(1) The medicaid agency pays for outpatient diabetes education for an eligible client when:

(a) The department of health (DOH) has approved the billing facility to provide diabetes education services; and

(b) The client is referred by a licensed health care provider.

(2) The agency requires the diabetes education teaching curriculum to have measurable, behaviorally stated educational objectives. The diabetes education teaching curriculum must include all the following core modules:

(a) An overview of diabetes management and prevention of complications;

(b) Healthy coping, including identification of participants' challenges and barriers related to living with diabetes and utilization of problem solving and motivational skills to increase success in managing diabetes;

(c) Healthy eating, including individualized meal planning;

(d) Being active, including a structured approach to physical activity;

(e) Reducing risk of acute complications, such as hypoglycemia and hyperglycemia, and sick day management;

(f) Prevention of other chronic complications, such as retinopathy, nephropathy, neuropathy, cardiovascular disease, and foot and skin problems;

(g) Monitoring, including immediate and long-term diabetes control through monitoring of glucose, ketones, and glycosylated hemoglobin, and the use of continuous glucose monitoring when applicable;

(h) Medication administration, including oral and/or injected diabetes medication and use of insulin pumps; and

(i) Problem solving skills to set up specific, measurable, achievable, relevant, and time-bound (SMART) goals and support diabetes self-care behaviors.