H.B. 205 Enrolled

INSURANCE COVERAGE FOR METABOLIC DISEASE
1998 GENERAL SESSION
STATE OF UTAH
Sponsor: Trisha S. Beck
Patrice Arent

AN ACT RELATING TO INSURANCE; REQUIRING HEALTH INSURANCE POLICIES TO
COVER DIETARY PRODUCTS FOR TREATMENT OF INBORN ERRORS OF AMINO
ACID OR UREA CYCLE METABOLISM.
This act affects sections of Utah Code Annotated 1953 as follows:
ENACTS:
31A-22-623, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 31A-22-623 is enacted to read:
31A-22-623. Coverage of inborn metabolic errors.
(1) As used in this section:
(a) "Dietary products" means medical food or a low protein modified food product that:
(i) is specifically formulated to treat inborn errors of amino acid or urea cycle metabolism;
(ii) is not a natural food that is naturally low in protein; and
(iii) is used under the direction of a physician.
(b) "Inborn errors of amino acid or urea cycle metabolism" means a disease caused by an
inherited abnormality of body chemistry which is treatable by the dietary restriction of one or more
amino acid.
(2) The commissioner shall establish, by rule, minimum standards of coverage for dietary
products used for the treatment of inborn errors of amino acid or urea cycle metabolism at levels
consistent with the major medical benefit provided under a disability insurance policy.