CGM Anti-Denial Campaign Website

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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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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

Profile Information

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 — 4 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 — 4 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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