STAND. COM. REP. NO. 2395

                                   Honolulu, Hawaii
                                                     , 2000

                                   RE:  S.B. No. 2657
                                        S.D. 1




Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was
referred S.B. No. 2657 entitled: 

     "A BILL FOR AN ACT RELATING TO HEALTH,"

begs leave to report as follows:

     The purpose of this measure is to require all health
insurance policies to provide coverage for outpatient diabetes
self-management training, education, equipment, and supplies.

     Your Committee received testimony in support of this measure
from the Department of Health, Queen's Health Management,
American Diabetes Association, Hawaii Association of Diabetes
Educators, Honolulu Medical Group, Hawaii Nurses' Association,
Haleiwa Family Health Center, and eighteen private individuals.
Informational testimony was provided by the State Insurance
Commissioner.  Testimony in opposition was received from Hawaii
Medical Service Association, Kaiser Permanente, and State Farm
Insurance Companies.

     Your Committee finds that diabetes is one of the most
prevalent diseases in Hawaii.  Much of the treatment for diabetes
involves self-management, however, health insurance policies do
not usually provide coverage for education instruction, including
visits to physicians for consultation on managing the condition.

     Your Committee further finds that effective outpatient self-
management by diabetics results directly in a significant
reduction in both the economic and human devastation wrought by

 
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                                   STAND. COM. REP. NO. 2395
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the disease.  There is ample evidence that tight control of blood
sugar levels through patient self-management can dramatically
lower the incidence of complications, increase life expectancy,
and significantly enhance the quality of life of diabetics.  In
addition, studies show that providing diabetics with the
appropriate supplies and training for self-management results in
a decrease in health care services utilization and costs.

     Your Committee has amended this measure by:

     (1)  Replacing references to "diabetics" with "persons with
          diabetes";

     (2)  Deleting reference to prescriptions by other licensed
          health care professionals;

     (3)  Replacing references to "satisfies" and "completed a
          course" with "certified";

     (4)  Clarifying that the coverage includes "diabetes self-
          management";

     (5)  Clarifying that the diabetes program be recognized by
          the American Diabetes Association;

     (6)  Adding that the requirement of coverage for diabetes
          self-management training and education is also
          satisfied by group sessions or individual training
          sessions if medically necessary;

     (7)  Deleting reference to medical nutrition therapy;

     (8)  Clarifying that diabetes equipment and supplies include
          one blood glucose monitor, and all insulin preparations
          and all insulin cartridges;

     (9)  Replacing "plan formulary" with "open formulary";

    (10)  Adding coverage for podiatric services, as defined by
          medicare; and

    (11)  Making technical, nonsubstantive changes to reflect
          preferred drafting style and for clarity and
          consistency.

     As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee is in accord with the intent and purpose
of S.B. No. 2657, as amended herein, and recommends that it pass

 
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Second Reading in the form attached hereto as S.B. No. 2657,
S.D. 1, and be referred to the Committee on Commerce and Consumer
Protection.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health and Human
                                   Services,



                                   ______________________________
                                   SUZANNE CHUN OAKLAND, Chair

 
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