Older T1Ds: Article: Would you find home health care for injections useful?

I read this article today and was very interested in hearing from older T1Ds. I’m young and still have well-functioning body parts. Do any of you use home health care aides to give you injections? Is this something that you would find useful? Or do you find it suspicious?

Home Health Insulin Injections Draw More CMS Scrutiny
By Kerry Young, CQ HealthBeat Associate Editor

Medicare has signaled that it is taking a closer look at cases where diabetics get home health services to aid them with insulin injections, a field of care that has been noted for its potential for abuse and fraud.

The agency is seeking comments on a list of health conditions that appear to qualify people for such help, including amputations, rheumatoid arthritis and dementia. The review comes amid concerns that some people who could handle their own insulin needs, especially with pen injectors, are getting skilled nursing services solely for this purpose.

The Centers for Medicare and Medicaid Services raised the topic for discussion as part of a proposed rule used to make annual changes to payment policies on home health services. CMS said in the rule, released July 1, that it is not planning a change in its current policy regarding home health for insulin injections. Still, its consideration of the topic is seen as an alert.

“They are going to be scrutinizing these cases,” said Mary Carr, vice president for regulatory affairs for the National Association for Home Care and Hospice.

Carr said that she understands why CMS would raise the discussion about home health for insulin injections.

“I don’t think it’s an unreasonable request,” she said.

In the proposed rule, CMS notes that an inspector general report in 2013 found “systemic weakness that results in Medicare coverage of unnecessary home health care for diabetic patients.” OIG agents found “falsified medical records documenting patients having hand tremors and poor vision preventing them from drawing insulin into a syringe, visually verifying the correct dosage and injecting the insulin themselves, when the patients did not in fact suffer those symptoms,” CMS said in the proposed rule.

Treating diabetes will be one of the bigger challenges for Medicare as baby boomers age. The population of people enrolled in Medicare who have diabetes may rise from 8.2 million in 2009 to 14.6 million in 2034, according to a paper published in the journal Diabetes Care.

I am not that old, but if I needed the help i think it should be available or … I would be in a nursing home on medicaid!! How much would that cost?


Pen insulin injectors are rather easy to use. Since the insulin is already in the pen, perhaps shaky hands etc. would not be a problem but eye sight is essential. I don’t see how a TID using the injector pen could work very successfully with a home nurse coming by maybe once ? a day. I am a T1D and injections must be made prior to any food being consumed and this means a minimum of 5 injections (plus blood glucose checks) each day. I am 84.

Would a pump work better for those needing assistance? I have heard they are changed every 2-3 days. I have no idea if this would work with a home nurse visit since I don’t use one.

Sad to hear about the fraud involved with diabetic care.