TN HB0428

Requires TennCare to cover continuous glucose monitors (CGMs) for enrollees with Type 1 diabetes, gestational diabetes, problematic hypoglycemia history, or insulin dependency

Type 2 diabetes patients qualify for CGM coverage if they meet additional criteria including hemoglobin A1C of 7% or higher, frequent hypoglycemia episodes below 50 mg/dl, hypoglycemic unawareness, dawn phenomenon with fasting blood sugars exceeding 200 mg/dl, or ER visits/hospitalizations for ketoacidosis or hypoglycemia

CGM must be prescribed by or in consultation with an endocrinologist or healthcare practitioner experienced in diabetes management who documents the patient meets eligibility criteria

Effective date is January 1, 2026