Medtronic insulin pumps and continuous glucose monitors will be considered out-of-network effective Jan. 1, 2012
We've amended our Durable Medical Equipment (DME) vendor contracts for insulin pumps and continuous glucose monitors for effective dates of Jan. 1, 2012, and beyond. Medtronic, one of three manufacturers of insulin pumps, was unwilling to participate in the Regence BlueShield network under the same terms as other medical equipment providers. Instead, Medtronic demanded a substantial increase in reimbursement, which would have resulted in significant additional cost for our members and employers. We would not agree to this increase, and as a result, Medtronic has decided to terminate its contract with us effective Jan. 1, 2012.
This change applies to all Regence group and Individual members, including our Regence MedAdvantage and FEP members.
Members who are currently using Medtronic insulin pumps and continuous glucose monitors can purchase supplies from Edgepark Medical Supplies at their in-network benefit level. Members can contact Edgepark Medical Supplies at 1 (800) 321-0591 or www.edgepark.com.
Members who require a new pump or replacement pump or continuous glucose monitor will receive their highest level of benefits when they purchase Animas or Roche insulin pumps, or when they use patch pump (OmniPod) technology through Edgepark or other participating in-network DME providers.
Members will still have access to all brands of pumps and continuous glucose monitors, including Medtronic (Minimed). However, members who select Medtronic equipment will utilize their out- of-network benefits and be financially responsible for any differences between our allowed amount and the purchase price offered by the out-of-network provider.
Members who use insulin pumps or continuous glucose monitors or who have submitted claims for diabetic supplies in the past will be notified of this change. We're also notifying physicians so they can advise their patients appropriately.
We know that this change may cause some confusion and disruption for some members, but our 2012 DME agreements for insulin pumps and continuous glucose monitors will result in substantial savings for members and employers while still providing members with a wide range of equipment options. We're committed to ensuring that our members have access to the care they need while keeping costs affordable.
If you have any questions, please contact your Regence sales executive.
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