PARRIS N. GLENDENING, Governor

Ch. 270

2. INTENDED TO BE USED UNDER THE DIRECTION OF A
PHYSICIAN FOR THE DIETARY TREATMENT OF AN INHERITED METABOLIC DISEASE.

(II) "LOW PROTEIN MODIFIED FOOD PRODUCT" DOES NOT
INCLUDE A NATURAL FOOD THAT IS NATURALLY LOW IN PROTEIN.

(4) "MEDICAL FOOD" MEANS A FOOD THAT IS:

(I)      INTENDED FOR THE DIETARY TREATMENT OF A DISEASE OR
CONDITION FOR WHICH NUTRITIONAL REQUIREMENTS ARE ESTABLISHED BY
MEDICAL EVALUATION; AND

(II) FORMULATED TO BE CONSUMED OR ADMINISTERED
ENTERALLY UNDER THE DIRECTION OF A PHYSICIAN.

(A)     (B) THE PROVISIONS OF THIS SECTION APPLY TO A NONPROFIT HEALTH
SERVICE PLAN THAT:

(1)      IS WRITTEN ON AN EXPENSE INCURRED BASIS;

(2)      PROVIDES COVERAGE FOR A FAMILY MEMBER OF THE INSURED:
AND

(3)      IS DELIVERED OR ISSUED FOR DELIVERY IN THE STATE.

(B)     (C) A NONPROFIT HEALTH SERVICE PLAN SHALL INCLUDE UNDER THE
FAMILY MEMBER COVERAGE, COVERAGE FOR NUTRITIONAL FOOD SUPPLEMENTS
OR FORMULAS MEDICAL FOODS AND LOW PROTEIN MODIFIED FOOD PRODUCTS
FOR THE TREATMENT OF PHENYLKETONURIA (PKU) THAT INHERITED METABOLIC
DISEASES IF THE MEDICAL FOODS OR LOW PROTEIN MODIFIED FOOD PRODUCTS
ARE:

(1) EQUIVALENT TO PRESCRIPTION DRUGS;

(2) (1) PRESCRIBED AS MEDICALLY NECESSARY FOR THE
THERAPEUTIC TREATMENT OF PHENYLKETONURIA INHERITED METABOLIC
DISEASES; AND

(3) (2) ADMINISTERED UNDER THE DIRECTION OF A PHYSICIAN.

470FF.

(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2) (I) "INHERITED METABOLIC DISEASE" MEANS A DISEASE CAUSED
BY AN INHERITED ABNORMALITY OF BODY CHEMISTRY.

(II)     "INHERITED METABOLIC DISEASE" INCLUDES A DISEASE FOR
WHICH THE STATE SCREENS NEWBORN BABIES.

(3) (I) "LOW PROTEIN MODIFIED FOOD PRODUCT" MEANS A FOOD
PRODUCT THAT IS:

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