Wells says CBP proposal for CGMs expected, insulin pumps inclusion ‘a surprise’

Wells Fargo analyst Larry Biegelsen notes that CMS released its proposed CY26 Home Health Prospective Payment System rule, in which it recommended a new competitive bidding program that includes insulin pumps and CGMs. CMS has proposed to classify all CGMs and insulin pumps as “as items requiring frequent and substantial servicing” in an effort to increase device choice and access. CMS is also proposing to move class II devices into the competitive bidding program. Abbott (ABT), DexCom (DXCM), Tandem Diabetes (TNDM), Insulet (PODD), and Beta Bionics (BBNX) are all class II devices. Medtronic (MDT) is a class III device and would remain under fee schedule reimbursement. Lastly, the firm’s impression is that CBP would not impact items covered by Medicare Part D. This means that Insulet may be excluded from CBP because their pump goes through the pharmacy under Medicare Part D. Wells is not surprised to see CBP proposal for CGMs, but is surprised that insulin pumps were also included.