Numerous studies have demonstrated the clinical value of continuous glucose monitoring (CGM) in type 1 diabetes and type 2 diabetes populations. However, the eligibility criteria for CGM coverage required by the Centers for Medicare & Medicaid Services (CMS) ignore conclusive evidence that supports CGM use in various diabetes populations that are currently deemed ineligible. This article discusses the limitations and inconsistencies of the CMS eligibility criteria relative to current scientific evidence and proposes workable solutions to address this issue and improve the safety and care of all individuals with diabetes.

It has been one year--since January 1, 2013--that comprehensive medication review has been recognized as a medication therapy management (MTM) service that must be offered annually by Medicare Part D prescription drug plans to \"qualified beneficiaries.\" This requirement solidifies the Centers for Medicare & Medicaid Services\' commitment to ensure all beneficiaries, including those in long-term care facilities, receive quality MTM services. Consultant pharmacists, who have long provided federally mandated medication regimen review services, may have their first opportunity to be paid for the additional services that they provide to individual Medicare beneficiaries residing in those facilities.