HOUSE BILL No. 4360
February 19, 1997, Introduced by Reps. Hammerstrom, Martinez, DeHart, Scott, Mans and Goschka and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3406j.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 SEC. 3406J. (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.
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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 TRAINING TO ENSURE THAT PERSONS
9 WITH DIABETES ARE TRAINED AS TO THE PROPER SELF-MANAGEMENT AND
10 TREATMENT OF THEIR DIABETIC CONDITION, INCLUDING INFORMATION ON
11 MEDICAL NUTRITION THERAPY. THIS COVERAGE FOR SELF-MANAGEMENT
12 TRAINING AND MEDICAL NUTRITION THERAPY TRAINING IS LIMITED TO
13 VISITS MEDICALLY NECESSARY UPON THE DIAGNOSIS OF DIABETES, WHEN A
14 PHYSICIAN DIAGNOSES A SIGNIFICANT CHANGE IN THE PATIENT'S SYMP-
15 TOMS OR CONDITIONS THAT NECESSITATES CHANGES IN A PATIENT'S
16 SELF-MANAGEMENT, OR WHEN REEDUCATION OR REFRESHER TRAINING IS
17 NECESSARY AND IT IS RECOMMENDED OR PRESCRIBED BY A PHYSICIAN.
18 THE TRAINING MAY BE PROVIDED BY THE PHYSICIAN OR A MEMBER OF THE
19 PHYSICIAN'S STAFF AS PART OF AN OFFICE VISIT FOR DIABETES DIAGNO-
20 SIS OR TREATMENT OR BY A DIABETES OUTPATIENT TRAINING PROGRAM
21 CERTIFIED TO RECEIVE MEDICAID OR MEDICARE REIMBURSEMENT.
22 TRAINING PROVIDED BY AN OUTPATIENT DIABETIC SELF-MANAGEMENT PRO-
23 GRAM MAY BE LIMITED TO GROUP SETTINGS WHENEVER PRACTICABLE.
24 COVERAGE FOR SELF-MANAGEMENT TRAINING AND MEDICAL NUTRITION THER-
25 APY TRAINING ALSO INCLUDES HOME VISITS IF MEDICALLY NECESSARY.
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1 (2) COVERAGE UNDER THIS SECTION IS NOT SUBJECT TO DOLLAR
2 LIMITS, DEDUCTIBLES, AND COINSURANCE PROVISIONS THAT ARE GREATER
3 THAN THOSE FOR PHYSICAL ILLNESS GENERALLY.
4 (3) AS USED IN THIS SECTION:
5 (A) "DIABETES" INCLUDES ALL OF THE FOLLOWING:
6 (i) GESTATIONAL DIABETES.
7 (ii) INSULIN-USING DIABETES.
8 (iii) NON-INSULIN-USING DIABETES.
9 (B) "MEDICAID" MEANS TITLE XIX OF THE SOCIAL SECURITY ACT,
10 CHAPTER 531, 49 STAT. 620, 42 U.S.C. 1396 TO 1396g AND 1396i TO
11 1396v.
12 (C) "MEDICARE" MEANS TITLE XVIII OF THE SOCIAL SECURITY ACT,
13 CHAPTER 531, 49 STAT. 620, 42 U.S.C. 1395 TO 1395b, 1395b-2,
14 1395c TO 1395i, 1395i-2 TO 1395i-4, 1395j TO 1395t, 1395u TO
15 1395w-2, AND 1395w-4 TO 1395ccc.
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