BY REPRESENTATIVES Gotlieb, Chavez, George, Gordon, Mace, Morrison, Tupa, and S. Williams;
also SENATORS Chlouber, Feeley, Hernandez, J. Johnson,
Linkhart, Martinez, Pascoe, Phillips, Reeves, Rupert, Tanner,
and Thiebaut.
CONCERNING THE REQUIREMENT OF HEALTH INSURERS TO
PROVIDE COVERAGE FOR THE TREATMENT OF DIABETES.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. 1016102,
Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW
SUBSECTION to read:
1016102. Definitions.
As used in this article, unless the context otherwise requires:
(28.7) "PATIENT WITH DIABETES"
MEANS A PERSON WITH ELEVATED BLOOD GLUCOSE LEVELS WHO HAS BEEN
DIAGNOSED AS HAVING DIABETES BY AN APPROPRIATELY LICENSED HEALTH
CARE PROFESSIONAL.
SECTION 2. 1016104,
Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW
SUBSECTION to read:
1016104. Mandatory coverage
provisions. (13) Diabetes.
(a) ANY HEALTH BENEFIT PLAN, EXCEPT SUPPLEMENTAL POLICIES
COVERING A SPECIFIED DISEASE OR OTHER LIMITED BENEFIT, THAT PROVIDES
HOSPITAL, SURGICAL, OR MEDICAL EXPENSE INSURANCE SHALL PROVIDE
COVERAGE FOR DIABETES THAT SHALL INCLUDE EQUIPMENT, SUPPLIES,
AND OUTPATIENT SELFMANAGEMENT TRAINING AND EDUCATION, INCLUDING
MEDICAL NUTRITION THERAPY IF PRESCRIBED BY A HEALTH CARE PROVIDER
LICENSED TO PRESCRIBE SUCH ITEMS PURSUANT TO COLORADO LAW, AND,
IF COVERAGE IS PROVIDED THROUGH A MANAGED CARE PLAN, SUCH QUALIFIED
PROVIDER SHALL BE A PARTICIPATING PROVIDER IN SUCH MANAGED CARE
PLAN.
(b) DIABETES OUTPATIENT SELFMANAGEMENT
TRAINING AND EDUCATION WHEN PRESCRIBED SHALL BE PROVIDED BY A
CERTIFIED, REGISTERED, OR LICENSED HEALTH CARE PROFESSIONAL WITH
EXPERTISE IN DIABETES.
(c) THE BENEFITS PROVIDED IN THIS SUBSECTION
(13) ARE SUBJECT TO THE SAME ANNUAL DEDUCTIBLES OR COPAYMENTS
ESTABLISHED FOR ALL OTHER COVERED BENEFITS WITHIN A GIVEN POLICY.
(d) PRIVATE THIRDPARTY PAYORS SHALL
NOT REDUCE OR ELIMINATE COVERAGE DUE TO THE REQUIREMENTS OF THIS
SUBSECTION (13).
SECTION 3. Effective
date applicability. This act shall take effect July
1, 1998, and shall apply to all individual and group health policies,
plans, or contracts issued or renewed on or after said date.
SECTION 4. Safety
clause. The general assembly hereby finds, determines, and
declares that this act is necessary for the immediate preservation
of the public peace, health, and safety.
____________________________ ____________________________
Charles E. Berry Tom Norton
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Judith M. Rodrigue Patricia K. Dicks
CHIEF CLERK OF THE HOUSE ASSISTANT SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE
OF COLORADO