Glucose Monitors LCD Change as of November 1, 2012

Glucose Monitors LCD Change

CMS has issued a change to the Glucose Monitors LCD (Local Coverage Determination) effective November 1, 2012.  This change is contradictory to the LCD with respect of Refill Requirements, Prescription Requirements and Continued Use and Documentation.  There are additional changes coming on January 1, 2013.  We are advising not to change any procedure or process for diabetic supplies at this time. 

In addition, CMS has created three “Delivery Methods” in the LCD for delivery of diabetic supplies to the patient.  Your Delivery Method would be classified as “Method 1 – Direct Delivery to the Beneficiary by the Supplier”.


We will keep you informed as this LCD is clarified and implemented.

Express Scripts/Medco

Express Scripts 2012 Medicare Part D Compliance Attestation, Page 2, paragraph 4, last line states OIG Exclusion verification should be conducted “Monthly”.  This is apparently an Express Scripts/Medco requirement because Jeff cannot find any reference of a change in any federal statute. Jeff does not understand why this requirement was changed.  Verification is made on date of hiring and annually thereafter.

We will keep you updated with all future changes.

Jenny Schell

Jenny is a Board Certified DME Specialist and for the last 9 years has assisted independent pharmacies, home health care facilities, medical supply companies, physicians and small healthcare practices in choosing the best comprehensive customized healthcare compliance and consulting services they require.

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