PARRIS N. GLENDENING, Governor

Ch. 168

(1) INSURERS AND NONPROFIT HEALTH SERVICE PLANS THAT PROVIDE
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS ON AN
EXPENSE-INCURRED BASIS UNDER HEALTH INSURANCE POLICIES THAT ARE ISSUED
OR DELIVERED IN THE STATE; AND

(2) HEALTH MAINTENANCE ORGANIZATIONS THAT PROVIDE HOSPITAL,
MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER
CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE.

(B) AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE FOR
ALL MEDICALLY APPROPRIATE AND NECESSARY DIABETES EQUIPMENT, DIABETES
SUPPLIES, AND DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING AND
EDUCATIONAL SERVICES, INCLUDING MEDICAL NUTRITION THERAPY, THAT THE
INSURED'S OR ENROLLEES TREATING PHYSICIAN OR OTHER APPROPRIATELY
LICENSED HEALTH CARE PROVIDER, OR A PHYSICIAN WHO SPECIALIZES IN THE
TREATMENT OF DIABETES, CERTIFIES ARE NECESSARY FOR THE TREATMENT OF:

(1) INSULIN-USING DIABETES;

(2) NONINSULIN-USING DIABETES; OR

(3) ELEVATED BLOOD GLUCOSE LEVELS INDUCED BY PREGNANCY.

(C) IF CERTIFIED AS NECESSARY UNDER SUBSECTION (B) OF THIS SECTION,
THE DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING AND EDUCATIONAL
SERVICES, INCLUDING MEDICAL NUTRITION THERAPY, TO BE PROVIDED TO THE
INSURED OR ENROLLEE SHALL BE PROVIDED THROUGH A PROGRAM SUPERVISED
BY AN APPROPRIATELY LICENSED, REGISTERED, OR CERTIFIED HEALTH CARE
PROVIDER WHOSE SCOPE OF PRACTICE INCLUDES DIABETES EDUCATION OR
MANAGEMENT.

(D) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION, THE COVERAGE
REQUIRED UNDER THIS SECTION MAY BE SUBJECT TO THE ANNUAL DEDUCTIBLES
OR COINSURANCE REQUIREMENTS IMPOSED BY AN ENTITY SUBJECT TO THIS
SECTION FOR SIMILAR COVERAGES UNDER THE SAME HEALTH INSURANCE POLICY
OR CONTRACT.

(2) THE ANNUAL DEDUCTIBLES OR COINSURANCE REQUIREMENTS
IMPOSED UNDER PARAGRAPH (1) OF THIS SUBSECTION FOR THE COVERAGE
REQUIRED UNDER THIS SECTION MAY NOT BE GREATER THAN THE ANNUAL
DEDUCTIBLES OR COINSURANCE REQUIREMENTS IMPOSED BY THE ENTITY FOR
SIMILAR COVERAGES.

(E) AN ENTITY SUBJECT TO THIS SECTION MAY NOT REDUCE OR ELIMINATE
COVERAGES IN ITS HEALTH INSURANCE POLICIES OR CONTRACTS DUE TO THE
REQUIREMENTS OF THIS SECTION.

- 1807 -