Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter R - DIABETES
Section 21.2606 - Diabetes Self-Management Training
Current through Reg. 50, No. 13; March 28, 2025
(a) A health benefit plan must provide diabetes self-management training or coverage for diabetes self-management training for which a physician or practitioner has written an order, including a written order of a practitioner practicing under protocols jointly developed with a physician, to each insured or the caretaker of the insured in accordance with the standards contained in Insurance Code § 1358.054.
(b) A person may not provide a component of diabetes self-management training under subsection (a) of this section unless the subject matter of the component is within the scope of the person's practice and the person meets the education requirements as determined by the person's licensing agency in consultation with the Commissioner of Public Health.
(c) Self-management training should include the development of an individualized management plan that is created for and in collaboration with the insured and that meets the requirements of the minimum standards for benefits in accordance with § 21.2604 of this title (relating to Minimum Standards for Benefits for Persons with Diabetes).
(d) Nutrition counseling and instructions on the proper use of diabetes equipment and supplies must be provided or covered as part of the training.
(e) Diabetes self-management training must be provided, or coverage for diabetes self-management training must be provided to an insured or a caretaker, upon the following occurrences relating to an insured, provided that any training involving the administration of medications must comply with the applicable delegation rules from the appropriate licensing agency:
(f) An HMO must provide oversight of its diabetes self-management training program on an ongoing basis to ensure compliance with this section.
(g) Health benefit plans provided by entities other than HMOs must disclose in the plan how to access providers or benefits described in subsection (a) of this section.