SRC-JXG C.S.S.B. 982 76(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 982
By: Madla
Health Services
4/14/1999
Committee Report (Substituted)


DIGEST 

In 1997, the Legislature passed S.B. 163 to require health plans to provide
certain benefits to persons suffering from diabetes, including diabetes
equipment, supplies, and self-management training. The Texas Diabetes
Council estimates that there are 1.6 million Texans suffering from
diabetes; 920,000 diagnosed and 680,000 not diagnosed. Diabetes is the
sixth leading cause of death in Texas, claiming 12,299 individuals,
according to the Bureau of Vital Statistics reports. C.S.S.B. 982 would
authorize dietitians to provide nutritional diabetes counseling and related
diabetes information, and to be reimbursed for that service. 

PURPOSE

As proposed, C.S.S.B. 982 clarifies authorization of certain persons
allowed to receive reimbursement for diabetes self-management training. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the licensing board of practitioners or
providers in SECTION 1 (Section 4(d), Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 4, Article 21.53G, Insurance Code, to require
diabetes selfmanagement training under this article to be provided by a
health care practitioner or provider who is licensed, registered, certified
in this state to provide appropriate health care services, acting within
the scope of practice authorized by the license, registration or
certification of the practitioner or provider. Requires a health benefit
plan to provide diabetes self-management training or coverage for diabetes
self-management training for which a physician or practitioner has written
an order to each insured or the caretaker of the insured from a certain
diabetes self-management training program, including a multidisciplinary
team to assist in the coordination of certain persons. Defines "nutritional
counseling." Authorizes the appropriate licensing board of practitioners or
providers authorized to provide diabetes self-management training in
accordance with this section, by rule, to determine the recent didactic and
experiential preparation in diabetes clinical and educational issues
required by this section to qualify licensees of the National Certified
Board for Diabetes Educators (NCBDE) to provide the training, and, by rule,
to determine and define the component or components of diabetes
self-management training authorized by Subsections (ii) and (iii) of
Subsection (b), in consultation with the Texas Diabetes Council. Makes
conforming changes.  

SECTION 2. Effective date: September 1, 1999. 
           Makes application of this Act prospective.

SECTION 3. Emergency clause.


SUMMARY OF COMMITTEE CHANGES

SECTION 1. 

Amends Section 4, Article 21.53G, Insurance Code, to require diabetes
self-management  training to be provided by a health care practitioner or
provider acting within the scope of practice authorized by the license,
registration or certification of the practitioner or provider. Requires a
health benefit plan to provide diabetes self-management training or
coverage for diabetes self-management training for which a physician or
practitioner has written an order to each insured or the caretaker of the
insured from a multidisciplinary team, coordinated by a Certified Diabetes
Educator or a person who has completed  at least 24 hours of approved
continuing education that includes at least a dietitian and a nurse
educator who collaborate routinely; a Certified Diabetes Educator who is
certified by NCBDE; a licensed health care practitioner, who has been
determined by his or her licensing board to have recent didactic and
experiential preparation in diabetes clinical and educational issues; or
certain licensed health care practitioners or providers of a diabetes
self-management training program. Authorizes the appropriate licensing
board of practitioners or providers authorized to provide diabetes
self-management training in accordance with this section, by rule, to
determine the recent didactic and experiential preparation in diabetes
clinical and educational issues required by this section to qualify
licensees of NCBDE to provide the training, and, by rule, to determine and
define the component or components of diabetes self-management training
authorized by Subsections (ii) and (iii) of Subsection (b), in consultation
with the Texas Diabetes Council. Deletes text regarding a health care
professional or a Certified Diabetes Educator. Makes conforming changes. 

SECTION 2.

Amends SECTION 2 to provide the effective date: September 1, 1999, and to
make application of this Act prospective.  

 Redesignates proposed SECTION 2 as SECTION 3.

SECTION 3.

 Adds SECTION 3 regarding the emergency clause.