Text: HF02159 Text: HF02161 Text: HF02100 - HF02199 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 514C.14 DIABETES COVERAGE.
1 2 1. a. Notwithstanding the uniformity of treatment
1 3 requirements of section 514C.6, a policy or contract providing
1 4 for third-party payment or prepayment of health or medical
1 5 expenses shall provide coverage benefits for the costs
1 6 associated with equipment, supplies, and outpatient self-
1 7 management training and education, including medical nutrition
1 8 therapy, for the treatment of insulin-dependent diabetes,
1 9 insulin-using diabetes, gestational diabetes, and non-insulin-
1 10 using diabetes if prescribed by a licensed health care
1 11 provider authorized to prescribe such items.
1 12 b. Diabetes outpatient self-management training and
1 13 education shall be provided by a licensed health care provider
1 14 with expertise in treating diabetes.
1 15 2. Benefits provided pursuant to this section shall be
1 16 subject to the same deductible or coinsurance requirements as
1 17 all other covered benefits under a policy or contract.
1 18 3. This section applies to the following classes of third-
1 19 party payment provider contracts or policies delivered, issued
1 20 for delivery, continued, or renewed in this state on or after
1 21 July 1, 1998:
1 22 a. Individual or group accident and sickness insurance
1 23 providing coverage on an expense-incurred basis.
1 24 b. An individual or group hospital or medical service
1 25 contract issued pursuant to chapter 509, 514, or 514A.
1 26 c. An individual or group health maintenance organization
1 27 contract regulated under chapter 514B.
1 28 d. An individual or group Medicare supplemental policy,
1 29 unless coverage pursuant to such policy is preempted by
1 30 federal law.
1 31 e. An organized delivery system licensed by the director
1 32 of public health.
1 33 EXPLANATION
1 34 This bill provides that a third-party payor of health or
1 35 medical expenses shall provide coverage benefits to an insured
2 1 or enrollee for the costs associated with equipment, supplies,
2 2 and outpatient self-management training and education,
2 3 including medical nutrition therapy, for the treatment of
2 4 insulin-dependent diabetes, insulin-using diabetes,
2 5 gestational diabetes, and non-insulin-using diabetes if
2 6 prescribed by a licensed health care provider authorized to
2 7 prescribe such items.
2 8 This bill provides that the section applies to the third-
2 9 party payor contracts or policies delivered, issued for
2 10 delivery, continued, or renewed in this state on or after July
2 11 1, 1998, by an individual or group accident and sickness
2 12 insurance providing coverage on an expense-incurred basis; an
2 13 individual or group hospital or medical service contract
2 14 issued pursuant to chapter 509, 514, or 514A; an individual or
2 15 group health maintenance organization contract regulated under
2 16 chapter 514B; an individual or group Medicare supplemental
2 17 policy, unless coverage pursuant to such policy is preempted
2 18 by federal law; and an organized delivery system licensed by
2 19 the director of public health.
2 20 LSB 3479HH 77
2 21 mj/sc/14
Text: HF02159 Text: HF02161 Text: HF02100 - HF02199 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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