Sec. 38a-518e. Mandatory coverage for diabetes outpatient self-management training.
Sec. 38a-518e. Mandatory coverage for diabetes outpatient self-management
training. (a) Each group 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. 44, 60.)
History: P.A. 99-284 effective January 1, 2000.
See Sec. 38a-492e for similar provisions re individual policies.