OIG Report Highlights Medicare Overpayments for Continuous Glucose Monitors

The U.S. Department of Health and Human Services Office of the Inspector General (OIG) released a report highlighting that Medicare payments for continuous glucose monitors (CGMs) and related supplies substantially exceeded the suppliers' acquisition costs between July 2022 and June 2023. Medicare Part B payments surged from $109 million in 2018 to $1.3 billion in 2023, with payments surpassing supplier costs by 69% in one year and total costs by 8%. Most Medicare payments covered monthly supply costs, as CGMs themselves require infrequent replacement. The report also identified $7 million in potential overpayments caused by improper coding. To address these discrepancies, OIG recommended actions to prevent overpayments, including supporting reductions in Medicare payment rates for CGMs and supplies. These recommendations align with updates to the competitive bidding program to help ensure payment rates better reflect actual supplier costs and improve Medicare's cost efficiency in managing diabetes technology supplies.