Text: S03021 Text: S03023 Text: S03000 - S03099 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend Senate File 8 as follows:
1 2 #1. By striking everything after the enacting
1 3 clause and inserting the following:
1 4 "Section 1. NEW SECTION. 514C.14 DIABETES
1 5 COVERAGE.
1 6 1. Notwithstanding the uniformity of treatment
1 7 requirements of section 514C.6, a policy or contract
1 8 providing for third-party payment or prepayment of
1 9 health or medical expenses shall provide coverage
1 10 benefits for the cost associated with equipment,
1 11 supplies, and self-management training and education
1 12 for the treatment of all types of diabetes mellitus
1 13 when prescribed by a physician licensed under chapter
1 14 148, 150, or 150A. Coverage benefits shall include
1 15 coverage for the cost associated with all of the
1 16 following:
1 17 a. Blood glucose meter and glucose strips for home
1 18 monitoring.
1 19 b. Payment for diabetes self-management training
1 20 and education only under all of the following
1 21 conditions:
1 22 (1) The physician managing the individual's
1 23 diabetic condition certifies that such services are
1 24 needed under a comprehensive plan of care related to
1 25 the individual's diabetic condition to ensure therapy
1 26 compliance or to provide the individual with necessary
1 27 skills and knowledge to participate in the management
1 28 of the individual's condition.
1 29 (2) The diabetic self-management training and
1 30 education program is certified by the Iowa department
1 31 of public health. The department shall consult with
1 32 the American diabetes association, Iowa affiliate, in
1 33 developing the standards for certification of diabetes
1 34 education programs as follows:
1 35 (a) Initial training shall cover up to ten hours
1 36 of initial outpatient diabetes self-management
1 37 training within a continuous twelve-month period for
1 38 each individual that meets any of the following
1 39 conditions:
1 40 (i) A new onset of diabetes.
1 41 (ii) Poor glycemic control as evidenced by a
1 42 glycosylated hemoglobin of nine and five-tenths or
1 43 more in the ninety days before attending the training.
1 44 (iii) A change in treatment regimen from no
1 45 diabetes medications to any diabetes medication, or
1 46 from oral diabetes medication to insulin.
1 47 (iv) High risk for complications based on poor
1 48 glycemic control; documented acute episodes of severe
1 49 hypoglycemia or acute severe hyperglycemia occurring
1 50 in the past year during which the individual needed
2 1 third-party assistance for either emergency room
2 2 visits or hospitalization.
2 3 (v) High risk based on documented complications of
2 4 a lack of feeling in the foot or other foot
2 5 complications such as foot ulcer or amputation, pre-
2 6 proliferative or proliferative retinopathy or prior
2 7 laser treatment of the eye, or kidney complications
2 8 related to diabetes, such as macroalbuminuria or
2 9 elevated creatinine.
2 10 (b) An individual who receives the initial
2 11 training shall be eligible for a single follow-up
2 12 training session of up to one hour each year.
2 13 2. a. This section applies to the following
2 14 classes of third-party payment provider contracts or
2 15 policies delivered, issued for delivery, continued, or
2 16 renewed in this state on or after July 1, 1999:
2 17 (1) Individual or group accident and sickness
2 18 insurance providing coverage on an expense-incurred
2 19 basis.
2 20 (2) An individual or group hospital or medical
2 21 service contract issued pursuant to chapter 509, 514,
2 22 or 514A.
2 23 (3) An individual or group health maintenance
2 24 organization contract regulated under chapter 514B.
2 25 (4) Any other entity engaged in the business of
2 26 insurance, risk transfer, or risk retention, which is
2 27 subject to the jurisdiction of the commissioner.
2 28 (5) A plan established pursuant to chapter 509A
2 29 for public employees.
2 30 (6) An organized delivery system licensed by the
2 31 director of public health.
2 32 b. This chapter shall not apply to accident only,
2 33 specified disease, short-term hospital or medical,
2 34 hospital confinement indemnity, credit, dental,
2 35 vision, Medicare supplement, long-term care,
2 36 disability income insurance coverage, coverage issued
2 37 as a supplement to liability insurance, workers'
2 38 compensation or similar insurance, or automobile
2 39 medical payment insurance.
2 40 Sec. 2. Section 509.3, subsection 6, Code 1999, is
2 41 amended by striking the subsection.
2 42 Sec. 3. Section 514.7, unnumbered paragraph 3,
2 43 Code 1999, is amended by striking the unnumbered
2 44 paragraph.
2 45 Sec. 4. Section 514B.1, subsection 5, paragraph c,
2 46 Code 1999, is amended by striking the paragraph."
2 47
2 48
2 49
2 50 O. GENE MADDOX
3 1
3 2
3 3
3 4 JOHN W. JENSEN
3 5
3 6
3 7
3 8 PATRICK J. DELUHERY
3 9 SF 8.201 78
3 10 mj/gg
Text: S03021 Text: S03023 Text: S03000 - S03099 Text: S Index Bills and Amendments: General Index Bill History: General Index
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