Relating to third-party payment of insurance benefits for medically necessary food, and vitamins and individual amino acids, for certain covered conditions, and including applicability provisions

F. This bill relates to third-party payment of insurance benefits for medically necessary food, and vitamins and individual amino acids, for certain covered conditions. The bill defines “covered condition” as inherited metabolic disorders; medical and surgical conditions of malabsorption; immunoglobulin E and non-immunoglobulin E-mediated allergies to food proteins; and inflammatory or immune mediated conditions of the alimentary tract. The definition also includes, as detailed in the bill, specific conditions under each of the different categories of conditions. The bill also defines “medically necessary food” and “medically necessary vitamins and individual amino acids”. The bill requires a health carrier that offers individual, group, or small group contracts, policies, or plans in this state that provide for third-party payment or prepayment of health or medical expenses to offer coverage for medically necessary food and the medical equipment and supplies, not to include durable medical equipment, necessary to administer the food; and for medically necessary vitamins and individual amino acids. The bill requires that the coverage be a minimum of percent of the cost to a covered person for medically necessary food and the medical equipment and supplies necessary to administer the food, and medically necessary vitamins and individual amino acids. The bill prohibits the coverage from being subject to cost-sharing that is greater than the cost-sharing that the policy, contract, or plan requires for other health or medical expenses covered under the policy, contract, or plan. Prior authorization cannot be a requirement for coverage. The commissioner of insurance must adopt rules to administer the requirements of the bill. The bill applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2022, by the third-party payment providers enumerated in the bill. specifies the types of specialized health-related insurance that are not subject to the bill.