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. It is the intent of the legislature that the
1-5 health care providers authorized by this Act to provide diabetes
1-6 self-management training or a component of diabetes self-management
1-7 training be skilled and experienced professionals with education in
1-8 diabetes, educational principles, and behavior strategies necessary
1-9 to meet the needs of a patient diagnosed with diabetes and, to the
1-10 extent possible, that the health care providers coordinate the care
1-11 provided to the patient.
1-12 SECTION 2. Section 1, Article 21.53G, Insurance Code, is
1-13 amended by adding Subdivision (5) to read as follows:
1-14 (5) "Nutrition counseling" has the meaning assigned by
1-15 Section 2, Licensed Dietitian Act (Article 4512h, Vernon's Texas
1-16 Civil Statutes).
1-17 SECTION 3. Section 4, Article 21.53G, Insurance Code, is
1-18 amended to read as follows:
1-19 Sec. 4. DIABETES SELF-MANAGEMENT TRAINING. (a) Diabetes
1-20 self-management training under this article must be provided by a
1-21 health care practitioner or provider who is licensed, registered,
1-22 or certified in this state to provide appropriate health care
1-23 services and who is acting within the scope of practice authorized
1-24 by the practitioner's or provider's license, registration, or
2-1 certification. Self-management training includes:
2-2 (1) training provided to a qualified insured after the
2-3 initial diagnosis of diabetes in the care and management of that
2-4 condition, including nutrition [nutritional] counseling and proper
2-5 use of diabetes equipment and supplies;
2-6 (2) additional training authorized on the diagnosis of
2-7 a physician or other health care practitioner of a significant
2-8 change in the qualified insured's symptoms or condition that
2-9 requires changes in the qualified insured's self-management regime;
2-10 and
2-11 (3) periodic or episodic continuing education training
2-12 when prescribed by an appropriate health care practitioner as
2-13 warranted by the development of new techniques and treatments for
2-14 diabetes.
2-15 (b) Coverage for diabetes self-management training provided
2-16 by a health benefit plan under this article to a qualified insured
2-17 must include coverage for the following, if provided on the written
2-18 order of a physician or health care practitioner, including the
2-19 written order of a health care practitioner practicing under
2-20 protocols jointly developed with a physician:
2-21 (1) a diabetes self-management training program
2-22 recognized by the American Diabetes Association;
2-23 (2) diabetes self-management training given by a
2-24 multidisciplinary team:
2-25 (A) the non-physician members of which are
2-26 coordinated by:
3-1 (i) a diabetes educator who is certified
3-2 by the National Certification Board for Diabetes Educators; or
3-3 (ii) a person who has completed at least
3-4 24 hours of continuing education that meets guidelines established
3-5 by the Texas Board of Health and that includes a combination of
3-6 diabetes-related educational principles and behavioral strategies;
3-7 (B) that consists of at least a licensed
3-8 dietitian and a registered nurse and may include a pharmacist and a
3-9 social worker; and
3-10 (C) each member of which, other than a social
3-11 worker, has recent didactic and experiential preparation in
3-12 diabetes clinical and educational issues as determined by the
3-13 member's licensing agency, in consultation with the commissioner of
3-14 public health, unless the member's licensing agency, in
3-15 consultation with the commissioner of public health, determines
3-16 that the core educational preparation for the member's license
3-17 includes the skills the member needs to provide diabetes
3-18 self-management training;
3-19 (3) diabetes self-management training provided by a
3-20 diabetes educator certified by the National Certification Board for
3-21 Diabetes Educators; or
3-22 (4) diabetes self-management training in which one or
3-23 more of the following components are provided:
3-24 (A) the nutrition counseling component provided
3-25 by a licensed dietitian, for which the licensed dietitian shall be
3-26 paid;
4-1 (B) the pharmaceutical component provided by a
4-2 pharmacist, for which the pharmacist shall be paid;
4-3 (C) any component of the training provided by a
4-4 physician assistant or registered nurse, for which the physician
4-5 assistant or registered nurse shall be paid, except that the
4-6 physician assistant or registered nurse may not be paid for
4-7 providing a nutrition counseling or pharmaceutical component unless
4-8 a licensed dietitian or pharmacist is unavailable to provide that
4-9 component; or
4-10 (D) any component of the training provided by a
4-11 physician.
4-12 (c) A person may not provide a component of diabetes
4-13 self-management training under Subsection (b)(4) of this section
4-14 unless the subject matter of the component is within the scope of
4-15 the person's practice and the person meets the education
4-16 requirements, as determined by the person's licensing agency, in
4-17 consultation with the commissioner of public health.
4-18 SECTION 4. This Act takes effect September 1, 1999, and
4-19 applies only to a health benefit plan that is delivered, issued for
4-20 delivery, or renewed on or after January 1, 2000. A health benefit
4-21 plan that is delivered, issued for delivery, or renewed before
4-22 January 1, 2000, is governed by the law as it existed immediately
4-23 before the effective date of this Act, and that law is continued in
4-24 effect for that purpose.
4-25 SECTION 5. The importance of this legislation and the
4-26 crowded condition of the calendars in both houses create an
S.B. No. 982
5-1 emergency and an imperative public necessity that the
5-2 constitutional rule requiring bills to be read on three several
5-3 days in each house be suspended, and this rule is hereby suspended.
________________________________ ________________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 982 passed the Senate on
April 22, 1999, by the following vote: Yeas 30, Nays 0;
May 28, 1999, Senate refused to concur in House amendment and
requested appointment of Conference Committee; May 29, 1999, House
granted request of the Senate; May 30, 1999, Senate adopted
Conference Committee Report by a viva-voce vote.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 982 passed the House, with
amendment, on May 22, 1999, by a non-record vote; May 29, 1999,
House granted request of the Senate for appointment of Conference
Committee; May 30, 1999, House adopted Conference Committee Report
by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
________________________________
Date
________________________________
Governor