40-2,163. Coverage for certain expenses relating to care and treatment of diabetes; educational expenses; exceptions.
40-2,163
40-2,163. Coverage for certain expenses relating tocare and treatment of diabetes; educational expenses; exceptions.(a) This section shall be known and may be cited as the"diabetes coverage act."
(b) Any individual or group health insurance policy, medicalservice plan, contract, hospital service corporation contract, hospital andmedical service corporation contract, fraternal benefit society or healthmaintenance organization which provides coverage for accident and healthservices and which is delivered, issued for delivery, amended or renewed on orafter January 1, 1999, also, shall provide coverage for equipment, andsupplies, limited to hypodermic needles and supplies used exclusively withdiabetes management andoutpatient self-management training and education, including medical nutritiontherapy, for the treatment of insulin dependent diabetes, insulin-usingdiabetes, gestational diabetes and noninsulin using diabetes if prescribed bya health care professional legally authorized to prescribe such services andsupplies under thelaw. Such coverage shall include coverage for insulin only if such coveragealso includes coverage of prescription drugs.
(c) Diabetes outpatient self-management training and education shall beprovided by a certified, registered or licensed health care professional withexpertise in diabetes. The coverage for outpatient self-management trainingand education shall berequired pursuant to this section only if ordered by a health care professionallegally authorized to prescribe such services and the diabetic (1) istreated at a program approved by the American diabetes association; (2) istreated by a person certified by the national certification board for diabeteseducators; or (3) is, as to nutritional education, treated by a licenseddietitian pursuant to a treatment plan authorized by such healthcareprofessional.
(d) (1) The benefits provided in this act shall be subject to the sameannual deductible or co-insurance and the same requirement of medical necessityestablished for all other covered benefitswithin a given policy. In the case of a policy requiring that services beprovided by or uponreferral from a primary care physician, the benefits provided by this act shallbe subject to such requirement.
(2) Private third party payors may not reduce or eliminate coverage due tothe requirements of this act.
(3) Enforcement of the provisions of this act shall be performed by thecommissioner of insurance.
(e) The provisions of this act shall not apply to any medicare supplementpolicy of insurance, as defined by the commissioner of insurance by rule andregulation, any policy of long-term care insurance, as defined by K.S.A.40-2227, and amendments thereto, any specified disease or specified accidentcoverage or any accident only coverage as defined by the commissioner ofinsurance by rule and regulation, whether written on a group, blanket, orindividual basis.
History: L. 1998, ch. 174, § 28; July 1.