There is a newer version of the South Dakota Codified Laws
2006 South Dakota Code - 58-18B-56 — Policies to provide coverage for diabetes supplies, equipment andeducation--Exceptions--Conditions and limitations.
58-18B-56. Policies to provide coverage for diabetes supplies, equipment and education-- Exceptions--Conditions and limitations. Every small employer health benefit plan delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for equipment, supplies, and self-management training and education, including medical nutrition therapy, for treatment of persons diagnosed with diabetes if prescribed by a physician or other licensed health care provider legally authorized to prescribe such treatment. Medical nutrition therapy does not include any food items or nonprescription drugs. Coverage for
medically necessary equipment and supplies shall include blood
glucose monitors, blood glucose monitors for the legally blind,
test strips for glucose monitors, urine testing strips, insulin,
injection aids, lancets, lancet devices, syringes, insulin pumps
and all supplies for the pump, insulin infusion devices, prescribed
oral agents for controlling blood sugars, glucose agents, glucagon
kits, insulin measurement and administration aids for the visually
impaired, and other medical devices for treatment of
diabetes.
Diabetes
self-management training and education shall be covered if: (a) the
service is provided by a physician, nurse, dietitian, pharmacist,
or other licensed health care provider who satisfies the current
academic eligibility requirements of the National Certification
Board for Diabetic Educators and has completed a course in diabetes
education and training or has been certified as a diabetes
educator; and (b) the training and education is based upon a
diabetes program recognized by the American Diabetes Association or
a diabetes program with a curriculum approved by the American
Diabetes Association or the South Dakota Department of
Health.
Coverage of
diabetes self-management training is limited to (a) persons who are
newly diagnosed with diabetes or have received no prior diabetes
education; (b) persons who require a change in current therapy; (c)
persons who have a co-morbid condition such as heart disease or
renal failure; or (d) persons whose diabetes condition is unstable.
Under these circumstances, no more than two comprehensive education
programs per lifetime and up to eight follow-up visits per year
need be covered. Coverage is limited to the closest available
qualified education program that provides the necessary management
training to accomplish the prescribed treatment.
The benefits
provided in this section are subject to the same dollar limits,
deductibles, coinsurance, and other restrictions established for
all other benefits covered in the plan.
Source: SL 1999, ch 252, § 5.
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