Medi-Cal: covered benefits: continuous glucose monitors.
If enacted, AB 848 would expand the benefits available under Medi-Cal, which provides coverage for low-income individuals in California. By adding CGMs to the list of covered benefits, the legislation would address existing healthcare gaps for diabetic patients who rely on these devices for continuous monitoring of their blood glucose levels. This amendment is contingent upon federal financial participation, meaning that the effectiveness and full implementation of the bill depend on the state obtaining necessary federal approvals.
Assembly Bill 848, introduced by Assembly Member Gray, aims to amend Section 14132 of the Welfare and Institutions Code specifically to include continuous glucose monitors (CGMs) and associated supplies as a covered benefit under the Medi-Cal program. The primary objective of this bill is to ensure that low-income individuals suffering from diabetes can access necessary medical equipment to manage their condition effectively, ultimately improving their healthcare outcomes and reducing long-term health complications related to diabetes.
The sentiment surrounding AB 848 is generally positive, particularly among healthcare advocates and lawmakers who recognize the importance of making diabetes management more accessible to economically disadvantaged populations. Supporters argue that providing CGMs through Medi-Cal will save the state long-term healthcare costs by preventing severe complications that can arise from poorly managed diabetes. However, some skepticism remains regarding the logistics of implementation, such as the need for rebate agreements with manufacturers and the possibility of utilization controls.
Notably, a point of contention in AB 848 may arise from the requirement that the manufacturer of the CGMs enter into a rebate agreement with the state department. Some stakeholders have raised concerns over whether this could limit access to various brands or types of monitors, potentially affecting patient choice and the quality of care. Additionally, the decision to allow the department to implement the bill's provisions via all-county letters without additional regulatory action raises questions about the transparency and oversight of how these changes will be enacted.