SENATE BILL No. 763

 

 

September 12, 2007, Introduced by Senator SWITALSKI and referred to the Committee on Health Policy.

 

 

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

(MCL 500.100 to 500.8302) by adding section 3406s.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3406s. (1) An insurer that delivers, issues for delivery,

 

or renews in this state on or after January 1, 2008 an expense-

 

incurred hospital, medical, or surgical policy or certificate that

 

provides for prescription coverage and a health maintenance

 

organization that issues or renews a group or individual contract

 

on or after January 1, 2008 that provides for prescription coverage

 

shall provide coverage for amino acid-based elemental formulas,

 

regardless of delivery methods, for the diagnosis and treatment of

 

any of the following:

 

     (a) Multiple food allergies or protein intolerances.

 


     (b) Eosinophilic disorders.

 

     (c) Short bowel syndrome.

 

     (2) Subsection (1) only applies if the insured's or enrollee's

 

treating health care provider has issued a written treatment plan

 

and order stating that the amino acid-based elemental formula is

 

medically necessary for the treatment of the disease or disorder.

 

     (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.