Section 16.03.09.641 - DIABETES EDUCATION AND TRAINING SERVICES: PARTICIPANT ELIGIBILITYThe medical necessity for diabetes education and training are evidenced by the following:
01.Participants with Diabetes. Are eligible for a Diabetes Management Program when:a. A recent diagnosis of diabetes within ninety (90) days of enrollment with no history of prior diabetes education; orb. 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; orc. Recent manifestations from poor diabetes control including neuropathy, retinopathy, recurrent hypoglycemia, repeated infections, or nonhealing wounds.02.Participants with Pre-Diabetes. Are eligible for the National Diabetes Prevention Program when they meet the program's guidance.Idaho Admin. Code r. 16.03.09.641