HB 840

Abstract

Health insurance; formula and enteral nutrition products. Requires health insurers, health care subscription plans, and health maintenance organizations whose policy, contract, or plan includes coverage for medicines to classify medically necessary formula and enteral nutrition products as medicine and to include coverage for medically necessary formula and enteral nutrition products for covered individuals requiring treatment for an inherited metabolic disorder. Such coverage is required to be provided on the same terms and subject to the same conditions imposed on other medicines covered under the policy, contract, or plan. The measure provides that the required coverage includes any medical equipment, supplies, and services that are required to administer the covered formula or enteral nutrition products. These requirements apply only to formula and enteral nutrition products that are furnished pursuant to the prescription or order of a physician or other health care professional qualified to make such prescription or order for the management of an inherited metabolic disorder and are used under medical supervision. This bill is identical to SB 605.

Health insurance; formula and enteral nutritionproducts. Requires health insurers, health care subscription plans, and health maintenance organizations whose policy, contract,or plan includes coverage for medicines to classify medically necessaryformula and enteral nutrition products as medicine and to includecoverage for medically necessary formula and enteral nutrition productsfor covered individuals requiring treatment for an inherited metabolicdisorder. Such coverage is required to be provided on the same termsand subject to the same conditions imposed on other medicines coveredunder the policy, contract, or plan. The measure provides that therequired coverage includes any medical equipment, supplies, and servicesthat are required to administer the covered formula or enteral nutritionproducts. These requirements apply only to formula and enteral nutritionproducts that are furnished pursuant to the prescription or orderof a physician or other health care professional qualified to makesuch prescription or order for the management of an inherited metabolicdisorder and are used under medical supervision.