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§ 3904. Medical foods insurance coverage

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 P.S. InsuranceEffective: April 20, 2015

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 40 P.S. Insurance (Refs & Annos)
Chapter 19. Medical Foods Insurance Coverage Act
Effective: April 20, 2015
40 P.S. § 3904
§ 3904. Medical foods insurance coverage
(a) Nutritional supplements.--Except as provided in section 7,1 any health insurance policy which is delivered, issued for delivery, renewed, extended or modified in this Commonwealth by any health care insurer shall provide that the health insurance benefits applicable under the policy include coverage for the cost of nutritional supplements (formulas) as medically necessary for the therapeutic treatment of phenylketonuria, branched-chain ketonuria, galactosemia and homocystinuria as administered under the direction of a physician.
(b) Amino acid-based elemental medical formula.--Except as provided in section 7, any health insurance policy which is delivered, issued for delivery, renewed, extended or modified in this Commonwealth by any health care insurer shall provide that the health insurance benefits applicable under the policy include coverage for infants and children for the usual and customary cost of amino acid-based elemental medical formula ordered by a physician as medically necessary and administered orally or enterally for food protein allergies, food protein-induced enterocolitis syndrome, eosinophilic disorders and short-bowel syndrome. An amino acid-based elemental formula covered under this section is a formula made of 100% free amino acids as the protein source.

Credits

1996, Dec. 20, P.L. 1492, No. 191, § 4, effective June 20, 1997. Amended 2014, Oct. 22, P.L. 2564, No. 158, § 1, effective in 180 days [April 20, 2015].

Footnotes

40 P.S. § 3903.
40 P.S. § 3904, PA ST 40 P.S. § 3904
Current through Act 10 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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