§ 33-22-316 — Coverage For Self-Management Training And Education For Treatment Of Diabetes

33-22-316 . Coverage for self-management training and education for treatment of diabetes. (1) Each individual policy, certificate of insurance, and membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for outpatient self-management training and education for the treatment of diabetes. Any education must be provided by a licensed health care professional with expertise in diabetes.
(2) (a) Coverage must include an annual benefit for medically necessary and prescribed outpatient self-management training and education for the treatment of diabetes. At a minimum, the benefit must consist of:
(i) 20 visits of training and education in diabetes self-management in either an individual or group setting within the first year of diagnosis if the insured has not received the training and education previously; and
(ii) 12 visits of followup diabetes self-management training and education services in subsequent years for an insured who has previously received and exhausted the initial 20 visits of education under subsection (2)(a)(i).
(b) Nothing in subsection (2)(a) prohibits an insurer from providing a greater benefit.
(c) For the purposes of this subsection (2), the term "visit" refers to a period of 30 minutes.
(3) Annual copayment and deductible provisions are subject to the same terms and conditions applicable to all other covered benefits within a given policy.
(4) This section does not apply to disability income, hospital indemnity, medicare supplement, accident-only, vision, dental, specific disease, or long-term care policies.

Legislative History

En. Sec. 1, Ch. 520, L. 2023.