Diabetes Education And Training Services: Participant Eligibility

Medical necessity for diabetes education and training are evidenced by the following: (7-1-26) 01. Participants with Diabetes. Are eligible for a Diabetes Management Program when: (7-1-26) a. A recent diagnosis of diabetes within ninety (90) days of enrollment with no history of prior IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 132 Page 52 diabetes education; or (7-1-26) b. Uncontrolled diabetes manifested by two (2) or more fasting blood sugar of greater than one hundred forty milligrams per decaliter (140 mg/dL), hemoglobin A1c greater than eight percent (8%), or random blood sugar greater than one hundred eighty milligrams per decaliter (180 mg/dL), in addition to the manifestations; or (7-1-26) c. Recent manifestations from poor diabetes control including neuropathy, retinopathy, recurrent hypoglycemia, repeated infections, or nonhealing wounds. (7-1-26) 02. Participants with Pre-Diabetes. Are eligible for the National Diabetes Prevention Program when they meet the program’s guidance. (7-1-26)