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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