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certified nurse practitioner or certified nurse midwife from | | whom such care may be obtained. |
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| | | 2. Application. This section applies to all policies and, | | contracts and certificates executed, delivered, issued for | delivery, continued or renewed in this State on or after January | 1, 1997. For purposes of this section, all contracts are deemed | | to be renewed no later than the next yearly anniversary of the | | contract date. |
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| | | Sec. A-10. 24-A MRSA §4240, as enacted by PL 1995, c. 592, §4, is | | amended to read: |
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| | | §4240. Coverage for diabetes supplies |
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| | | All health maintenance organization individual and group | | health contracts and certificates must provide coverage for the | | medically appropriate and necessary equipment, limited to | | insulin, oral hypoglycemic agents, monitors, test strips, | | syringes and lancets, and the out-patient self-management | | training and educational services used to treat diabetes, if: |
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| | | 1. Certification of medical necessity. The enrollee's | | treating physician or a physician who specializes in the | | treatment of diabetes certifies that the equipment and services | | are necessary; and |
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| | | 2. Provision of medical services. The diabetes out-patient | | self-management training and educational services are provided | | through ambulatory diabetes education facilities authorized by | | the State's Diabetes Control Project within the Bureau of Health. |
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| | | The requirements of this section apply to all group policies, | | contracts and certificates executed, delivered, issued for | | delivery, continued or renewed in this State.__For purposes of | | this section, all contracts are deemed to be renewed no later | | than the next yearly anniversary of the contract date. |
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| | | Sec. A-11. 24-A MRSA §4241, sub-§§1 and 2, as enacted by PL 1995, c. | | 617, §5 and affected by §6, are amended to read: |
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| | | 1. Coverage in managed care plans. With respect to managed | | care plans that require enrollees to select primary care | | physicians, a health maintenance organization that issues group | policies and, contracts and certificates must meet the following | | requirements. |
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| | | A. The health maintenance organization must permit a physician | | who specializes in obstetrics and gynecology to serve as a | | primary care physician if the physician qualifies |
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