nothing in government years. The ink is barely dry on the LCDs and billing codes. 

These devices are more sophisticated than the aforementioned glucometers, something providers say – and I agree – that CMS is overlooking. These devices have completely changed the game for diabetes and I fear that, if CMS clamps down on reimbursement and access, patients will suffer.  

I’ve written about the bid program, and the inclusion of diabetes, in its various forms, since I started at HME News many moons ago. And while I can’t draw an apples-to-apples comparison between the upcoming round and previous rounds, I think it’s fair to say the results probably won’t be any better this time around. 

When trying to pull up a few old stories on our website about this, I hesitated trying to recall an appropriate search time. Oh yes. “Draconian.” 

That pulled up a couple of doozies, including the aptly titled “Bottom drops out of diabetes market” from 2013. In that article, providers were scratching their heads over the rock bottom payment amounts for the diabetes national mail order program: 72% lower than the existing fee schedule. 

Will we see history repeat itself? Will CMS fail to see the projected savings and scrap the program again? Stay tuned. 

Amid the whirlwind return of bidding, Mattel has launched a Type 1 Barbie, complete with CGM and insulin pump. Let me tell you: In the diabetes community, this is a Big Deal. My online algorithms keep kicking up the story: The New York Times, CBS, CNN – you name it, they’ve featured it this week.  

I’m neither a kid with diabetes nor a Barbie aficionado, but I love it. I haven’t been this excited over a Barbie doll since they launched the Stevie Nicks Barbie in 2023.  

But I can't help but wonder, as Barbie gets a CGM, will Medicare beneficiaries get to keep theirs?