1 STATE OF OKLAHOMA
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2 1st Session of the 58th Legislature (2021)
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3 SENATE BILL 990 By: Hicks
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6 AS INTRODUCED
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7 An Act relating to health insurance; amending 36 O.S.
7 2011, Section 6060.2, which relates to treatment of
8 diabetes; requiring private high deductible health
8 plans to allow insureds to set aside certain monies
9 for certain purpose; and providing an effective date.
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12 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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13 SECTION 1. AMENDATORY 36 O.S. 2011, Section 6060.2, is
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14 amended to read as follows:
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15 Section 6060.2. A. 1. Every health benefit plan issued or
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16 renewed on or after November 1, 1996, shall, subject to the terms of
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17 the policy contract or agreement, include coverage for the following
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18 equipment, supplies and related services for the treatment of Type
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19 I, Type II, and gestational diabetes, when medically necessary and
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20 when recommended or prescribed by a physician or other licensed
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21 health care provider legally authorized to prescribe under the laws
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22 of this state:
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23 a. blood glucose monitors,
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24 b. blood glucose monitors to the legally blind,
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 1 c. test strips for glucose monitors,
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2 d. visual reading and urine testing strips,
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3 e. insulin,
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4 f. injection aids,
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5 g. cartridges for the legally blind,
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6 h. syringes,
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7 i. insulin pumps and appurtenances thereto,
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8 j. insulin infusion devices,
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9 k. oral agents for controlling blood sugar, and
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10 l. podiatric appliances for prevention of complications
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11 associated with diabetes.
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12 2. The State Board of Health shall develop and annually update,
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13 by rule, a list of additional diabetes equipment, related supplies
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14 and health care provider services that are medically necessary for
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15 the treatment of diabetes, for which coverage shall also be
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16 included, subject to the terms of the policy, contract, or
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17 agreement, if the equipment and supplies have been approved by the
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18 federal Food and Drug Administration (FDA). Additional FDA-approved
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19 diabetes equipment and related supplies, and health care provider
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20 services shall be determined in consultation with a national
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21 diabetes association affiliated with this state, and at least three
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22 (3) medical directors of health benefit plans, to be selected by the
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23 State Department of Health.
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 1 3. All policies specified in this section shall also include
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2 coverage for:
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3 a. podiatric health care provider services as are deemed
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4 medically necessary to prevent complications from
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5 diabetes, and
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6 b. diabetes self-management training. As used in this
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7 subparagraph, “diabetes self-management training”
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8 means instruction in an inpatient or outpatient
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9 setting which enables diabetic patients to understand
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10 the diabetic management process and daily management
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11 of diabetic therapy as a method of avoiding frequent
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12 hospitalizations and complications. Diabetes self-
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13 management training shall comply with standards
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14 developed by the State Board of Health in consultation
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15 with a national diabetes association affiliated with
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16 this state and at least three (3) medical directors of
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17 health benefit plans selected by the State Department
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18 of Health. Coverage for diabetes self-management
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19 training, including medical nutrition therapy relating
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20 to diet, caloric intake, and diabetes management, but
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21 excluding programs the only purpose of which are
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22 weight reduction, shall be limited to the following:
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23 (1) visits medically necessary upon the diagnosis of
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24 diabetes,
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 1 (2) a physician diagnosis which represents a
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2 significant change in the symptoms or condition
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3 of the patient making medically necessary changes
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4 in the self-management of the patient, and
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5 (3) visits when reeducation or refresher training is
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6 medically necessary;
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7 provided, however, payment for the coverage required for diabetes
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8 self-management training pursuant to the provisions of this section
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9 shall be required only upon certification by the health care
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10 provider providing the training that the patient has successfully
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11 completed diabetes self-management training.
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12 4. Diabetes self-management training shall be supervised by a
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13 licensed physician or other licensed health care provider legally
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14 authorized to prescribe under the laws of this state. Diabetes
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15 self-management training may be provided by the physician or other
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16 appropriately registered, certified, or licensed health care
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17 professional as part of an office visit for diabetes diagnosis or
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18 treatment. Training provided by appropriately registered,
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19 certified, or licensed health care professionals may be provided in
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20 group settings where practicable.
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21 5. Coverage for diabetes self-management training and training
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22 related to medical nutrition therapy, when provided by a registered,
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23 certified, or licensed health care professional, shall also include
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24 home visits when medically necessary and shall include instruction
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 1 in medical nutrition therapy only by a licensed registered dietician
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2 or licensed certified nutritionist when authorized by the
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3 supervising physician of the patient when medically necessary.
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4 6. Coverage may be subject to the same annual deductibles or
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5 coinsurance as may be deemed appropriate and as are consistent with
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6 those established for other covered benefits within a given policy.
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7 7. Beginning on or after the effective date of this act, all
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8 high deductible plans, as defined in Section 6060.15 of this title,
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9 issued, renewed or delivered in this state by a private insurer
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10 providing coverage pursuant to this section shall allow an insured
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11 to set aside funds on a tax-free basis, up to the contribution limit
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12 provided in Section 223 of the Internal Revenue Code, as amended, to
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13 pay for certain out-of-pocket medical expenses.
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14 B. 1. Health benefit plans shall not reduce or eliminate
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15 coverage due to the requirements of this section.
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16 2. Enforcement of the provisions of this act section shall be
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17 performed by the Insurance Department and the State Department of
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18 Health.
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19 C. As used in this section, “health benefit plan” means any
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20 plan or arrangement as defined in subsection C of Section 6060.4 of
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21 this title.
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22 SECTION 2. This act shall become effective November 1, 2021.
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24 58-1-255 CB 1/21/2021 8:29:54 PM
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