Public comment

Type 1 & LADA
1

I think someone is asking for public comment from the community on the topic of A1c.

One of the doctors posted it. I had to look up the acronyms to understand what I am reading.

NCQA = National Committee for Quality Assurance (NCQA) https://www.ncqa.org/

HEDIS = Healthcare Effectiveness Data and Information Set.

I think those private groups provide some sort of accreditation to health plans. They are not governmental.

What do you guys think? Is this something or nothing?

Epic says they will incorporate CGM data into the Electronic Medical Record (EMR) soon, so this might relate to that.

“:police_car_light: ATTENTION DIABETES ADVOCATES & HEALTHCARE INNOVATORS :police_car_light:
For decades, HbA1c has been the “gold standard” for measuring diabetes management. But anyone living with or treating diabetes knows that an A1C is just an average—it doesn’t tell the full story of the daily highs, lows, and the “rollercoaster” in between.

We have a massive opportunity to change the narrative. :loudspeaker:

The NCQA is currently seeking public comment on new HEDIS measures, and there is a pivotal shift on the table: the integration of Continuous Glucose Monitor (CGM) reporting.

This is our chance to move beyond solely looking at A1C and start prioritizing Time in Range (TIR).

Why this matters:
:white_check_mark: Real-Time Data: TIR reflects the daily lived experience of person with diabetes.
:white_check_mark: Better Outcomes: Reducing glycemic variability is key to preventing long-term complications.
:white_check_mark: Modern Medicine: It’s time our reporting standards catch up to the technology patients are actually using.

We need the voices of clinicians, advocates, and patients to ensure these measures reflect the future of care, not the past.

:backhand_index_pointing_down: Read the proposed measures here:https://wpcdn.ncqa.org/www-prod/wp-content/uploads/01.-CGD-E.pdf

I’m curious to hear from my network—is this the breakthrough in quality measurement we’ve been waiting for? What are your thoughts on transitioning the focus from A1C to CGM metrics?“

The post came from Dr Robert Gabby.

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2

The problem is that they will say 80-180 is “in range”.

So you can hover around 170 for weeks and they will say “100% in range!”

It just depends on how they classify range and if they use any intelligent metrics to analyze it.

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3

There are also requests for feedback from CMS (from https://www.patientrightsadvocate.org/)

“CMS has proposed updates to the Transparency in Coverage rule. Now is the time to weigh in.

CMS acknowledges what patients, employers, and researchers have experienced since 2022: posting massive pricing files alone has not delivered real transparency.

The proposed rule makes important improvements, including standardization and better data structure, and those changes deserve support.

But the proposal does not yet go far enough.

The current timeline delays implementation until 2028. There is no requirement for insurers to attest to the accuracy of their data. Key payment mechanics that determine what is actually paid remain undisclosed. Utilization files lack claim counts needed for meaningful comparison. And prescription drug pricing transparency still has no finalized path forward.

Transparency only works if the data is usable, accountable, and complete.
CMS is accepting public comments now. PatientRightsAdvocate encourages employers, purchasers, patients, and industry stakeholders to submit comments and help strengthen this rule so it delivers real accountability and real price transparency.

Comment deadline: February 23, 2026

Link Here: Regulations.gov “

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4

I do agree that A1C really doesn’t mean much…i say that for this reason…the A1C tests only capture data for the past 90-days. Since many of us only visit our Endo one time a year, they are only getting data for the past quarter from that A1C. Dexcom / Clarity app also only track 90-days.

So you could have been living in the 300s for the first 9 month but as long as you show up at that A1C test and the last 90 days have been managed, no way too know about the other 9 months until patient begins experiencing the “opathys” that result from prolonged hyperglycemia.