North Carolina § 58-65-91 - Coverage for certain treatment of diabetes.

§ 58-65-91. Coverage for certain treatment of diabetes.

Every insurance certificate or subscriber contract under any hospital service plan or medical service plan governed by this Article and Article 66 of this Chapter, and every preferred provider plan under G.S. 58-50-56 that is issued, renewed, or amended on or after October 1, 1997, shall provide coverage for medically appropriate and necessary services, including diabetes outpatient self-management training and educational services, and equipment, supplies, medications, and laboratory procedures used to treat diabetes. Diabetes outpatient self-management training and educational services shall be provided by a physician or a health care professional designated by the physician. The hospital or medical service plan shall determine who shall provide and be reimbursed for the diabetes outpatient self-management training and educational services. The same deductibles, coinsurance, and other limitations as apply to similar services covered under the policy, contract, or plan shall apply to the diabetes coverage required under this section. For the purposes of this section, "physician" is a person licensed to practice in this State under Article 1 or Article 7 of Chapter 90 of the General Statutes. History (1997-225, s. 2; 1997-519, s. 3.12.) Editor's Note. - Session Laws 1997-225, s. 4, provides: "Nothing in this act shall apply to specified accident, specified disease, hospital indemnity, or long-term care health insurance policies." Session Laws 1997-225, s. 5, provides: "The North Carolina Commission for Health Services [now the Commission for Public Health] shall develop voluntary standards or guidelines for diabetes outpatient self-management training and educational services based on clinical practice recommendations and guidelines established by the Center for Disease Control and the American Diabetes Association. These standards or guidelines are not subject to Article 2A of Chapter 150B of the General Statutes."