Bill > HB0428

This bill requires TennCare (Tennessee's Medicaid program) to provide continuous glucose monitoring (CGM) devices to eligible enrollees with specific medical conditions. A CGM is a device that automatically tracks blood glucose levels through a sensor worn on the body. The bill mandates coverage for patients with Type 1 diabetes, gestational diabetes, a history of problematic hypoglycemia, or those requiring insulin. For patients with Type 2 diabetes, coverage is available if they meet specific medical criteria, such as having a hemoglobin A1C of 7% or higher, experiencing frequent hypoglycemia, having a history of hypoglycemic unawareness, experiencing dawn phenomenon with high fasting blood sugar, or having a history of emergency room visits or hospitalizations related to diabetes complications. The CGM must be prescribed by or in consultation with an endocrinologist or healthcare practitioner experienced in diabetes management who can document that the patient meets the specified eligibility requirements. The bill will take effect on January 1, 2026, and aims to improve diabetes management and patient care for TennCare enrollees.

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https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB0428&ga=114