Ch. 270

1995 LAWS OF MARYLAND

1. SPECIALLY FORMULATED TO HAVE LESS THAN 1 GRAM
OF PROTEIN PER SERVING; AND

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 HOSPITAL OR MAJOR
MEDICAL INSURANCE POLICY 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 HOSPITAL OR MAJOR MEDICAL INSURANCE POLICY 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.

477PP.

(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.

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