(a)All individual and group health insurance policies
providing coverage on an expense incurred basis, individual and
group service or indemnity type contracts issued by any insurer
including any nonprofit corporation and individual and group
service contracts issued by a health maintenance organization,
which provide coverage shall also provide coverage for the
equipment, supplies and outpatient self-management training and
education, including medical nutrition therapy for the treatment
of insulin-dependent diabetes, insulin-using diabetes,
gestational diabetes and noninsulin using diabetes if prescribed
by a health care professional legally authorized to prescribe
such items under law. Covered diabetes outpatient
self-management training and education shall be provided by a
certified,
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(a) All individual and group health insurance policies
providing coverage on an expense incurred basis, individual and
group service or indemnity type contracts issued by any insurer
including any nonprofit corporation and individual and group
service contracts issued by a health maintenance organization,
which provide coverage shall also provide coverage for the
equipment, supplies and outpatient self-management training and
education, including medical nutrition therapy for the treatment
of insulin-dependent diabetes, insulin-using diabetes,
gestational diabetes and noninsulin using diabetes if prescribed
by a health care professional legally authorized to prescribe
such items under law. Covered diabetes outpatient
self-management training and education shall be provided by a
certified, registered or licensed health care professional with
expertise in diabetes. For purposes of this section, required
covered outpatient self-management training and education shall
be limited to:
(i) A one-time evaluation and training program when
medically necessary, within one (1) year of diagnosis;
(ii) Additional medically necessary self-management
training shall be provided upon a significant change in
symptoms, condition or treatment. This additional training shall
be limited to three (3) hours per year.
(b) The benefits provided under this section shall be
subject to the same annual deductibles or coinsurance
established for all other covered benefits within a given
policy. Private third-party payors may not reduce or eliminate
coverage due to the requirements of this section. Enforcement of
this section shall be performed by the commissioner or his
designee.
(c) This section shall apply to a private health benefit
plan as defined under W.S. 26-1-102(a)(xxxiii) delivered or
issued on or after July 1, 2001.
ARTICLE 3
CLINICAL TRIALS COVERAGE