Insurance Committee

Filed: 5/15/2007

 

 


 

 


 
09500SB0935ham001 LRB095 05753 KBJ 35843 a

1
AMENDMENT TO SENATE BILL 935

2     AMENDMENT NO. ______. Amend Senate Bill 935 on page 3, by
3 replacing lines 12 through 24 with the following:
4     "A group or individual policy of accident and health
5 insurance or managed care plan amended, delivered, issued, or
6 renewed after the effective date of this amendatory Act of the
7 95th General Assembly must provide coverage and reimbursement
8 when documentation is presented demonstrating a medical
9 necessity and treatment plan for amino acid-based elemental
10 formulas, regardless of delivery method, for the diagnosis and
11 treatment of (i) an individual with multiple food allergies or
12 intolerances making amino acid-based elemental formulas a
13 medically necessary treatment, (ii) eosinophilic disorders,
14 and (iii) short bowel syndrome, when the prescribing physician
15 has issued a written order stating that the amino acid-based
16 elemental formula is medically necessary for the treatment of a
17 disease or disorder."; and
 

 

 

09500SB0935ham001 - 2 - LRB095 05753 KBJ 35843 a

1 on page 4, by deleting lines 1 through 12; and
 
2 on page 13, by deleting lines 25 and 26.
 
3 on page 14, by replacing lines 1 through 18 with the following:
4     "The Department of Healthcare and Family Services must
5 provide coverage and reimbursement when documentation is
6 presented demonstrating a medical necessity and treatment plan
7 for amino acid-based elemental formulas, regardless of
8 delivery method, for the diagnosis and treatment of (i) an
9 individual with multiple food allergies or intolerances making
10 amino acid-based elemental formulas a medically necessary
11 treatment, (ii) eosinophilic disorders, and (iii) short bowel
12 syndrome, when the prescribing physician has issued a written
13 order stating that the amino acid-based elemental formula is
14 medically necessary for the treatment of a disease or
15 disorder.".