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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)