{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6060.2","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6060.2","heading":"Treatment of diabetes - Equipment, supplies and","body":"services.\n\nA. 1. Every health benefit plan issued or renewed on or after\n\nNovember 1, 1996, shall, subject to the terms of the policy contract\n\nor agreement, include coverage for the following equipment, supplies\n\nand related services for the treatment of Type I, Type II, and\n\ngestational diabetes, when medically necessary and when recommended\n\nor prescribed by a physician or other licensed health care provider\n\nlegally authorized to prescribe under the laws of this state:\n\na. blood glucose monitors,\n\nb. blood glucose monitors to the legally blind,\n\nc. test strips for glucose monitors,\n\nd. visual reading and urine testing strips,\n\ne. insulin,\n\nf. injection aids,\n\ng. cartridges for the legally blind,\n\nh. syringes,\n\ni. insulin pumps and appurtenances thereto,\n\nj. insulin infusion devices,\n\nk. oral agents for controlling blood sugar, and\n\nl. podiatric appliances for prevention of complications\n\nassociated with diabetes.\n\n2. The State Board of Health shall develop and annually update,\n\nby rule, a list of additional diabetes equipment, related supplies\n\nand health care provider services that are medically necessary for\n\nthe treatment of diabetes, for which coverage shall also be\n\nincluded, subject to the terms of the policy, contract, or\n\nagreement, if the equipment and supplies have been approved by the\n\nfederal Food and Drug Administration (FDA). Additional FDA-approved\n\ndiabetes equipment and related supplies, and health care provider\n\nservices shall be determined in consultation with a national\n\ndiabetes association affiliated with this state, and at least three\n\n(3) medical directors of health benefit plans, to be selected by the\n\nState Department of Health.\n\n3. All policies specified in this section shall also include\n\ncoverage for:\n\na. podiatric health care provider services as are deemed\n\nmedically necessary to prevent complications from\n\ndiabetes, and\n\nb. diabetes self-management training. As used in this\n\nsubparagraph, \"diabetes self-management training\"\n\nmeans instruction in an inpatient or outpatient\n\nsetting which enables diabetic patients to understand\n\nthe diabetic management process and daily management\n\nof diabetic therapy as a method of avoiding frequent\n\nhospitalizations and complications. Diabetes self-\n\nmanagement training shall comply with standards\n\ndeveloped by the State Board of Health in consultation\n\nwith a national diabetes association affiliated with\n\nthis state and at least three medical directors of\n\nhealth benefit plans selected by the State Department\n\nof Health. Coverage for diabetes self-management\n\ntraining, including medical nutrition therapy relating\n\nto diet, caloric intake, and diabetes management, but\n\nexcluding programs the only purpose of which are\n\nweight reduction, shall be limited to the following:\n\n(1) visits medically necessary upon the diagnosis of\n\ndiabetes,\n\n(2) a physician diagnosis which represents a\n\nsignificant change in the symptoms or condition\n\nof the patient making medically necessary changes\n\nin the self-management of the patient, and\ng programs the only purpose of which are\n\nweight reduction, shall be limited to the following:\n\n(1) visits medically necessary upon the diagnosis of\n\ndiabetes,\n\n(2) a physician diagnosis which represents a\n\nsignificant change in the symptoms or condition\n\nof the patient making medically necessary changes\n\nin the self-management of the patient, and\n\n(3) visits when reeducation or refresher training is\n\nmedically necessary;\n\nprovided, however, payment for the coverage required for diabetes\n\nself-management training pursuant to the provisions of this section\n\nshall be required only upon certification by the health care\n\nprovider providing the training that the patient has successfully\n\ncompleted diabetes self-management training.\n\n4. Diabetes self-management training shall be supervised by a\n\nlicensed physician or other licensed health care provider legally\n\nauthorized to prescribe under the laws of this state. Diabetes\n\nself-management training may be provided by the physician or other\n\nappropriately registered, certified, or licensed health care\n\nprofessional as part of an office visit for diabetes diagnosis or\n\ntreatment. Training provided by appropriately registered,\n\ncertified, or licensed health care professionals may be provided in\n\ngroup settings where practicable.\n\n5. Coverage for diabetes self-management training and training\n\nrelated to medical nutrition therapy, when provided by a registered,\n\ncertified, or licensed health care professional, shall also include\n\nhome visits when medically necessary and shall include instruction\n\nin medical nutrition therapy only by a licensed registered dietician\n\nor licensed certified nutritionist when authorized by the\n\nsupervising physician of the patient when medically necessary.\n\n6. Coverage may be subject to the same annual deductibles or\n\ncoinsurance as may be deemed appropriate and as are consistent with\n\nthose established for other covered benefits within a given policy.\n\n7. Any health benefit plan, as defined pursuant to Section\n\n6060.4 of this title, that provides coverage for insulin pursuant to\n\nthis section shall cap the total amount that a covered person is\n\nrequired to pay for insulin at an amount not to exceed Thirty\n\nDollars ($30.00) per thirty-day supply or Ninety Dollars ($90.00)\n\nper ninety-day supply of insulin for each covered insulin\n\nprescription, regardless of the amount or type of insulin needed to\n\nfill the prescription or prescriptions of the covered person.\n\na. Nothing in this paragraph shall prevent a health\n\nbenefit plan from reducing the cost-sharing of a\n\ncovered person to an amount less than Thirty Dollars\n\n($30.00) per thirty-day supply or Ninety Dollars\n\n($90.00) per ninety-day supply.\n\nb. The Insurance Commissioner shall ensure all health\n\nbenefit plans comply with the requirements of this\n\nparagraph.\n\nc. The Commissioner may promulgate rules as necessary to\n\nimplement and administer the requirements of this\n\nparagraph and to align with federal requirements.\n\nB. 1. Health benefit plans shall not reduce or eliminate\n\ncoverage due to the requirements of this section.\n\n2. Enforcement of the provisions of this act shall be performed\n\nby the Insurance Department and the State Department of Health.\n\nC. As used in this section, \"health benefit plan\" means any\n\nplan or arrangement as defined in subsection C of Section 6060.4 of\n\nthis title.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"3b02474c175bacb7b453284d03d32464b38cd05f3eb3564bebbcbff45a7aeb86","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6060.18","next":"us-ok/okla.-stat.-tit.-36-36-6060.20"},"notice":"GroundRules: Original legal text. Not legal advice."}