§4089e. Treatment of inherited metabolic diseases

Link to law: http://legislature.vermont.gov/statutes/section/08/107/04089e
Published: 2015

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The Vermont Statutes Online



Title

08

:
Banking and Insurance






Chapter

107

:
HEALTH INSURANCE






Subchapter

001
:
GENERALLY










 

§

4089e. Treatment of inherited metabolic diseases

(a) For the

purposes of this section:

(1)

"Inherited metabolic disease" means a disease caused by an inherited

abnormality of body chemistry for which the state screens newborn infants.

(2)

"Insurer" means any health insurance company, nonprofit hospital and

medical service corporation, managed care organization and health maintenance

organization. The term does not apply to coverage for specified disease or

other limited benefit coverage.

(3) "Low

protein modified food product" means a food product that is specifically

formulated to have less than one gram of protein per serving and is intended to

be used under the direction of a physician for the dietary treatment of a

metabolic disease.

(4)

"Medical food" means an amino acid modified preparation that is

intended to be used under the direction of a physician for the dietary

treatment of an inherited metabolic disease.

(b) An insurer

shall provide coverage for medical foods prescribed for medically necessary

treatment for an inherited metabolic disease.

(c) Coverage for

low protein modified food products prescribed for medically necessary treatment

of an inherited metabolic disease shall be at least $2,500.00 during any

continuous period of twelve months for any insured individual. (Added 1997, No.

128 (Adj. Sess.), § 1, eff. April 27, 1998)
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