Eosinophilic gastrointestinal disorder; formula

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36-2907.01. Eosinophilic gastrointestinal disorder; formula

A. Any coverage that is offered by a contractor providing services to persons eligible pursuant to section 36-2901 and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or a registered nurse practitioner if:

1. The person has been diagnosed with an eosinophilic gastrointestinal disorder.

2. The person is under the continuous supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15.

3. There is risk of a mental or physical impairment without the use of the formula.

B. This section does not apply to limited benefit coverage as defined in section 20-1137.


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