                                 CODE OF VIRGINIA

COVERAGE FOR DIABETES (§ 38.2-3418.10)

A. Each insurer proposing to issue an individual or group hospital policy or
major medical policy in this Commonwealth, each corporation proposing to issue
an individual or group hospital, medical or major medical subscription contract,
and each health maintenance organization providing a health care plan for health
care services shall provide coverage for diabetes as provided in this section.

B. Such coverage shall include benefits for equipment, supplies and in-person
outpatient self-management training and education, including medical nutrition
therapy, for the treatment of insulin-dependent diabetes, insulin-using
diabetes, gestational diabetes and noninsulin-using diabetes if prescribed by a
health care professional legally authorized to prescribe such items under law.
As used herein, the terms &#8220;equipment&#8221; and &#8220;supplies&#8221;
shall not be considered durable medical equipment.

C. To qualify for coverage under this section, diabetes in-person outpatient
self-management training and education shall be provided by a certified,
registered or licensed health care professional. A managed care health insurance
plan, as defined in Chapter 58 (&#xA7; 38.2-5800 et seq.) of this title, may
require such health care professional to be a member of the plan&#8217;s
provider network; provided that such network includes sufficient health care
professionals who are qualified by specific education, experience, and
credentials to provide the covered benefits described in this section.

D. No insurer, corporation, or health maintenance organization shall impose upon
any person receiving benefits pursuant to this section any copayment, fee or
condition that is not equally imposed upon all individuals in the same benefit
category, nor shall any insurer, corporation or health maintenance organization
impose any policy-year or calendar-year dollar or durational benefit limitations
or maximums for benefits or services provided under this section.

E. The requirements of this section shall apply to all insurance policies,
contracts and plans delivered, issued for delivery, reissued, or extended on and
after July 1, 2000, or at any time thereafter when any term of the policy,
contract or plan is changed or any premium adjustment is made.

F. This section shall not apply to short-term travel, accident only, or limited
or specified disease policies or contracts, nor to policies or contracts
designed for issuance to persons eligible for coverage under Title XVIII of the
Social Security Act, known as Medicare, or any other similar coverage under
state or federal governmental plans.

HISTORY: 1999, c. 35; 2000, cc. 1025, 1060; 2014, c. 814.