IC 27-8-14.5-6: Coverage for diabetes self-management training

Sec. 6. (a) A health insurance plan issued by an insurer must provide coverage for diabetes self-management training that is:

(1) medically necessary;

(2) ordered in writing by a physician licensed under IC 25-22.5, a podiatrist licensed under IC 25-29, an advanced practice registered nurse licensed under IC 25-23, or a physician assistant licensed under IC 25-27.5; and

(3) provided by a health care professional who:

(A) is licensed, registered, or certified under IC 25; and

(B) has specialized training in the management of diabetes.

(b) Coverage for diabetes self-management training may be limited to the following:

(1) One (1) or more visits after receiving a diagnosis of diabetes.

(2) One (1) or more visits after receiving a diagnosis by a physician licensed under IC 25-22.5 or a podiatrist licensed under IC 25-29 that:

(A) represents a significant change in the insured's symptoms or condition; and

(B) makes changes in the insured's self-management medically necessary.

(3) One (1) or more visits for reeducation or refresher training.

(c) Coverage for diabetes self-management training is subject to the requirements of the health insurance plan regarding the use of participating providers.