HOUSE BILL No. 4395 March 9, 1999, Introduced by Reps. Scott, DeHart, Martinez, Woodward, Prusi, Bogardus, Brater, Vaughn, Switalski, Daniels, Hardman, Lemmons, Quarles, Rison, Hale, Reeves, Clark, Garza, Price, Stallworth and Thomas and referred to the Committee on Insurance and Financial Services. A bill to amend 1956 PA 218, entitled "The insurance code of 1956," (MCL 500.100 to 500.8302) by adding section 3406n. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 SEC. 3406N. (1) AN INSURER THAT DELIVERS, ISSUES FOR DELIV- 2 ERY, OR RENEWS IN THIS STATE AN EXPENSE-INCURRED HOSPITAL, MEDI- 3 CAL, OR SURGICAL POLICY OR CERTIFICATE SHALL INCLUDE COVERAGE FOR 4 THE FOLLOWING EQUIPMENT, SUPPLIES, AND EDUCATIONAL TRAINING FOR 5 THE TREATMENT OF DIABETES, IF RECOMMENDED OR PRESCRIBED BY A 6 PHYSICIAN: 7 (A) BLOOD GLUCOSE MONITORS AND BLOOD GLUCOSE MONITORS FOR 8 THE LEGALLY BLIND. 9 (B) DATA MANAGEMENT SYSTEMS. 10 (C) TEST STRIPS FOR GLUCOSE MONITORS AND VISUAL READING AND 11 URINE TESTING STRIPS. 00573'99 DKH 2 1 (D) INSULIN. 2 (E) INJECTION AIDS. 3 (F) CARTRIDGES FOR THE LEGALLY BLIND. 4 (G) SYRINGES. 5 (H) INSULIN PUMPS AND APPURTENANCES THERETO. 6 (I) INSULIN INFUSION DEVICES. 7 (J) ORAL AGENTS FOR CONTROLLING BLOOD SUGAR. 8 (K) DIABETES SELF-MANAGEMENT EDUCATION TO ENSURE THAT PER- 9 SONS WITH DIABETES ARE EDUCATED AS TO THE PROPER SELF-MANAGEMENT 10 AND TREATMENT OF THEIR DIABETIC CONDITION, INCLUDING INFORMATION 11 ON PROPER DIETS. THIS COVERAGE FOR SELF-MANAGEMENT EDUCATION AND 12 EDUCATION RELATING TO DIET SHALL BE LIMITED TO VISITS MEDICALLY 13 NECESSARY UPON THE DIAGNOSIS OF DIABETES, WHEN A PHYSICIAN DIAG- 14 NOSES A SIGNIFICANT CHANGE IN THE PATIENT'S SYMPTOMS OR CONDI- 15 TIONS THAT NECESSITATES CHANGES IN A PATIENT'S SELF-MANAGEMENT, 16 OR WHEN REEDUCATION OR REFRESHER EDUCATION IS NECESSARY. THIS 17 EDUCATION MAY BE PROVIDED BY THE PHYSICIAN OR A MEMBER OF THE 18 PHYSICIAN'S STAFF AS PART OF AN OFFICE VISIT FOR DIABETES DIAGNO- 19 SIS OR TREATMENT OR BY A DIABETES OUTPATIENT EDUCATION PROGRAM 20 CERTIFIED TO RECEIVE MEDICAID OR MEDICARE REIMBURSEMENT. 21 EDUCATION PROVIDED BY AN OUTPATIENT DIABETIC SELF-MANAGEMENT PRO- 22 GRAM MAY BE LIMITED TO GROUP SETTINGS WHENEVER PRACTICABLE. 23 COVERAGE FOR SELF-MANAGEMENT EDUCATION AND EDUCATION RELATING TO 24 DIET SHALL ALSO INCLUDE HOME VISITS WHEN MEDICALLY NECESSARY. 25 (2) COVERAGE UNDER THIS SECTION IS NOT SUBJECT TO DOLLAR 26 LIMITS, DEDUCTIBLES, AND COINSURANCE PROVISIONS THAT ARE GREATER 27 THAN THOSE FOR PHYSICAL ILLNESS GENERALLY, EXCEPT THAT INSULIN 00573'99 3 1 INFUSION PUMP COVERAGE MAY BE LIMITED TO THE PURCHASE OF 1 PUMP 2 PER YEAR AND THE INSURER MAY REQUIRE THE INSURED TO USE A PUMP 3 FOR 30 DAYS BEFORE PURCHASE. 4 (3) AS USED IN THIS SECTION: 5 (A) "MEDICAID" MEANS TITLE XIX OF THE SOCIAL SECURITY ACT, 6 CHAPTER 531, 49 STAT. 620, 42 U.S.C. 1396 TO 1396f, 1396g-1 TO 7 1396r-6, AND 1396r-8 TO 1396v. 8 (B) "MEDICARE" MEANS TITLE XVIII OF THE SOCIAL SECURITY ACT, 9 CHAPTER 531, 49 STAT. 620, 42 U.S.C. 1395 TO 1395b, 1395b-2, 10 1395b-6 TO 1395b-7, 1395c TO 1395i, 1395i-2 TO 1395i-5, 1395j TO 11 1395t, 1395u TO 1395w, 1395w-2 TO 1395w-4, 1395w-21 TO 1395w-28, 12 1395x TO 1395yy, AND 1395bbb TO 1395ggg. 00573'99 Final page. DKH