MISSISSIPPI LEGISLATURE

2000 Regular Session

To: Insurance

By: Representative Frierson

AN ACT TO REQUIRE CERTAIN INDIVIDUAL AND GROUP HEALTH INSURANCE POLICIES AND PLANS TO OFFER COVERAGE FOR MEDICALLY NECESSARY FORMULAS FOR THE TREATMENT OF INHERITED DISEASES OF AMINO ACID, ORGANIC ACID, CARBOHYDRATE OR FAT METABOLISM, AND MALABSORPTION ORIGINATING FROM CONGENITAL DEFECTS; TO PROVIDE THAT COVERAGE FOR INHERITED DISEASES OF AMINO ACIDS AND ORGANIC ACIDS SHALL INCLUDE FOOD PRODUCTS MODIFIED TO BE LOW PROTEIN; TO PROVIDE THAT THIS ACT APPLIES NOTWITHSTANDING THE EXISTENCE OF ANY PREEXISTING CONDITION; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. (1) Each individual or group health insurance policy, contract, certificate or plan, pooled risk health insurance policy or plan, or any type of managed or capitated health care plan or policy that is regulated by the State of Mississippi, which is issued, issued for delivery, renewed, continued or executed in this state after June 30, 2000, shall make available as part of the application, coverage for prescription and nonprescription enteral formulas for home use that are prescribed by a physician as medically necessary for the treatment of inherited diseases of amino acid, organic acid, carbohydrate or fat metabolism, as well as malabsorption originating from congenital defects present at birth or acquired during the neonatal period. Coverage for inherited diseases of amino acids and organic acids shall include food products modified to be low protein.

(2) This section applies to any person or family notwithstanding the existence of any preexisting condition.

(3) This section does not apply to policies, contracts or plans that provide coverage only for accidents or specified diseases.

SECTION 2. This act shall take effect and be in force from and after July 1, 2000.