Text: SF00007 Text: SF00009 Text: SF00000 - SF00099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 SENATE FILE 8 1 2 1 3 AN ACT 1 4 RELATING TO COVERAGE UNDER A POLICY OR CONTRACT PROVIDING 1 5 FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH OR MEDICAL 1 6 EXPENSES BY PROVIDING COVERAGE FOR COSTS ASSOCIATED WITH 1 7 EQUIPMENT, SUPPLIES, AND EDUCATION FOR THE TREATMENT OF 1 8 DIABETES. 1 9 1 10 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 1 11 1 12 Section 1. NEW SECTION. 514C.14 DIABETES COVERAGE. 1 13 1. Notwithstanding the uniformity of treatment 1 14 requirements of section 514C.6, a policy or contract providing 1 15 for third-party payment or prepayment of health or medical 1 16 expenses shall provide coverage benefits for the cost 1 17 associated with equipment, supplies, and self-management 1 18 training and education for the treatment of all types of 1 19 diabetes mellitus when prescribed by a physician licensed 1 20 under chapter 148, 150, or 150A. Coverage benefits shall 1 21 include coverage for the cost associated with all of the 1 22 following: 1 23 a. Blood glucose meter and glucose strips for home 1 24 monitoring. 1 25 b. Payment for diabetes self-management training and 1 26 education only under all of the following conditions: 1 27 (1) The physician managing the individual's diabetic 1 28 condition certifies that such services are needed under a 1 29 comprehensive plan of care related to the individual's 1 30 diabetic condition to ensure therapy compliance or to provide 1 31 the individual with necessary skills and knowledge to 1 32 participate in the management of the individual's condition. 1 33 (2) The diabetic self-management training and education 1 34 program is certified by the Iowa department of public health. 1 35 The department shall consult with the American diabetes 2 1 association, Iowa affiliate, in developing the standards for 2 2 certification of diabetes education programs as follows: 2 3 (a) Initial training shall cover up to ten hours of 2 4 initial outpatient diabetes self-management training within a 2 5 continuous twelve-month period for each individual that meets 2 6 any of the following conditions: 2 7 (i) A new onset of diabetes. 2 8 (ii) Poor glycemic control as evidenced by a glycosylated 2 9 hemoglobin of nine and five-tenths or more in the ninety days 2 10 before attending the training. 2 11 (iii) A change in treatment regimen from no diabetes 2 12 medications to any diabetes medication, or from oral diabetes 2 13 medication to insulin. 2 14 (iv) High risk for complications based on poor glycemic 2 15 control; documented acute episodes of severe hypoglycemia or 2 16 acute severe hyperglycemia occurring in the past year during 2 17 which the individual needed third-party assistance for either 2 18 emergency room visits or hospitalization. 2 19 (v) High risk based on documented complications of a lack 2 20 of feeling in the foot or other foot complications such as 2 21 foot ulcer or amputation, pre-proliferative or proliferative 2 22 retinopathy or prior laser treatment of the eye, or kidney 2 23 complications related to diabetes, such as macroalbuminuria or 2 24 elevated creatinine. 2 25 (b) An individual who receives the initial training shall 2 26 be eligible for a single follow-up training session of up to 2 27 one hour each year. 2 28 2. a. This section applies to the following classes of 2 29 third-party payment provider contracts or policies delivered, 2 30 issued for delivery, continued, or renewed in this state on or 2 31 after July 1, 1999: 2 32 (1) Individual or group accident and sickness insurance 2 33 providing coverage on an expense-incurred basis. 2 34 (2) An individual or group hospital or medical service 2 35 contract issued pursuant to chapter 509, 514, or 514A. 3 1 (3) An individual or group health maintenance organization 3 2 contract regulated under chapter 514B. 3 3 (4) Any other entity engaged in the business of insurance, 3 4 risk transfer, or risk retention, which is subject to the 3 5 jurisdiction of the commissioner. 3 6 (5) A plan established pursuant to chapter 509A for public 3 7 employees. 3 8 (6) An organized delivery system licensed by the director 3 9 of public health. 3 10 b. This chapter shall not apply to accident only, 3 11 specified disease, short-term hospital or medical, hospital 3 12 confinement indemnity, credit, dental, vision, Medicare 3 13 supplement, long-term care, basic hospital and medical- 3 14 surgical expense coverage as defined by the commissioner, 3 15 disability income insurance coverage, coverage issued as a 3 16 supplement to liability insurance, workers' compensation or 3 17 similar insurance, or automobile medical payment insurance. 3 18 Sec. 2. Section 509.3, subsection 6, Code 1999, is amended 3 19 by striking the subsection. 3 20 Sec. 3. Section 514.7, unnumbered paragraph 3, Code 1999, 3 21 is amended by striking the unnumbered paragraph. 3 22 Sec. 4. Section 514B.1, subsection 5, paragraph c, Code 3 23 1999, is amended by striking the paragraph. 3 24 3 25 3 26 3 27 MARY E. KRAMER 3 28 President of the Senate 3 29 3 30 3 31 3 32 RON J. CORBETT 3 33 Speaker of the House 3 34 3 35 I hereby certify that this bill originated in the Senate and 4 1 is known as Senate File 8, Seventy-eighth General Assembly. 4 2 4 3 4 4 4 5 MICHAEL E. MARSHALL 4 6 Secretary of the Senate 4 7 Approved , 1999 4 8 4 9 4 10 4 11 THOMAS J. VILSACK 4 12 Governor
Text: SF00007 Text: SF00009 Text: SF00000 - SF00099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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