BILL NO. 0185 - Diabetes and Health Insurance in Wyoming

BILL NO. 0185
ENROLLED ACT NO. 76, HOUSE OF REPRESENTATIVES
FIFTY-SIXTH LEGISLATURE OF THE STATE OF WYOMING
2001 GENERAL SESSION
AN ACT relating to insurance coverage; mandating coverage
for diabetes outpatient self-management training, education
and equipment and supplies under health insurance policies
as specified; providing for applicability of the section;
amending a provision to realign the chapter as specified;
and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1. W.S. 26-20-201 is created to read:

ARTICLE 2

DIABETES COVERAGE

26-20-201. Diabetes coverage required.

(a) All individual and group health insurance
policies providing coverage on an expense incurred basis,
individual and group service or indemnity type contracts
issued by any insurer including any nonprofit corporation
and individual and group service contracts issued by a
health maintenance organization, which provide coverage
shall also provide coverage for the equipment, supplies and
outpatient self-management training and education,
including medical nutrition therapy for the treatment of
insulin-dependent diabetes, insulin-using diabetes,
gestational diabetes and noninsulin using diabetes if
prescribed by a health care professional legally authorized
to prescribe such items under law. Covered diabetes
outpatient self-management training and education shall be
provided by a certified, registered or licensed health care
professional with expertise in diabetes. For purposes of
this section, required covered outpatient self-management
training and education shall be limited to:

Page 1

(i) A one-time evaluation and training program
when medically necessary, within one (1) year of diagnosis;

(ii) Additional medically necessary self-
management training shall be provided upon a significant
change in symptoms, condition or treatment. This additional
training shall be limited to three (3) hours per year.

(b) The benefits provided under this section shall be
subject to the same annual deductibles or coinsurance
established for all other covered benefits within a given
policy. Private third-party payors may not reduce or
eliminate coverage due to the requirements of this section.
Enforcement of this section shall be performed by the
commissioner or his designee.

(c) This section shall apply to a private health
benefit plan as defined under W.S. 26-1-102(a)(xxxiii)
delivered or issued on or after July 1, 2001.

Section 2. W.S. 26-20-104 is amended to read:

CHAPTER 20

MANDATED COVERAGE

ARTICLE 1

NEWBORN AND ADOPTED CHILDREN COVERAGE

26-20-104. Applicability of article.

The requirements of this chapter article regarding newly
born children apply to all insurance policies and
subscriber contracts delivered or issued for delivery in
this state more than one hundred twenty (120) days after
May 30, 1975. The requirements of this chapter article
regarding adopted children apply to all insurance policies

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and subscriber contracts delivered or issued for delivery
in this state after June 8, 1989.
Section 3. This act is effective July 1, 2001.
(END)

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Cheyenne, Wyoming 82002

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