Report Title:

Diabetes Education; Insurance Coverage

Description:

Requires diabetes education that is provided under a health insurance policy to be provided through a certified diabetes educator, a program recognized by the American Diabetes Association, or a health care professional who has completed an accredited comprehensive diabetes education review course; provided that when deemed medically necessary by a health care professional authorized to prescribe, the diabetes education shall be provided by a certified diabetes educator or a program recognized by the American Diabetes Association. (SB683 HD1)

THE SENATE

S.B. NO.

683

TWENTY-SECOND LEGISLATURE, 2003

S.D. 2

STATE OF HAWAII

H.D. 1


 

A BILL FOR AN ACT

 

relating to diabetes education.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432D-   Coverage for diabetes. Each policy, contract, plan, or agreement issued, renewed, or amended in this State by a health maintenance organization pursuant to this chapter shall provide coverage for outpatient diabetes self-management training, education, equipment, and supplies, if:

(1) The equipment, supplies, training, and education are medically necessary;

(2) The equipment, supplies, training, and education are prescribed by a health care professional authorized to prescribe; and

(3) The diabetes education is provided by:

(A) A certified diabetes educator;

(B) A program recognized by the American Diabetes Association; or

(C) A health care professional who has completed an accredited comprehensive diabetes education review course;

provided that when deemed medically necessary by a health care provider, the diabetes education shall be provided by a certified diabetes educator or a program recognized by the American Diabetes Association."

SECTION 2. Section 431:10A-121, Hawaii Revised Statutes, is amended to read as follows:

"§431:10A-121 Coverage for diabetes. Each policy of accident and health or sickness insurance providing coverage for health care, other than an accident-only, specified disease, hospital indemnity, medicare supplement, long-term care, or other limited benefit health insurance policy, that is issued or renewed in this State, shall provide coverage for outpatient diabetes self-management training, education, equipment, and supplies, if:

(1) The equipment, supplies, training, and education are medically necessary; [and]

(2) The equipment, supplies, training, and education are prescribed by a health care professional authorized to prescribe[.]; and

(3) The diabetes education is provided by:

(A) A certified diabetes educator;

(B) A program recognized by the American Diabetes Association; or

(C) A health care professional who has completed an accredited comprehensive diabetes education review course;

provided that when deemed medically necessary by a health care provider, the diabetes education shall be provided by a certified diabetes educator or a program recognized by the American Diabetes Association."

SECTION 3. Section 432:1-612, Hawaii Revised Statutes, is amended to read as follows:

"[[]§432:1-612[]] Diabetes coverage. All group health care contracts under this chapter shall provide, to the extent provided under section 431:10A-121, coverage for outpatient diabetes self-management training, education, equipment, and supplies[.]; provided that the diabetes education is provided by:

(1) A certified diabetes educator;

(2) A program recognized by the American Diabetes Association; or

(3) A health care professional who has completed an accredited comprehensive diabetes education review course;

provided that when deemed medically necessary by a health care provider, the diabetes education shall be provided by a certified diabetes educator or a program recognized by the American Diabetes Association."

SECTION 4. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.5, 431:10A-116.6, 431:10A-119, and 431:10A-120, [and 431:10A-121,] and chapter 431M."

SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.