June 22, 2006, Introduced by Reps. Nofs and Mortimer and referred to the Committee on Health Policy.
A bill to amend 1980 PA 350, entitled
"The nonprofit health care corporation reform act,"
(MCL 550.1101 to 550.1704) by adding section 416e.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 416e. (1) A health care corporation that issues or renews
in this state on or after January 1, 2007 a group or nongroup
certificate shall provide coverage for the treatment of genetic
inborn errors of metabolism that involve amino acid, carbohydrate,
and fat metabolism and for which medically standard methods of
diagnosis, treatment, and monitoring exist.
(2) Coverage under this section shall include expenses of
diagnosing, monitoring, and controlling disorders by nutritional
and medical assessment, including clinical services, biochemical
analysis, medical supplies, prescription drugs, corrective lenses
for conditions related to the genetic inborn error of metabolism,
nutritional management, and special medical foods used in treatment
to compensate for the metabolic abnormality and to maintain
adequate nutritional status.
(3) Coverage under this section shall not have deductibles,
copayment, coinsurance, dollar limits, or durational limits that
are less favorable than those for physical illness generally.
(4) As used in this section:
(a) "Genetic inborn error of metabolism" means a rare,
inherited disorder that meets all of the following:
(i) Is present at birth.
(ii) If untreated, results in mental retardation or death.
(iii) Causes the necessity for consumption of special medical
foods.
(b) "Special medical foods" means nutritional substances in
any form that meet all of the following:
(i) Are formulated to be consumed or administered internally
under the supervision of a physician.
(ii) Are specifically processed or formulated to be distinct in
1 or more nutrients present in natural food.
(iii) Are intended for the medical and nutritional management of
patients with limited capacity to metabolize ordinary foodstuffs or
certain nutrients contained in ordinary foodstuffs or who have
other specific nutrient requirements as established by medical
evaluation.
(iv) Are essential to optimize growth, health, and metabolic
homeostasis.
(c) "Treatment" means medical services provided by licensed
health care professionals, including physicians and dietitians,
with specific training in managing patients diagnosed with genetic
inborn errors of metabolism.