| 1 | 1 | | BILL AS INTRODUCED H.207 |
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| 2 | 2 | | 2025 Page 1 of 2 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | VT LEG #380803 v.1 |
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| 6 | 6 | | H.207 1 |
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| 7 | 7 | | Introduced by Representative Branagan of Georgia 2 |
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| 8 | 8 | | Referred to Committee on 3 |
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| 9 | 9 | | Date: 4 |
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| 10 | 10 | | Subject: Health; health insurance; diabetes treatment 5 |
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| 11 | 11 | | Statement of purpose of bill as introduced: This bill proposes to modify 6 |
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| 12 | 12 | | provisions regarding health insurance coverage of diabetes treatment, including 7 |
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| 13 | 13 | | eliminating language allowing a health insurer to require that the treatment be 8 |
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| 14 | 14 | | provided by a health care professional under contract with the insurer and 9 |
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| 15 | 15 | | adding a prohibition on cost-sharing requirements. 10 |
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| 16 | 16 | | An act relating to health insurance coverage for diabetes treatment 11 |
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| 17 | 17 | | It is hereby enacted by the General Assembly of the State of Vermont: 12 |
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| 18 | 18 | | Sec. 1. 8 V.S.A. § 4089c is amended to read: 13 |
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| 19 | 19 | | § 4089c. DIABETES TREATMENT 14 |
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| 20 | 20 | | (a)(1) A health insurer shall provide coverage for the equipment, supplies, 15 |
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| 21 | 21 | | and outpatient self-management training and education, including medical 16 |
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| 22 | 22 | | nutrition therapy, for the treatment of insulin dependent diabetes, insulin using 17 |
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| 23 | 23 | | diabetes, gestational diabetes, and noninsulin using diabetes if prescribed by a 18 |
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| 24 | 24 | | health care professional legally authorized to prescribe such items under law. 19 BILL AS INTRODUCED H.207 |
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| 25 | 25 | | 2025 Page 2 of 2 |
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| 26 | 26 | | |
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| 27 | 27 | | |
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| 28 | 28 | | VT LEG #380803 v.1 |
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| 29 | 29 | | A health insurer may require that such prescriptions be made, and care be 1 |
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| 30 | 30 | | given, by a health care professional under contract with the insurer. 2 |
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| 31 | 31 | | (2) Diabetes outpatient self-management training and education required 3 |
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| 32 | 32 | | to be covered by this section shall be provided by a certified, registered, or 4 |
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| 33 | 33 | | licensed health care professional with specialized training in the education and 5 |
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| 34 | 34 | | management of diabetes. 6 |
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| 35 | 35 | | (3) Benefits required to be covered by this section shall not be subject to 7 |
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| 36 | 36 | | the same any dollar limits, deductibles, and coinsurance factors within the 8 |
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| 37 | 37 | | provisions of the health insurance policy or to any co-payment, coinsurance, 9 |
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| 38 | 38 | | deductible, or other cost-sharing requirement. 10 |
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| 39 | 39 | | (b) For the purposes of this section, “insurer” means any health insurance 11 |
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| 40 | 40 | | company, nonprofit hospital and medical service corporation, and health 12 |
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| 41 | 41 | | maintenance organization. The term does not apply to coverage for specified 13 |
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| 42 | 42 | | disease or other limited benefit coverage. 14 |
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| 43 | 43 | | Sec. 2. EFFECTIVE DATE 15 |
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| 44 | 44 | | This act shall take effect on January 1, 2026 and shall apply to all health 16 |
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| 45 | 45 | | insurance plans issued on and after January 1, 2026 on such date as a health 17 |
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| 46 | 46 | | insurer offers, issues, or renews the health insurance plan, but in no event later 18 |
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| 47 | 47 | | than January 1, 2027. 19 |
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