HOUSE BILL No. 5782


     March 12, 2002, Introduced by Rep. Spade and referred to the Committee on Insurance and Financial Services.


        A bill to amend 1980 PA 350, entitled

   "The nonprofit health care corporation reform act,"

   (MCL 550.1101 to 550.1704) by adding section 416c.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1
             SEC. 416C.  (1) A HEALTH CARE CORPORATION THAT ISSUES OR

 2
        RENEWS IN THIS STATE ON OR AFTER JANUARY 1, 2003 A GROUP OR NON-

 3
        GROUP CERTIFICATE THAT PROVIDES PRESCRIPTION COVERAGE SHALL PRO-

 4
        VIDE COVERAGE FOR LOW-PROTEIN MODIFIED FOOD PRODUCTS SUBJECT TO

 5
        BOTH OF THE FOLLOWING:

 6
             (A) THE LOW-PROTEIN MODIFIED FOOD PRODUCTS ARE PRESCRIBED

 7
        FOR THE THERAPEUTIC TREATMENT OF AMINO ACID DISORDERS.

 8
             (B) THE LOW-PROTEIN MODIFIED FOOD PRODUCTS ARE ADMINISTERED

 9
        UNDER THE DIRECTION OF A PHYSICIAN.

10
             (2) COVERAGE UNDER THIS SECTION SHALL NOT HAVE DEDUCTIBLES

11
        AND COPAYMENT PROVISIONS THAT ARE LESS FAVORABLE THAN THOSE FOR


   03721'01                                                 DKH                                   2

 1
        PRESCRIPTION COVERAGE GENERALLY.  COVERAGE UNDER THIS SECTION MAY

 2
        BE LIMITED TO A CAP OF $4,000.00 PER PLAN YEAR ON BOTH INDIVIDUAL

 3
        MEDICAL FOOD EXPENDITURES AND MEDICAL FORMULAS.  THIS $4,000.00

 4
        CAP SHALL BE ADJUSTED ANNUALLY BY THE COMMISSIONER PURSUANT TO

 5
        THE CONSUMER PRICE INDEX.

 6
             (3) AS USED IN THIS SECTION:

 7
             (A) "CONSUMER PRICE INDEX" MEANS THE PERCENTAGE OF CHANGE IN

 8
        THE CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS IN THE UNITED

 9
        STATES CITY AVERAGE FOR ALL ITEMS FOR THE PRIOR 12-MONTH PERIOD

10
        AS REPORTED BY THE UNITED STATES DEPARTMENT OF LABOR, BUREAU OF

11
        LABOR STATISTICS, AND AS CERTIFIED BY THE COMMISSIONER.

12
             (B) "LOW-PROTEIN MODIFIED FOOD PRODUCT" MEANS A FOOD PRODUCT

13
        THAT IS SPECIALLY FORMULATED TO HAVE LESS THAN 1 GRAM OF PROTEIN

14
        PER SERVING.  LOW-PROTEIN MODIFIED FOOD PRODUCT DOES NOT INCLUDE

15
        A NATURAL FOOD THAT IS NATURALLY LOW IN PROTEIN.



























   03721'01          Final page.                            DKH