Sec. 38a-492e. Mandatory coverage for diabetes outpatient self-management training.
Sec. 38a-492e. Mandatory coverage for diabetes outpatient self-management
training. (a) Each individual health insurance policy providing coverage of the type
specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued
for delivery, renewed or continued in this state on or after January 1, 2000, shall provide
coverage for outpatient self-management training for the treatment of insulin-dependent
diabetes, insulin-using diabetes, gestational diabetes and non-insulin-using diabetes if
the training is prescribed by a licensed health care professional who has appropriate
state licensing authority to prescribe such training. As used in this section, "outpatient
self-management training" includes, but is not limited to, education and medical nutrition therapy. Diabetes self-management training shall be provided by a certified, registered or licensed health care professional trained in the care and management of diabetes
and authorized to provide such care within the scope of the professional's practice.
(b) Benefits shall cover: (1) Initial training visits provided to an individual after the
individual is initially diagnosed with diabetes that is medically necessary for the care
and management of diabetes, including, but not limited to, counseling in nutrition and
the proper use of equipment and supplies for the treatment of diabetes, totaling a maximum of ten hours; (2) training and education that is medically necessary as a result of
a subsequent diagnosis by a physician of a significant change in the individual's symptoms or condition which requires modification of the individual's program of self-management of diabetes, totaling a maximum of four hours; and (3) training and education
that is medically necessary because of the development of new techniques and treatment
for diabetes totaling a maximum of four hours.
(c) Benefits provided pursuant to this section shall be subject to the same terms and
conditions applicable to all other benefits under such policies.
(P.A. 99-284, S. 43, 60.)
History: P.A. 99-284 effective January 1, 2000.
See Sec. 38a-518e for similar provisions re group policies.