HB0185 - Insurance coverage for diabetes.

 

2001

State of Wyoming

01LSO-0508.E1 ENGROSSED

 

 

 

HOUSE BILL NO.  HB0185

 

 

Insurance coverage for diabetes.

 

Sponsored by:  Representative(s) Willford, Diercks,
Johnson, W. and McOmie and Senator(s) Hanes

 

 

A BILL

 

for

 

 1  AN ACT relating to insurance coverage; mandating coverage
 2  for diabetes outpatient self-management training, education
 3  and equipment and supplies under health insurance policies
 4  as specified; providing for applicability of the section;
 5  amending a provision to realign the chapter as specified;
 6  and providing for an effective date.

 7 

 8  Be It Enacted by the Legislature of the State of Wyoming:

 9 

10         Section 1.  W.S. 26-20-201 is created to read:

11 

12                         ARTICLE 2

13                   DIABETES COVERAGE

14 

15         26-20-201.  Diabetes coverage required.

16 

 

Page  1

 

 

 

 1         (a)  All individual and group health insurance
 2  policies providing coverage on an expense incurred basis,
 3  and individual and group service or indemnity type
 4  contracts issued by any insurer including any nonprofit
 5  corporation which provide coverage shall also provide
 6  coverage for the equipment, supplies and outpatient
 7  self-management training and education, including medical
 8  nutrition therapy for the treatment of insulin-dependent
 9  diabetes, insulin-using diabetes, gestational diabetes and
10  noninsulin using diabetes if prescribed by a health care
11  professional legally authorized to prescribe such items
12  under law. Covered diabetes outpatient self-management
13  training and education shall be provided by a certified,
14  registered or licensed health care professional with
15  expertise in diabetes. For purposes of this section,
16  required covered outpatient self-management training and
17  education shall be limited to:

18 

19              (i)  A one-time evaluation and training program
20  when medically necessary, within one (1) year of diagnosis;

21 

22              (ii)  Additional medically necessary self-
23  management training shall be provided upon a significant

Page  2

 

 

 

 1  change in symptoms, condition or treatment. This additional
 2  training shall be limited to three (3) hours per year.

 3 

 4         (b)  The benefits provided under this section shall be
 5  subject to the same annual deductibles or coinsurance
 6  established for all other covered benefits within a given
 7  policy. Private third-party payors may not reduce or
 8  eliminate coverage due to the requirements of this section.
 9  Enforcement of this section shall be performed by the
10  commissioner or his designee.

11 

12         (c)  This section shall apply to all individual and
13  group health insurance policies delivered or issued on or
14  after July 1, 2001.

15 

16         Section 2.  W.S. 26-20-104 is amended to read:

17 

18                         CHAPTER 20

19                   MANDATED COVERAGE

20 

21                         ARTICLE 1

22              NEWBORN AND ADOPTED CHILDREN COVERAGE

23 

24         26-20-104.  Applicability of article.

 

Page  3

 

 

 

 1 

 2  The requirements of this chapter article regarding newly
 3  born children apply to all insurance policies and
 4  subscriber contracts delivered or issued for delivery in
 5  this state more than one hundred twenty (120) days after
 6  May 30, 1975. The requirements of this chapter article
 7  regarding adopted children apply to all insurance policies
 8  and subscriber contracts delivered or issued for delivery
 9  in this state after June 8, 1989.

10 

11         Section 3.  This act is effective July 1, 2001.

12 

13                         (END)

 

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