HOUSE BILL No. 4359
February 19, 1997, Introduced by Reps. Hammerstrom, Martinez, DeHart, Scott, Mans and Goschka and referred to the Committee on Insurance. A bill to amend 1980 PA 350, entitled "The nonprofit health care corporation reform act," (MCL 550.1101 to 550.1704) by adding section 416b. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 SEC. 416B. (1) A HEALTH CARE CORPORATION CERTIFICATE SHALL 2 PROVIDE BENEFITS IN EACH GROUP AND NONGROUP CERTIFICATE FOR THE 3 FOLLOWING EQUIPMENT, SUPPLIES, AND EDUCATIONAL TRAINING FOR THE 4 TREATMENT OF DIABETES, IF RECOMMENDED OR PRESCRIBED BY A 5 PHYSICIAN: 6 (A) BLOOD GLUCOSE MONITORS AND BLOOD GLUCOSE MONITORS FOR 7 THE LEGALLY BLIND. 8 (B) DATA MANAGEMENT SYSTEMS. 9 (C) TEST STRIPS FOR GLUCOSE MONITORS AND VISUAL READING AND 10 URINE TESTING STRIPS. 01008'97 * 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 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. 01008'97 * 3 1 (2) BENEFITS UNDER THIS SECTION ARE NOT SUBJECT TO DOLLAR 2 LIMITS, DEDUCTIBLES, AND COPAYMENT 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 1396f AND 1396g-1 TO 11 1396w. 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, 1395w-4 TO 1395yy, AND 1395bbb TO 1395ddd. 01008'97 * Final page. DKH