§ 27-8-14.5-6 — Coverage for diabetes self-management training

Indiana § 27-8-14.5-6

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 14.5: Coverage for Services Related to Diabetes

Text

(a) A health insurance plan issued by an
insurer must provide coverage for diabetes self-management training
that is:
(1) medically necessary;
(2) ordered in writing by a physician licensed under IC 25-22.5,
a podiatrist licensed under IC 25-29, an advanced practice
registered nurse licensed under IC 25-23, or a physician assistant
licensed under IC 25-27.5; and
(3) provided by a health care professional who:
(A) is licensed, registered, or certified under IC 25; and
(B) has specialized training in the management of diabetes.
(b) Coverage for diabetes self-management training may be limited
to the following:
(1) One (1) or more visits after receiving a diagnosis of diabetes.
(2) One (1) or more visits after receiving a diagnosis by a
physician licensed under IC 25-22.5 or a podiatrist licensed under
IC 25-29 that:
(A) represents a significant change in the insured's symptoms
or condition; and
(B) makes changes in the insured's self-management medically
necessary.
(3) One (1) or more visits for reeducation or refresher training.
(c) Coverage for diabetes self-management training is subject to the
requirements of the health insurance plan regarding the use of
participating providers.

Legislative History

As added by P.L.190-1997, SEC.1. Amended by P.L.143-2022, SEC.74.