SB3565 Summary

• Group accident and health insurance policies amended, delivered, issued, or renewed after the effective date must provide coverage for outpatient diabetes self-management training and education, equipment, and supplies for type 1, type 2, and gestational diabetes mellitus.

• Coverage for diabetes self-management training is limited to up to 3 medically necessary visits upon initial diagnosis and up to 2 additional visits upon significant changes in the patient's symptoms or medical condition as determined by the patient's physician.

• Insurers must cover prescribed diabetes equipment including blood glucose monitors, monitors for the legally blind with cartridges, and lancets and lancing devices, subject to the policy's standard deductible, co-payment, and co-insurance provisions.

• Insurers must cover prescribed diabetes pharmaceuticals and supplies including insulin, syringes, needles, test strips, FDA-approved oral agents, glucagon emergency kits, and treatment for pain associated with diabetes complications including diabetic peripheral neuropathy.

• Coverage must also be provided for regular foot care exams by a physician or referred provider, and diabetes self-management training may be provided during office visits, group settings, or home visits with physician authorization.