By:  Madla                                             S.B. No. 982
                                A BILL TO BE ENTITLED
                                       AN ACT
 1-1     relating to persons authorized to provide diabetes self-management
 1-2     training.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Section 4, Article 21.53G, Insurance Code, is
 1-5     amended to read as follows:
 1-6           Sec. 4.  Diabetes Self-Management Training.  (a)  Diabetes
 1-7     self-management training under this article must be provided by a
 1-8     health care practitioner or provider who is licensed, registered,
 1-9     or certified in this state to provide appropriate health care
1-10     services, acting within the scope of practice authorized by the
1-11     license, registration, or certification of the practitioner or
1-12     provider.  Self-management training includes:
1-13                 (1)  training provided to a qualified insured after the
1-14     initial diagnosis of diabetes in the care and management of that
1-15     condition, including nutritional counseling and proper use of
1-16     diabetes equipment and supplies;
1-17                 (2)  additional training authorized on the diagnosis of
1-18     a physician or other health care practitioner of a significant
1-19     change in the qualified insured's symptoms or condition that
1-20     requires changes in the qualified insured's self-management regime;
1-21     and
1-22                 (3)  periodic or episodic continuing education training
1-23     when prescribed by an appropriate health care practitioner as
1-24     warranted by the development of new techniques and treatments for
 2-1     diabetes.
 2-2           (b)  A health benefit plan shall provide diabetes
 2-3     self-management training or coverage for diabetes self-management
 2-4     training for which a physician or practitioner has written an order
 2-5     to each insured or the caretaker of the insured from:
 2-6                 (1)  a diabetes self-management training program
 2-7     recognized by the American Diabetes Association;
 2-8                 (2)  a multidisciplinary team, coordinated by a
 2-9     Certified Diabetes Educator who is certified by the National
2-10     Certification Board for Diabetes Educators or a person who has
2-11     completed at least 24 hours of approved continuing education that
2-12     includes a combination of diabetes education, educational
2-13     principles, and behavioral strategies, consisting of at least a
2-14     dietitian and a nurse educator who collaborate routinely and which
2-15     may include a pharmacist and a social worker, and each member of
2-16     which, other than a social worker, must have recent didactic and
2-17     experiential preparation in diabetes clinical and educational
2-18     issues;
2-19                 (3)  a Certified Diabetes Educator who is certified by
2-20     the National Certification Board for Diabetes Educators;
2-21                 (4)  a licensed health care practitioner, including a
2-22     physician, a physician assistant, a registered nurse, a licensed
2-23     dietitian, or a pharmacist, who has been determined by the
2-24     practitioner's licensing board to have recent didactic and
2-25     experiential preparation in diabetes clinical and educational
2-26     issues; or
 3-1                 (5)  the following licensed health care practitioners
 3-2     or providers, who may provide a component or components of a
 3-3     diabetes self-management training program:
 3-4                       (A)  a licensed dietitian, who may provide any
 3-5     nutritional counseling component;
 3-6                       (B)  a pharmacist, who may provide any
 3-7     pharmaceutical component; or
 3-8                       (C)  a physician, a physician assistant, a
 3-9     registered nurse, or an advanced practice nurse, who may provide
3-10     any other component of the training.
3-11           (c)  In this section, the term "nutritional counseling" has
3-12     the meaning assigned the term "nutrition counseling" in Section
3-13     2(12), Licensed Dietitian Act (Article 4512h, Vernon's Texas Civil
3-14     Statutes).
3-15           (d)  In consultation with the Texas Diabetes Council, the
3-16     appropriate licensing board of practitioners or providers
3-17     authorized to provide diabetes self-management training in
3-18     accordance with this section shall by rule determine the recent
3-19     didactic and experiential preparation in diabetes clinical and
3-20     educational issues required by this section to qualify licensees of
3-21     the board to provide the training and shall by rule determine and
3-22     define the component or components of diabetes self-management
3-23     training authorized by Subsections (b)(5)(B) and (C) of this
3-24     section.
3-25           SECTION 2.  This Act takes effect September 1, 1999, and
3-26     applies only to a health benefit plan that is delivered, issued for
 4-1     delivery, or renewed on or after January 1, 2000.  A health benefit
 4-2     plan that is delivered, issued for delivery, or renewed before
 4-3     January 1, 2000, is governed by the law as it existed immediately
 4-4     before the effective date of this Act, and that law is continued in
 4-5     effect for that purpose.
 4-6           SECTION 3.  The importance of this legislation and the
 4-7     crowded condition of the calendars in both houses create an
 4-8     emergency and an imperative public necessity that the
 4-9     constitutional rule requiring bills to be read on three several
4-10     days in each house be suspended, and this rule is hereby suspended.