The Commonwealth of Massachusetts
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PETITION OF:
The Commonwealth of Massachusetts
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PETITION OF:
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In the Year Two Thousand and Seven.
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|
An Act relative to the education and care of obesity and diabetes. |
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. Chapter 111 of the general laws is hereby amended by adding at the end thereof the following new chapter, chapter 111L.
Chapter 111L. Section 1.
a) The State Department of Public Health shall develop and establish an educational program for consumers, patients, and health care providers regarding diabetes, including:
1) Nutrition, body weight and lifestyle risk factors, which are strongly linked to the development of diabetes and which can complicate its management.
2) Disease prevalence.
3) Importance of testing, screening and measuring treatment goals according to recommended treatment effectiveness clinical measures.
4) Signs and symptoms.
5) Cardiovascular Disease Risk Factors for people with diabetes.
6) The benefits of moderate weight loss which can improve glycemic control, and reduce the risk of dyslipidemia, hypertension, and cardiovascular disease.
7) Availability to state benefit plan enrollees of drugs and biologicals to treat diabetes.
b) This educational program will be made available to the public free of charge and may include distribution of information through the Department of Public Health, the state Medical Board, other state agencies, as well as through other sources.
Section 2.
a) Health care professionals, managed care organizations, and other private payers receiving reimbursement through Medicaid, or any other state-managed program, shall utilize generally recognized clinical practice guidelines such as the American Diabetes Association goals, recommendations and standards that identify the reduction of body mass index (BMI), cardiovascular risk issues and glycemic control as key factors to managing diabetes.
b) Clinical practice guidelines utilized to provide more stringent methods to improve patient outcomes by health care professionals, as described in subsection (a), shall include:
1) Screening to detect pre-diabetes and diabetes should be considered in individuals 45 years of age or older, particularly in those individuals who carry excess weight for their height and frame, or who have other risk factors for diabetes.
2) Adoption of a stringent target goal for glycemic control to lower the risk of cardiovascular events.
3) Establishment of a program to reduce weight in order to reduce the risk of cardiovascular events, and additional diabetes-related complications.
4) Establishment of a disease management program.
Section 3.
a) Managed care organizations, and health service plans, licensed by the state, and providing treatment to patients with diabetes shall adopt generally recognized clinical practice guidelines such as the American Diabetes Association goals, recommendations and standards that identify the reduction of body mass index (BMI), cardiovascular risk issues and glycemic control as key factors to managing diabetes.
b) Clinical practice guidelines adopted by managed care organizations, and health service plans to provide more stringent methods to improve patient outcomes, as described in subsection (a) above, shall include:
1) Screening to detect pre-diabetes and diabetes should be considered in individuals 45 years of age or older, particularly in those individuals who carry excess weight for their height and frame, or who have other risk factors for diabetes.
2) Adoption of a stringent target goal for glycemic control to lower the risk of cardiovascular events.
3) Establishment of a program to reduce weight in order to reduce the risk of cardiovascular events, and additional diabetes-related complications.
4) Establishment of a disease management program.
c) A health service plan currently offering coverage for care of diabetes may not eliminate such coverage. A health service plan underwriter authorized to operate in this state may not discontinue a plan with such coverage.
Section 4. Department of Public Health Strategic Plan.
a) By January 1, 2010 the State Department of Health shall draft a strategic plan to decrease obesity rates in children and adults by 10 percent. The department shall consult with physicians, health professionals, school educators, worksite wellness and employee benefits counselors, athletic trainers in schools and professional athletes and trainers.
b) In developing its strategic plan, the department shall address the following:
1) Identification of barriers to effective control of obesity including the impact of diet, exercise, and lifestyle.
2) Review the current health effects of obesity and morbid obesity including rampant diabetes and make recommendations on best practices and appropriate clinical guidelines to manage diabetes mellitus.
3) Review current screening, treatment, and related activities in this state related to diabetes and identify gaps in service.
4) Identification of actions to be taken to reduce the morbidity and mortality from obesity and morbid obesity, including diabetes, by September 1, 2009; and
5) Establish a time-line for taking those actions.
c) The department shall, by January 1, 2010, report its findings to the legislature and the governor’s office; the report shall also include recommended policy and procedural changes, as well as required funding necessary to achieve the goals of the strategic plan.
Section 5. Diabetes Control and Prevention Plan. Requires the Department of Health to develop and implement a diabetes control and prevention plan. The department shall:
1) Conduct a needs assessment throughout the Commonwealth, including urban areas, geographic areas and ethnic and racial groupings.
2) Raise public awareness.
3) Establish a Diabetes Control and Prevention Advisory Committee to provide advice to the department on the implementation of the control and prevention plan. The committee shall include representatives from managed care organizations, physicians, and diabetes patient organizations.
a) If insufficient funds are appropriated from state General or Special Funds to meet the goal of the program, the Commissioner of the Department of Public Health shall seek funding to develop and implement the plan from the private sector, grant programs, and other appropriate sources.
Section 6. State Disease Management Program.
a) A managed care organization, and other organizations, including a vendor, that are under contract with the state to provide health care services to Medicaid and other state recipients, shall:
1) Develop and implement special disease management programs to manage diabetes and co-morbid conditions such as obesity and morbid obesity.
2) In developing and implementing the special disease management plan the managed care organization or vendor must utilize generally recognized clinical practice guidelines such as the nutrition recommendations and interventions established by the American Diabetes Association that identify weight loss as an important therapeutic strategy.
3) Services shall be provided to recipients of medical assistance and state healthcare who have a have diabetes or who present with a body mass index of in excess of 25 (kg/m2), and who may have other co-morbid conditions such as hypertension, dyslipidemia, and high blood pressure.
4) The department may request proposals from providers of disease management services, including managed care organizations, to comply with the requirements of this act.
Section 7. All health care service plans, and applicable specialized health care service plans, providing services to customers with diabetes in this state shall adopt, as a minimum standard of care, the most current nutrition recommendations and interventions established by American Diabetes Association when treating such a patient, or having reasonable cause to believe that the patient may develop diabetes.
. Chapter 111 of the general laws is hereby amended by adding at the end thereof the following new chapter, chapter 111L.
Chapter 111L. Section 1.
c) The State Department of Public Health shall develop and establish an educational program for consumers, patients, and health care providers regarding diabetes, including:
a. Nutrition, body weight and lifestyle risk factors, which are strongly linked to the development of diabetes and which can complicate its management.
b. Disease prevalence.
c. Importance of testing, screening and measuring treatment goals according to recommended treatment effectiveness clinical measures.
d. Signs and symptoms.
e. Cardiovascular Disease Risk Factors for people with diabetes.
f. The benefits of moderate weight loss which can improve glycemic control, and reduce the risk of dyslipidemia, hypertension, and cardiovascular disease.
g. Availability to state benefit plan enrollees of drugs and biologicals to treat diabetes.
d) This educational program will be made available to the public free of charge and may include distribution of information through the Department of Public Health, the state Medical Board, other state agencies, as well as through other sources.
Section 2.
e) Health care professionals, managed care organizations, and other private payers receiving reimbursement through Medicaid, or any other state-managed program, shall utilize generally recognized clinical practice guidelines such as the American Diabetes Association goals, recommendations and standards that identify the reduction of body mass index (BMI), cardiovascular risk issues and glycemic control as key factors to managing diabetes.
f) Clinical practice guidelines utilized to provide more stringent methods to improve patient outcomes by health care professionals, as described in subsection (a), shall include:
5) Screening to detect pre-diabetes and diabetes should be considered in individuals 45 years of age or older, particularly in those individuals who carry excess weight for their height and frame, or who have other risk factors for diabetes.
6) Adoption of a stringent target goal for glycemic control to lower the risk of cardiovascular events.
7) Establishment of a program to reduce weight in order to reduce the risk of cardiovascular events, and additional diabetes-related complications.
8) Establishment of a disease management program.
Section 3.
d) Managed care organizations, and health service plans, licensed by the state, and providing treatment to patients with diabetes shall adopt generally recognized clinical practice guidelines such as the American Diabetes Association goals, recommendations and standards that identify the reduction of body mass index (BMI), cardiovascular risk issues and glycemic control as key factors to managing diabetes.
e) Clinical practice guidelines adopted by managed care organizations, and health service plans to provide more stringent methods to improve patient outcomes, as described in subsection (a) above, shall include:
5) Screening to detect pre-diabetes and diabetes should be considered in individuals 45 years of age or older, particularly in those individuals who carry excess weight for their height and frame, or who have other risk factors for diabetes.
6) Adoption of a stringent target goal for glycemic control to lower the risk of cardiovascular events.
7) Establishment of a program to reduce weight in order to reduce the risk of cardiovascular events, and additional diabetes-related complications.
8) Establishment of a disease management program.
f) A health service plan currently offering coverage for care of diabetes may not eliminate such coverage. A health service plan underwriter authorized to operate in this state may not discontinue a plan with such coverage.
Section 4. Department of Public Health Strategic Plan.
d) By January 1, 2010 the State Department of Health shall draft a strategic plan to decrease obesity rates in children and adults by 10 percent. The department shall consult with physicians, health professionals, school educators, worksite wellness and employee benefits counselors, athletic trainers in schools and professional athletes and trainers.
e) In developing its strategic plan, the department shall address the following:
6) Identification of barriers to effective control of obesity including the impact of diet, exercise, and lifestyle.
7) Review the current health effects of obesity and morbid obesity including rampant diabetes and make recommendations on best practices and appropriate clinical guidelines to manage diabetes mellitus.
8) Review current screening, treatment, and related activities in this state related to diabetes and identify gaps in service.
9) Identification of actions to be taken to reduce the morbidity and mortality from obesity and morbid obesity, including diabetes, by September 1, 2009; and
10) Establish a time-line for taking those actions.
f) The department shall, by January 1, 2010, report its findings to the legislature and the governor’s office; the report shall also include recommended policy and procedural changes, as well as required funding necessary to achieve the goals of the strategic plan.
Section 5. Diabetes Control and Prevention Plan. Requires the Department of Health to develop and implement a diabetes control and prevention plan. The department shall:
4) Conduct a needs assessment throughout the Commonwealth, including urban areas, geographic areas and ethnic and racial groupings.
5) Raise public awareness.
6) Establish a Diabetes Control and Prevention Advisory Committee to provide advice to the department on the implementation of the control and prevention plan. The committee shall include representatives from managed care organizations, physicians, and diabetes patient organizations.
a) If insufficient funds are appropriated from state General or Special Funds to meet the goal of the program, the Commissioner of the Department of Public Health shall seek funding to develop and implement the plan from the private sector, grant programs, and other appropriate sources.
Section 6. State Disease Management Program.
b) A managed care organization, and other organizations, including a vendor, that are under contract with the state to provide health care services to Medicaid and other state recipients, shall:
5) Develop and implement special disease management programs to manage diabetes and co-morbid conditions such as obesity and morbid obesity.
6) In developing and implementing the special disease management plan the managed care organization or vendor must utilize generally recognized clinical practice guidelines such as the nutrition recommendations and interventions established by the American Diabetes Association that identify weight loss as an important therapeutic strategy.
7) Services shall be provided to recipients of medical assistance and state healthcare who have a have diabetes or who present with a body mass index of in excess of 25 (kg/m2), and who may have other co-morbid conditions such as hypertension, dyslipidemia, and high blood pressure.
8) The department may request proposals from providers of disease management services, including managed care organizations, to comply with the requirements of this act.
Section 7. All health care service plans, and applicable specialized health care service plans, providing services to customers with diabetes in this state shall adopt, as a minimum standard of care, the most current nutrition recommendations and interventions established by American Diabetes Association when treating such a patient, or having reasonable cause to believe that the patient may develop diabetes.
. Chapter 111 of the general laws is hereby amended by adding at the end thereof the following new chapter, chapter 111L.
Chapter 111L. Section 1.
g) The State Department of Public Health shall develop and establish an educational program for consumers, patients, and health care providers regarding diabetes, including:
a. Nutrition, body weight and lifestyle risk factors, which are strongly linked to the development of diabetes and which can complicate its management.
b. Disease prevalence.
c. Importance of testing, screening and measuring treatment goals according to recommended treatment effectiveness clinical measures.
d. Signs and symptoms.
e. Cardiovascular Disease Risk Factors for people with diabetes.
f. The benefits of moderate weight loss which can improve glycemic control, and reduce the risk of dyslipidemia, hypertension, and cardiovascular disease.
g. Availability to state benefit plan enrollees of drugs and biologicals to treat diabetes.
h) This educational program will be made available to the public free of charge and may include distribution of information through the Department of Public Health, the state Medical Board, other state agencies, as well as through other sources.
Section 2.
i) Health care professionals, managed care organizations, and other private payers receiving reimbursement through Medicaid, or any other state-managed program, shall utilize generally recognized clinical practice guidelines such as the American Diabetes Association goals, recommendations and standards that identify the reduction of body mass index (BMI), cardiovascular risk issues and glycemic control as key factors to managing diabetes.
j) Clinical practice guidelines utilized to provide more stringent methods to improve patient outcomes by health care professionals, as described in subsection (a), shall include:
9) Screening to detect pre-diabetes and diabetes should be considered in individuals 45 years of age or older, particularly in those individuals who carry excess weight for their height and frame, or who have other risk factors for diabetes.
10) Adoption of a stringent target goal for glycemic control to lower the risk of cardiovascular events.
11) Establishment of a program to reduce weight in order to reduce the risk of cardiovascular events, and additional diabetes-related complications.
12) Establishment of a disease management program.
Section 3.
g) Managed care organizations, and health service plans, licensed by the state, and providing treatment to patients with diabetes shall adopt generally recognized clinical practice guidelines such as the American Diabetes Association goals, recommendations and standards that identify the reduction of body mass index (BMI), cardiovascular risk issues and glycemic control as key factors to managing diabetes.
h) Clinical practice guidelines adopted by managed care organizations, and health service plans to provide more stringent methods to improve patient outcomes, as described in subsection (a) above, shall include:
9) Screening to detect pre-diabetes and diabetes should be considered in individuals 45 years of age or older, particularly in those individuals who carry excess weight for their height and frame, or who have other risk factors for diabetes.
10) Adoption of a stringent target goal for glycemic control to lower the risk of cardiovascular events.
11) Establishment of a program to reduce weight in order to reduce the risk of cardiovascular events, and additional diabetes-related complications.
12) Establishment of a disease management program.
i) A health service plan currently offering coverage for care of diabetes may not eliminate such coverage. A health service plan underwriter authorized to operate in this state may not discontinue a plan with such coverage.
Section 4. Department of Public Health Strategic Plan.
g) By January 1, 2010 the State Department of Health shall draft a strategic plan to decrease obesity rates in children and adults by 10 percent. The department shall consult with physicians, health professionals, school educators, worksite wellness and employee benefits counselors, athletic trainers in schools and professional athletes and trainers.
h) In developing its strategic plan, the department shall address the following:
11) Identification of barriers to effective control of obesity including the impact of diet, exercise, and lifestyle.
12) Review the current health effects of obesity and morbid obesity including rampant diabetes and make recommendations on best practices and appropriate clinical guidelines to manage diabetes mellitus.
13) Review current screening, treatment, and related activities in this state related to diabetes and identify gaps in service.
14) Identification of actions to be taken to reduce the morbidity and mortality from obesity and morbid obesity, including diabetes, by September 1, 2009; and
15) Establish a time-line for taking those actions.
i) The department shall, by January 1, 2010, report its findings to the legislature and the governor’s office; the report shall also include recommended policy and procedural changes, as well as required funding necessary to achieve the goals of the strategic plan.
Section 5. Diabetes Control and Prevention Plan. Requires the Department of Health to develop and implement a diabetes control and prevention plan. The department shall:
7) Conduct a needs assessment throughout the Commonwealth, including urban areas, geographic areas and ethnic and racial groupings.
8) Raise public awareness.
9) Establish a Diabetes Control and Prevention Advisory Committee to provide advice to the department on the implementation of the control and prevention plan. The committee shall include representatives from managed care organizations, physicians, and diabetes patient organizations.
a) If insufficient funds are appropriated from state General or Special Funds to meet the goal of the program, the Commissioner of the Department of Public Health shall seek funding to develop and implement the plan from the private sector, grant programs, and other appropriate sources.
Section 6. State Disease Management Program.
c) A managed care organization, and other organizations, including a vendor, that are under contract with the state to provide health care services to Medicaid and other state recipients, shall:
9) Develop and implement special disease management programs to manage diabetes and co-morbid conditions such as obesity and morbid obesity.
10) In developing and implementing the special disease management plan the managed care organization or vendor must utilize generally recognized clinical practice guidelines such as the nutrition recommendations and interventions established by the American Diabetes Association that identify weight loss as an important therapeutic strategy.
11) Services shall be provided to recipients of medical assistance and state healthcare who have a have diabetes or who present with a body mass index of in excess of 25 (kg/m2), and who may have other co-morbid conditions such as hypertension, dyslipidemia, and high blood pressure.
12) The department may request proposals from providers of disease management services, including managed care organizations, to comply with the requirements of this act.
Section 7. All health care service plans, and applicable specialized health care service plans, providing services to customers with diabetes in this state shall adopt, as a minimum standard of care, the most current nutrition recommendations and interventions established by American Diabetes Association when treating such a patient, or having reasonable cause to believe that the patient may develop diabetes.