Okla. Admin. Code § 310:590-3-2

Current through Vol. 42, No. 4, November 1, 2024

Section 310:590-3-2 - Related provider services

When deemed medically necessary and upon prescription or diagnosis by a physician or health care provider with prescribing authority working under the supervision of a physician, all individual or group health insurance defined by statute and or governed by the Oklahoma Insurance Commissioner or other appropriate statutory state agency as defined by statute shall reimburse/cover the following related provider services:

(1) insulin and prescription drugs including oral-glucose lowering agents, antihypertensive and lipid lowering agents and other medications for delaying or preventing both acute and chronic complications;

(2) medical nutrition therapy recommendations and instructions by a registered, licensed dietitian;

(3) self-glucose monitoring instruction by a licensed, registered health care professional;

(4) foot examination annually;

(5) annual screening dilated eye examinations by an eye physician for persons with diabetes;

(6) glycohemoglobin determination done as frequently as necessary to assess and achieve near normal glycemia;

(7) recommendations for appropriate life-style changes including smoking cessation, exercise, and stress management;

(8) lipid profile upon diagnosis for adults and annually thereafter. If lipid profile is abnormal and the person with diabetes is on a lipid lowering therapy, a lipid profile shall be done as frequently as necessary to assess and achieve the desired lipid level. Children shall have a lipid profile once glucose control has been established; and

(9) screening microalbumin annually.

Okla. Admin. Code § 310:590-3-2

Added at 14 Ok Reg 943, eff 1-8-97 through 7-14-97 (emergency); Added at 14 Ok Reg 3140, eff 7-25-97