HF 3889

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 04/02/2024 01:02pm

A bill for an act
relating to health insurance; requiring coverage for amino acid-based elemental
formula; amending Minnesota Statutes 2022, section 256B.0625, subdivision 32;
proposing coding for new law in Minnesota Statutes, chapter 62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.524] AMINO ACID-BASED FORMULA COVERAGE.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin (a) For purposes of this section, the following term has the
meaning given.
new text end

new text begin (b) "Formula" means an amino acid-based elemental formula.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin A health plan company must provide coverage for formula
when formula is medically necessary.
new text end

new text begin Subd. 3. new text end

new text begin Covered conditions. new text end

new text begin Conditions for which formula is medically necessary
include but are not limited to:
new text end

new text begin (1) cystic fibrosis;
new text end

new text begin (2) amino acid, organic acid, and fatty acid metabolic and malabsorption disorders;
new text end

new text begin (3) IgE mediated allergies to food proteins;
new text end

new text begin (4) food protein-induced enterocolitis syndrome;
new text end

new text begin (5) eosinophilic esophagitis;
new text end

new text begin (6) eosinophilic gastroenteritis;
new text end

new text begin (7) eosinophilic colitis; and
new text end

new text begin (8) mast cell activation syndrome.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, issued, or sold on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2022, section 256B.0625, subdivision 32, is amended to read:

Subd. 32.

Nutritional products.

Medical assistance covers nutritional products needed
for nutritional supplementation because solid food or nutrients thereof cannot be properly
absorbed by the body or needed for treatment of phenylketonuria, hyperlysinemia, maple
syrup urine disease, a combined allergy to human milk, cow's milk, and soy formula, or
any other childhood or adult diseases, conditions, or disorders identified by the commissioner
as requiring a similarly necessary nutritional product. new text begin Medical assistance covers amino
acid-based elemental formulas in the same manner as is required under section 62Q.524.
new text end Nutritional products needed for the treatment of a combined allergy to human milk, cow's
milk, and soy formula require prior authorization. Separate payment shall not be made for
nutritional products for residents of long-term care facilities. Payment for dietary
requirements is a component of the per diem rate paid to these facilities.