HOUSE BILL No. 4962

 

 

July 16, 2003, Introduced by Rep. Spade and referred to the Committee on Insurance.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1980 PA 350, entitled                                             

                                                                                

    "The nonprofit health care corporation reform act,"                         

                                                                                

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

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 416d.  (1) A health care corporation that issues or                    

                                                                                

2   renews in this state on or after January 1, 2004 a group or                 

                                                                                

3   nongroup certificate that provides prescription coverage shall              

                                                                                

4   provide coverage for low-protein modified food products subject             

                                                                                

5   to both of the following:                                                   

                                                                                

6       (a) The low-protein modified food products are prescribed for               

                                                                                

7   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             

                                                                                


                                                                                

1   prescription coverage generally.  Coverage under this section may           

                                                                                

2   be limited to a cap of $4,000.00 per plan year on low-protein               

                                                                                

3   modified foods.  This $4,000.00 cap shall be adjusted annually by           

                                                                                

4   the commissioner pursuant to the consumer price index.                      

                                                                                

5       (3) As used in this section:                                                

                                                                                

6       (a) "Consumer price index" means the percentage of change in                

                                                                                

7   the consumer price index for all urban consumers in the United              

                                                                                

8   States city average for all items for the prior 12-month period             

                                                                                

9   as reported by the United States department of labor, bureau of             

                                                                                

10  labor statistics, and as certified by the commissioner.                     

                                                                                

11      (b) "Low-protein modified food product" means a food product                

                                                                                

12  that is specially formulated to have less than 1 gram of protein            

                                                                                

13  per serving.  Low-protein modified food product does not include            

                                                                                

14  a natural food that is naturally low in protein.