Coverage of inborn metabolic errors.

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  • (1) As used in this section:
    • (a) "Dietary products" means medical food or a low protein modified food product that:
      • (i) is specifically formulated to treat inborn errors of amino acid or urea cycle metabolism;
      • (ii) is not a natural food that is naturally low in protein; and
      • (iii) is used under the direction of a physician.
    • (b) "Inborn errors of amino acid or urea cycle metabolism" means a disease caused by an inherited abnormality of body chemistry which is treatable by the dietary restriction of one or more amino acid.
  • (2) The commissioner shall establish, by rule, minimum standards of coverage for dietary products used for the treatment of inborn errors of amino acid or urea cycle metabolism at levels consistent with the major medical benefit provided under an accident and health insurance policy.




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