[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IP] Free Needles for Druggies, no help for diabetics



At 09:31 PM 10/14/1998  email @ redacted wrote:
>"Support for Drug Habits that End Life Rather Than Sustain It"

I'd like to add my 2 cents here... this is not an either/or
situation. I think that both groups should get support, but for
very different reasons. 

The free needles for drug addicts are not to help them get high
but to help prevent the spread of disease. The needles by
themselves don't cause or promote addiction (the bad part are
the nasty drugs they use). Since addicts will use whatever
needles they can find and get high in any case, I'd rather have
them use clean ones and not spread AIDS and whatever other
diseases they happen to have. I think it is in all our
self-interest to prevent the spread of these diseases into the
regular population. 

At the same time I believe that basic diabetes supplies ought to
covered by all insurance companies. Texas has a law on the books
that provides for this. I think that a letter writing campaign
directed on making this universal across the country would be
much better for us. 

Keep the issue focused on making sure that diabetic supplies are
universally and equally available to everyone. Adding the addict
stuff, will only muddy the water. Below is a copy of what I
wrote to my state (governor, senator & representative)

Sam

*****************************************************************
********************
Many diabetics have a difficult time getting some insurance
companies to pay for daily supplies and other durable medical
equipment that they need to maintain good health. This is
especially critical for insulin-dependent diabetics who are
totally dependent on these medical supplies just for staying
alive. These required items are expensive, however, and can
easily cost from $100/200 a month. With over 2% of the
population being classified as diabetic, this is not a small
problem.

The State of Texas has enacted the legislation shown (in full)
below. It mandates that insurance companies provide certain
minimum supplies for diabetics. I think that it could provide a
model for legislation on a national scale so that all Americans
with diabetes have equal access to these life-giving medicines
and supplies. 

I would appreciate your thoughts on this matter and any support
you could provide.

*****************************************************************
***********************

                                       AN ACT
1-1     relating to coverage under health benefit plans for
certain
1-2     supplies and services associated with the treatment of
diabetes.
1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF
TEXAS:
1-4           SECTION 1.  Subchapter E, Chapter 21, Insurance
Code, is
1-5     amended by adding Article 21.53G to read as follows:
1-6           Art. 21.53G.  COVERAGE FOR SUPPLIES AND SERVICES
ASSOCIATED
1-7     WITH TREATMENT OF DIABETES
1-8           Sec. 1.  DEFINITIONS.  In this article:
1-9                 (1)  "Diabetes equipment" means:
1-10                       (A)  blood glucose monitors,
including monitors
1-11     designed to be used by blind individuals;
1-12                       (B)  insulin pumps and associated
appurtenances;
1-13                       (C)  insulin infusion devices; and
1-14                       (D)  podiatric appliances for the
prevention of
1-15     complications associated with diabetes.
1-16                 (2)  "Diabetes supplies" means:
1-17                       (A)  test strips for blood glucose
monitors;
1-18                       (B)  visual reading and urine test
strips;
1-19                       (C)  lancets and lancet devices;
1-20                       (D)  insulin and insulin analogs;
1-21                       (E)  injection aids;
1-22                       (F)  syringes;
1-23                       (G)  prescriptive and nonprescriptive
oral agents
2-1     for controlling blood sugar levels; and
2-2                       (H)  glucagon emergency kits.
2-3                 (3)  "Health benefit plan" means a plan
described by
2-4     Section 2 of this article.
2-5                 (4)  "Qualified insured" means an individual
eligible
2-6     for coverage under a health benefit plan who has been
diagnosed
2-7     with:
2-8                       (A)  insulin dependent or noninsulin
dependent
2-9     diabetes;
2-10                       (B)  elevated blood glucose levels
induced by
2-11     pregnancy; or
2-12                       (C)  another medical condition
associated with
2-13     elevated blood glucose levels.
2-14           Sec. 2.  SCOPE OF ARTICLE.  (a)  This article
applies to a
2-15     health benefit plan that:
2-16                 (1)  provides benefits for medical or
surgical expenses
2-17     incurred as a result of a health condition, accident,
or sickness,
2-18     including:
2-19                       (A)  an individual, group, blanket,
or franchise
2-20     insurance policy or insurance agreement, a group
hospital service
2-21     contract, or an individual or group evidence of
coverage that is
2-22     offered by:
2-23                             (i)  an insurance company;
2-24                             (ii)  a group hospital service
corporation
2-25     operating under Chapter 20 of this code;
3-1                             (iii)  a fraternal benefit
society
3-2     operating under Chapter 10 of this code;
3-3                             (iv)  a stipulated premium
insurance
3-4     company operating under Chapter 22 of this code;
3-5                             (v)  a reciprocal exchange
operating under
3-6     Chapter 19 of this code; or
3-7                             (vi)  a health maintenance
organization
3-8     operating under the Texas Health Maintenance
Organization Act
3-9     (Chapter 20A, Vernon's Texas Insurance Code); or
3-10                       (B)  to the extent permitted by the
Employee
3-11     Retirement Income Security Act of 1974 (29 U.S.C.
Section 1001 et
3-12     seq.), a health benefit plan that is offered by a
multiple employer
3-13     welfare arrangement as defined by Section 3, Employee
Retirement
3-14     Income Security Act of 1974 (29 U.S.C. Section 1002);
or
3-15                 (2)  is offered by an approved nonprofit
health
3-16     corporation that is certified under Section 5.01(a),
Medical
3-17     Practice Act (Article 4495b, Vernon's Texas Civil
Statutes), and
3-18     that holds a certificate of authority  issued by the
commissioner
3-19     under Article 21.52F of this code.
3-20           (b)  This article does not apply to:
3-21                 (1)  a plan that provides coverage:
3-22                       (A)  only for a specified disease or
other
3-23     limited benefit;
3-24                       (B)  only for accidental death or
dismemberment;
3-25                       (C)  for wages or payments in lieu of
wages for a
4-1     period during which an employee is absent from work
because of
4-2     sickness or injury;
4-3                       (D)  as a supplement to liability
insurance;
4-4                       (E)  for credit insurance;
4-5                       (F)  only for dental or vision care;
or
4-6                       (G)  only for indemnity for hospital
confinement;
4-7                 (2)  a small employer plan written under
Chapter 26 of
4-8     this code;
4-9                 (3)  a Medicare supplemental policy as
defined by
4-10     Section 1882(g)(1), Social Security Act (42 U.S.C.
Section 1395ss);
4-11                 (4)  workers' compensation insurance
coverage;
4-12                 (5)  medical payment insurance issued as
part of a
4-13     motor vehicle insurance policy; or
4-14                 (6)  a long-term care policy, including a
nursing home
4-15     fixed indemnity policy, unless the commissioner
determines that the
4-16     policy provides benefit coverage so comprehensive that
the policy
4-17     is a health benefit plan as described by Subsection (a)
of this
4-18     section.
4-19           Sec. 3.  REQUIRED BENEFIT FOR SUPPLIES AND
SERVICES
4-20     ASSOCIATED WITH TREATMENT OF DIABETES.  A health
benefit plan that
4-21     provides benefits for the treatment of diabetes and
associated
4-22     conditions must provide coverage to each qualified
insured for:
4-23                 (1)  diabetes equipment;
4-24                 (2)  diabetes supplies; and
4-25                 (3)  diabetes self-management training
programs.
5-1           Sec. 4.  DIABETES SELF-MANAGEMENT TRAINING.
Diabetes
5-2     self-management training under this article must be
provided by a
5-3     health care practitioner or provider who is licensed,
registered,
5-4     or certified in this state to provide appropriate health
care
5-5     services.  Self-management training includes:
5-6                 (1)  training provided to a qualified
insured after the
5-7     initial diagnosis of diabetes in the care and management
of that
5-8     condition, including nutritional counseling and proper
use of
5-9     diabetes equipment and supplies;
5-10                 (2)  additional training authorized on the
diagnosis of
5-11     a physician or other health care practitioner of a
significant
5-12     change in the qualified insured's symptoms or condition
that
5-13     requires changes in the qualified insured's
self-management regime;
5-14     and
5-15                 (3)  periodic or episodic continuing
education training
5-16     when prescribed by an appropriate health care
practitioner as
5-17     warranted by the development of new techniques and
treatments for
5-18     diabetes.
5-19           Sec. 5.  EFFECT OF NEW TREATMENT MODALITIES.  In
addition to
5-20     the benefits required under Sections 3 and 4 of this
article, on
5-21     the approval of the United States Food and Drug
Administration of
5-22     new or improved diabetes equipment or diabetes
supplies, including
5-23     improved insulin or other prescription drugs, each
health benefit
5-24     plan subject to this article must include coverage of
the new or
5-25     improved equipment or supplies if medically necessary
and
6-1     appropriate as determined by a physician or other health
care
6-2     practitioner.
6-3           Sec. 6.  LIMITATION.  Benefits required under this
article
6-4     may be made subject to a deductible, copayment, or
coinsurance
6-5     requirement.  A deductible, copayment, or coinsurance
required by
6-6     the health benefit plan for benefits under this article
may not
6-7     exceed the deductible, copayment, or coinsurance
required by the
6-8     health benefit plan for treatment of other analogous
chronic
6-9     medical conditions.
6-10           Sec. 7.  RULES.  The commissioner shall adopt
rules as
6-11     necessary for the implementation of this article.  The
commissioner
6-12     may consult with the commissioner of public health and
other
6-13     appropriate entities in adopting rules under this
section.
6-14           SECTION 2.  This Act takes effect September 1,
1997, and
6-15     applies only to a health benefit plan that is
delivered, issued for
6-16     delivery, or renewed on or after January 1, 1998.  A
health benefit
6-17     plan that is delivered, issued for delivery, or renewed
before
6-18     January 1, 1998, is governed by the law as it existed
immediately
6-19     before the effective date of this Act, and that law is
continued in
6-20     effect for that purpose.
6-21           SECTION 3.  The importance of this legislation
and the
6-22     crowded condition of the calendars in both houses
create an
6-23     emergency and an imperative public necessity that the
6-24     constitutional rule requiring bills to be read on three
several
6-25     days in each house be suspended, and this rule is
hereby suspended.


S.B. No.163

         _______________________________
_______________________________
             President of the Senate              Speaker of the
House
               I hereby certify that S.B. No. 163 passed the
Senate on
         April 9, 1997, by a viva-voce vote and that the Senate
concurred in
         House amendment on April 28, 1997, by a viva-voce vote.


_______________________________
                                                 Secretary of
the Senate
               I hereby certify that S.B. No. 163 passed the
House, with
         amendment, on April 24, 1997, by a non-record vote.


_______________________________
                                                 Chief Clerk of
the House
         Approved:
         _______________________________
                     Date
         _______________________________
                   Governor



Insulin-Pumpers website http://www.bizsystems.com/Diabetes/