CGM Anti-Denial Campaign Website

All you need to fight for CGM coverage.

thomas radcliffe
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  • Safety Harbor, FL
  • United States
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State Law in Florida

There should be no question!The 2009 Florida StatutesTitle XXXVIIINSURANCEChapter 627INSURANCE RATES AND CONTRACTS627.6408  Diabetes treatment services.--(1)  A health insurance policy or group…Continue

Started Mar 13, 2010

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Aug 4, 2016
kiyoumins dcsafsg commented on thomas radcliffe's blog post Medicaid Based Coverage in Florida
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Medicaid Based Coverage in Florida

As of this last week we have been successful in obtaining coverage for a CGM (Dexcom) in Florida in a Medicaid Based HMO. The private provider was Healthease (Wellcare).A Clinical Guideline Policy now exists (HS-138).http://www.wellcare.com/WCAssets/corporate/assets/HS138_Continuous_Glucose_Monitoring.pdf See More
Mar 23, 2010
thomas radcliffe left a comment for Gina Capone
"As of this last week we have been successful in obtaining coverage for a CGM (Dexcom) in Florida in a Medicaid Based HMO. The private provider was Healthease (Wellcare). A Clinical Guideline Policy now exists…"
Mar 23, 2010
thomas radcliffe posted a blog post

Medicaid Based Coverage in Florida

As of this last week we have been successful in obtaining coverage for a CGM (Dexcom) in Florida in a Medicaid Based HMO. The private provider was Healthease (Wellcare).A Clinical Guideline Policy now exists (HS-138).http://www.wellcare.com/WCAssets/corporate/assets/HS138_Continuous_Glucose_Monitoring.pdf See More
Mar 23, 2010
thomas radcliffe posted a discussion

State Law in Florida

There should be no question!The 2009 Florida StatutesTitle XXXVIIINSURANCEChapter 627INSURANCE RATES AND CONTRACTS627.6408  Diabetes treatment services.--(1)  A health insurance policy or group health insurance policy sold in this state must provide coverage for all medically appropriate and necessary equipment, supplies, and diabetes outpatient self-management training and educational services used to treat diabetes, if the patient's treating physician or a physician who specializes in the…See More
Mar 13, 2010
thomas radcliffe posted a blog post

CGM Medicaid Florida

Hi,I am the Permanent Legal Guardian of a 9 year old type 1. She has had a prescription for a CGM for months now and her insurance, which is a Medicaid based HMO has denied coverage.We have been through a grievance, first level appeal, second level appeal, an administrative reconsideration of the second level appeal, and are now beginning the State Administrative Fair Hearing process before a hearing officer.And we are likely to lose. We have done all of the right things, given them all the…See More
Oct 17, 2009

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Which insurance company denied you?
Healthease
What kind of CGM do you have/want?
Minimed Real-Time or Guardian
How did you hear about the CGM Anti-Denial Petition?
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Thomas radcliffe's Blog

Medicaid Based Coverage in Florida

As of this last week we have been successful in obtaining coverage for a CGM (Dexcom) in Florida in a Medicaid Based HMO. The private provider was Healthease (Wellcare).

A Clinical Guideline Policy now exists (HS-138).

http://www.wellcare.com/WCAssets/corporate/assets/HS138_Continuous_Glucose_Monitoring.pdf




Posted on March 23, 2010 at 2:51pm — 2 Comments

CGM Medicaid Florida

Hi,

I am the Permanent Legal Guardian of a 9 year old type 1. She has had a prescription for a CGM for months now and her insurance, which is a Medicaid based HMO has denied coverage.



We have been through a grievance, first level appeal, second level appeal, an administrative reconsideration of the second level appeal, and are now beginning the State Administrative Fair Hearing process before a hearing officer.



And we are likely to lose. We have done all of the… Continue

Posted on October 17, 2009 at 9:00pm — 2 Comments

Comment Wall (1 comment)

At 8:24am on May 10, 2012, STELLA KWALE said…


Good Day,

How is everything with you, I picked interest on you after going through your short profile and deemed it necessary to write you immediately. I have something very vital to disclose to you, but I found it difficult to express myself here, since it's a public site.Could you please get back to me on:( mrsstellakwale@gmail.com ) for the full details.

Have a nice day

Thanks God bless.

Mrs Stella.

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Blog Posts

Medicaid Based Coverage in Florida

Posted by thomas radcliffe on March 23, 2010 at 2:51pm — 2 Comments

Security of medical records

Posted by lee w on January 24, 2010 at 8:30pm — 2 Comments

treatment with coverage

Posted by Cindy Fallsen on December 9, 2009 at 2:44pm — 3 Comments

CGM Medicaid Florida

Posted by thomas radcliffe on October 17, 2009 at 9:00pm — 2 Comments

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Patty Dziak left a comment for qizhenapp
"I'm wanting to change from dexcom to Medtronic sensors and it's going to cost me approximately $1290.00 just for sensor and transmitter. I pay for Medicare and Mutual of Omaha every month plus Humana almost $400.00 a month on disability…"
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