First Substitute H.B. 205

Representative Trisha S. Beck proposes to substitute the following bill:

1 INSURANCE COVERAGE FOR METABOLIC DISEASE
2 1998 GENERAL SESSION
3 STATE OF UTAH
4 Sponsor: Trisha S. Beck
5 AN ACT RELATING TO INSURANCE; REQUIRING HEALTH INSURANCE POLICIES
6 COVER DIETARY PRODUCTS FOR TREATMENT OF INBORN ERRORS OF AMINO
7 ACID OR UREA CYCLE METABOLISM.
8 This act affects sections of Utah Code Annotated 1953 as follows:
9 ENACTS:
10 31A-22-623, Utah Code Annotated 1953
11 Be it enacted by the Legislature of the state of Utah:
12 Section 1. Section 31A-22-623 is enacted to read:
13 31A-22-623. Coverage of inborn metabolic errors.
14 (1) As used in this section:
15 (a) "Dietary products" means medical food or a low protein modified food product that:
16 (i) is specifically formulated to treat inborn errors of amino acid or urea cycle metabolism;
17 (ii) is not a natural food that is naturally low in protein; and
18 (iii) is used under the direction of a physician.
19 (b) "Inborn errors of amino acid or urea cycle metabolism" means a disease caused by an
20 inherited abnormality of body chemistry which is treatable by the dietary restriction of one or more
21 amino acid.
22 (2) The commissioner shall establish, by rule, minimum standards of coverage for dietary
23 products used for the treatment of inborn errors of amino acid or urea cycle metabolism at levels
24 consistent with the major medical benefit provided under a disability insurance policy.

*HB0205S1*