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Second Regular Session

Sixty-first General Assembly

LLS NO. 98­0187.01 JGG SENATE BILL 98­058

STATE OF COLORADO

BY SENATOR Tanner;

also REPRESENTATIVE Clarke. REENGROSSED

HEWI

A BILL FOR AN ACT

CONCERNING COVERAGE UNDER A HEALTH BENEFIT PLAN OF SERVICES FOR PERSONS WITH DIABETES.

Bill Summary

(Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.)

Requires health benefit plans that provide hospital, surgical, or medical expense insurance to provide coverage for equipment, supplies, and outpatient self­management training and educational services when prescribed by a physician as medically necessary for the treatment of diabetes. Identifies what equipment and supplies for the treatment of diabetes must be included in the coverage. Identifies which professionals may provide diabetes outpatient self­management training and educational services. Specifies that the requirements set forth in the act shall not apply to accident­only, specified disease, hospital indemnity, medicare supplement, long­term care, or other limited health coverage plans. Defines the term "patient with 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 THAT 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. (12)  Diabetes. (a)  NOTWITHSTANDING ANY OTHER PROVISION OF THE LAW TO THE CONTRARY, ANY HEALTH BENEFIT PLAN THAT PROVIDES HOSPITAL, SURGICAL, OR MEDICAL EXPENSE INSURANCE SHALL PROVIDE BENEFITS FOR THE COVERAGE OF DIABETES WHICH BENEFITS SHALL INCLUDE EQUIPMENT, SUPPLIES, SELF-MANAGEMENT TRAINING, MEDICAL NUTRITION COUNSELING DETERMINED TO BE MEDICALLY NECESSARY BY A PHYSICIAN OR ADVANCED PRACTICE NURSE AND WHICH SHALL CONFORM TO BEST PRACTICES GUIDELINES AND PROTOCOLS.

SECTION 3.  Effective date ­ applicability. This act shall take effect July 1, 1998, and shall apply to policies, programs, 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.


Created: 2/9/98 Updated: 2/9/98