Health

California Medicaid Program Eases Authorization Requirements for Diabetes Supplies

courtesy of kffhealthnews.org

Life-Saving Supplies

June Voros relies on a continuous glucose monitor to manage her Type 1 diabetes. However, obtaining the supplies needed to make the monitor work was a tedious and stressful process for Voros, who is covered by California's Medicaid program, Medi-Cal. She had to navigate through separate approvals for each item and often experienced delays and shortages. But starting in October, Medi-Cal began relaxing prior authorization requirements, making it easier for Voros and others with diabetes to access the supplies they need.

Streamlining the Process

Previously, authorizations for diabetes supplies lasted only six months, which often resulted in complications for patients like Voros. Under the new rules, authorizations are extended to one year and can include all necessary supplies. Patients can now receive 90 days' worth of supplies and medications at once. The state is also implementing a policy that allows patients to obtain approvals from their healthcare providers through phone or video consultations, eliminating the need for in-person visits.

Improved Coverage

Over the past two years, California has expanded coverage for continuous glucose monitors and related supplies. This includes patients with Type 1 diabetes, Type 2 diabetes, gestational diabetes, and hypoglycemia. Previously, access to these monitors was limited to certain patients on a case-by-case basis. The enhanced coverage also includes newer and more advanced devices, such as the Dexcom G7, which is highly popular among diabetes patients.

Saving Lives and Money

Patient advocates and state health officials believe that these changes will have a significant impact on improving the lives of diabetes patients. By giving them more control over their blood sugar and ensuring timely access to supplies, the changes aim to prevent complications and reduce hospitalizations. The state hopes to provide diabetes patients with the care they need to lead healthy and fulfilling lives.

Personal Impact

For June Voros, the new preauthorization process and improved access to supplies have been life-changing. Before getting her continuous glucose monitor, she experienced frequent seizures and hospitalizations due to her diabetes. The bureaucratic hurdles and shortages of supplies caused immense stress for Voros. However, with the changes implemented by Medi-Cal, she now receives her supplies on time and feels better than ever.

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