25 LC 52 0828S
The Senate Committee on Health and Human Services offered the following
substitute to HB 352:
A BILL TO BE ENTITLED
AN ACT
To amend Code Section 49-4-159.4 of the Official Code of Georgia Annotated, relating to1
coverage for continuous glucose monitors, so as to revise coverage criteria to include2
Medicaid recipients with gestational diabetes; to provide for related matters; to provide for3
a short title; to repeal conflicting laws; and for other purposes.4
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:5
SECTION 1.6
This Act shall be known and may be cited as the "Georgia Gestational Diabetes Management7
Act."8
SECTION 2.9
Code Section 49-4-159.4 of the Official Code of Georgia Annotated, relating to coverage for10
continuous glucose monitors, is amended by revising subsection (a) as follows:11
"(a) On and after July 1, 2023 2025, the department shall include coverage for continuous12
glucose monitors as a benefit under Medicaid via the most cost-effective benefit delivery13
channel. The criteria for such coverage shall be updated to align with current standards of14
care and shall include, but shall not be limited to, requirements that:15
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(1) The recipient has been diagnosed with diabetes mellitus by a treating practitioner;16
(2) The recipient's treating practitioner has concluded that the recipient or the recipient's17
caregiver has had sufficient training in using a continuous glucose monitor as evidenced18
by the provision of a prescription therefor; and19
(3) The recipient:20
(A) Is treated with at least one daily administration of insulin; or21
(B) Has gestational diabetes; or22
(C) Has a history of problematic hypoglycemia with documentation of at least one of23
the following:24
(i) Recurrent level 2 hypoglycemic events (glucose less than 54 mg/dL (3.0 mmol/L))25
that persist despite two or more attempts to adjust medication, modify the diabetes26
treatment plan, or both; or27
(ii) A history of a level 3 hypoglycemic event (glucose less than 54 mg/dL28
(3.0 mmol/L)) characterized by altered mental or physical state requiring third-party29
assistance for treatment for hypoglycemia."30
SECTION 3.31
All laws and parts of laws in conflict with this Act are repealed.32
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