Bill > HB1255

This bill amends the Arkansas Medicaid Program's coverage for continuous glucose monitors (CGMs), a medical device used by people with diabetes to track blood sugar levels in real-time. The bill expands the ways beneficiaries can obtain CGMs by allowing them to be acquired through two methods: (1) a prescription at a pharmacy as a pharmacy benefit, and (2) a written order from a healthcare practitioner through a durable medical equipment (DME) provider as a DME benefit. The bill also requires the Department of Human Services to implement consistent approval requirements for CGM coverage, regardless of whether the device is obtained through a pharmacy or a DME provider. Additionally, the bill mandates that reimbursement for CGMs provided by DME providers must be at least equivalent to Medicare reimbursement rates, which are determined using the Healthcare Common Procedure Coding System. Notably, the bill specifies that DME providers will not be required to submit a National Drug Code when submitting claims for CGMs, potentially simplifying the billing process.

Health and Social Services

https://arkleg.state.ar.us/Bills/Detail?id=hb1255&ddBienniumSession=2025%2F2025R