Policy Change for Preferred Blood Glucose Meters and Test Strips

By May 15, 2025: (1) Billing team must update claims processing system to flag and require prior authorization for any LifeScan OneTouch blood glucose meters and test strips submitted for BadgerCare Plus and Medicaid members. (2) Pharmacy providers must identify all patients currently prescribed LifeScan OneTouch products and work with prescribers to transition them to preferred manufacturers listed on the ForwardHealth Diabetic Supply List Quick Reference. (3) Clinical staff must be trained that prior authorization for non-preferred meters requires documentation of one of three criteria: insulin pump compatibility, medical condition requiring specialized meter (e.g., talking meter for visual impairment), or clinical provider documentation that patient cannot use preferred products. (4) Designate staff to submit Prior Authorization Drug Attachment for Blood Glucose Meters and Test Strips form (F-00239) and Prior Authorization Request Form (F-11018) when non-preferred supplies are medically necessary. (5) Update patient communication templates to notify affected members of the change and required prescriber coordination. Failure to obtain prior authorization will result in claim denials; claims submitted without proper documentation may be denied or recouped by Wisconsin DHS.