HBA-TYH H.B. 1751 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 1751 By: Van de Putte Insurance 3/24/1999 Introduced BACKGROUND AND PURPOSE For persons with particular genetic conditions such as phenylketonuria (PKU), obtaining adequate nutrition is a significant daily challenge. Most foods are excluded from their diet because of their protein content. Even foods such as breads and pastas contain dangerously high amounts of protein. In infants, improper diet leads to irreversible mental retardation. For children and adults, improper diet leads to irreversible deterioration of brain function. Pregnant women with PKU risk brain abnormalities, heart defects, and other malformations in the unborn child. These individuals are primarily limited to physician-prescribed medical formulas and medically formulated foods. However, the formulas and foods are expensive. Additionally, it is impossible to obtain adequate nutrition from the medical formulas alone, thus medical foods are a medical necessity for these individuals. While health insurance policies are currently required to provide coverage for medical formulas, there is no requirement for the provision of medical foods. H.B. 1751 requires health insurance policies to provide coverage for medical foods, in addition to the formulas. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Article 3.79, Insurance Code, by adding the definition of "medical food" and requiring each health insurance policy to include coverage for formulas and medical foods necessary for the treatment of phenylketonuria or other heritable diseases. SECTION 2.Effective date: September 1, 1999. Makes application of this Act prospective, as of January 1, 2000. SECTION 3.Emergency clause.