House Bill 352 (AS PASSED HOUSE AND SENATE)
By: Representatives Seabaugh of the 34th, Cooper of the 45th, Mathis of the 133rd, Taylor of
the 173rd, Reese of the 140th, and others
A BILL TO BE ENTITLED
AN ACT
To amend Code Section 49-4-159.4 of the Official Code of Georgia Annotated, relating to
coverage for continuous glucose monitors, so as to revise coverage criteria to include
Medicaid recipients with gestational diabetes; to provide for related matters; to provide for
a short title; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
This Act shall be known and may be cited as the "Georgia Gestational Diabetes Management
Act."
SECTION 2.
Code Section 49-4-159.4 of the Official Code of Georgia Annotated, relating to coverage for
continuous glucose monitors, is amended by revising subsection (a) as follows:
"(a) On and after July 1, <del>2023</del> <ins>2025,</ins> the department shall include coverage for continuous
glucose monitors as a benefit under Medicaid via the most cost-effective benefit delivery
channel. The criteria for such coverage shall be updated to align with current standards of
care and shall include, but shall not be limited to, requirements that:
(1) The recipient has been diagnosed with diabetes mellitus by a treating practitioner;
(2) The recipient's treating practitioner has concluded that the recipient or the recipient's
caregiver has had sufficient training in using a continuous glucose monitor as evidenced
by the provision of a prescription therefor; and
(3) The recipient:
(A) Is treated with at least one daily administration of insulin; <del>or
</del> (B) <ins>Has gestational diabetes; or
(C)</ins> Has a history of problematic hypoglycemia with documentation of at least one of
the following:
(i) Recurrent level 2 hypoglycemic events (glucose less than 54 mg/dL (3.0 mmol/L))
that persist despite two or more attempts to adjust medication, modify the diabetes
treatment plan, or both; or
(ii) A history of a level 3 hypoglycemic event (glucose less than 54 mg/dL
(3.0 mmol/L)) characterized by altered mental or physical state requiring third-party
assistance for treatment for hypoglycemia."
SECTION 3.
All laws and parts of laws in conflict with this Act are repealed.