This bill mandates Medicaid coverage for continuous glucose monitors (CGMs) and related supplies for individuals diagnosed with diabetes who meet specific eligibility criteria. It amends Section 6 of P.L.1968, c.413 (C.30:4D-6) to include provisions that require a diagnosis of diabetes by a licensed healthcare practitioner, treatment with insulin or a history of problematic hypoglycemia, and adherence to prescribed usage guidelines for coverage. Recipients must also participate in follow-up care with their healthcare provider at least once every six months for the first 18 months after receiving the monitor. The bill further allows for coverage of expenses related to CGMs, including necessary repairs or replacement parts, contingent upon recipients meeting training requirements and any additional criteria established by the commissioner.

Additionally, the bill empowers the Commissioner of Human Services to apply for necessary State plan amendments or waivers to implement these changes and secure federal financial participation. The commissioner is authorized to adopt rules and regulations to facilitate the bill's objectives, with the ability to file these regulations immediately for a temporary period of up to six months. Overall, the legislation aims to improve diabetes management and patient outcomes by ensuring that eligible Medicaid recipients have access to essential monitoring technology.

Statutes affected:
Introduced: 30:4D-6