On Nov. 28, 2025, the Centers for Medicare & Medicaid Services (CMS) finalized a rule that will change how Medicare pays for insulin pumps and continuous glucose monitors (CGMs) by moving these devices into a competitive bidding process to be implemented by 2028. CMS cited the findings of the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) report showing waste associated with Medicare payments related to CGMs as the reason for the changes.
Due to the tireless efforts of those in the type 1 diabetes community, clinical leaders, and policymakers, use of insulin pumps and CGMs is the standard of care, and CMS has long recognized the importance of access to these devices. While Breakthrough T1D supports CMS’s goals of increasing choice and lowering costs for diabetes devices for people who rely on these devices, we are concerned that the announced plans could disrupt care. It is essential that any such changes be implemented carefully so as not to interrupt care or restrict access to currently covered devices.
We remain committed to working with CMS and partners across the diabetes community to ensure this transition lowers costs and strengthens, rather than disrupts, access to life-changing technology for people with type 1 diabetes.