S-0448.1  _______________________________________________

                         SENATE BILL 5178

          _______________________________________________

State of Washington      55th Legislature     1997 Regular Session

By Senators Wood, Wojahn, Deccio, Bauer, Fairley, Goings, Prince, Prentice, Franklin, Horn, Patterson and Winsley

Read first time 01/17/97.  Referred to Committee on Health & Long‑Term Care.

Adopting the diabetes cost reduction act.

    AN ACT Relating to the enactment of the diabetes cost reduction act; adding a new section to chapter 41.05 RCW; adding a new section to chapter 48.43 RCW; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 41.05 RCW to read as follows:

    The legislature finds that diabetes imposes a significant health risk and tremendous financial burden on the citizens and government of the state of Washington, and that access to the medically accepted standards of care for diabetes, its treatment and supplies, and self-management training and education is crucial to prevent or delay the short and long-term complications of diabetes and its attendant costs.

    (1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.

    (a) "Diabetic person" means a person with insulin using diabetes, noninsulin using diabetes, elevated blood glucose levels induced by pregnancy, or other medical conditions or medical therapies that wholly or partially consist of elevated blood glucose levels; and

    (b) "Health care provider" means a health care provider as defined in RCW 48.43.005.

    (2) All state-purchased health care purchased or renewed after the effective date of this act shall provide services or coverage for services for diabetic persons, to include at least the following:

    (a) Appropriate equipment and supplies, as prescribed by a health care provider, that includes insulin, syringes, injection aids, blood glucose monitors, test strips for blood glucose monitors, visual reading and urine test strips, insulin pumps and accessories to the pumps, insulin infusion devices, prescriptive oral agents for controlling blood sugar levels, podiatric appliances for prevention of complications associated with diabetes, and glucagon emergency kits; and

    (b) Outpatient self-management training and education, including medical nutrition therapy.

    (3) Diabetes outpatient self-management training and education may only be provided by health care providers with expertise in diabetes.

    (4) Coverage required under this section may be subject to, but may not exceed, the annual deductibles or coinsurance established for all other similar coverage within a policy.

    (5) Health insurance coverage may not be reduced or eliminated due to this section.

    (6) The health care authority shall enforce this section.

NEW SECTION. Sec. 2.  A new section is added to chapter 48.43 RCW to read as follows:

    The legislature finds that diabetes imposes a significant health risk and tremendous financial burden on the citizens and government of the state of Washington, and that access to the medically accepted standards of care for diabetes, its treatment and supplies, and self-management training and education is crucial to prevent or delay the short and long-term complications of diabetes and its attendant costs.

    (1) For the purposes of this section, "diabetic person" means a person with insulin using diabetes, noninsulin using diabetes, elevated blood glucose levels induced by pregnancy, or other medical conditions or medical therapies that wholly or partially consist of elevated blood glucose levels.

    (2) All health carriers, for health care purchased or renewed after the effective date of this act, shall provide coverage for diabetic persons, to include at least the following:

    (a) Appropriate equipment and supplies, as prescribed by a health care provider, that includes insulin, syringes, injection aids, blood glucose monitors, test strips for blood glucose monitors, visual reading and urine test strips, insulin pumps and accessories to the pumps, insulin infusion devices, prescriptive oral agents for controlling blood sugar levels, podiatric appliances for prevention of complications associated with diabetes, and glucagon emergency kits; and

    (b) Outpatient self-management training and education, including medical nutrition therapy.

    (3) Diabetes outpatient self-management training and education may only be provided by health care providers with expertise in diabetes.

    (4) Coverage required under this section may be subject to, but may not exceed, the annual deductibles or coinsurance established for all other similar coverage within a policy.

    (5) Health carriers may not be reduced or eliminate coverage due to this section.

    (6) The insurance commissioner shall enforce this section.

NEW SECTION. Sec. 3.  This act takes effect January 1, 1998.

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