By Van de Putte H.B. No. 1751 76R6317 AJA-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to health insurance coverage for medical foods. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Article 3.79, Insurance Code, is amended to read 1-5 as follows: 1-6 Art. 3.79. COVERAGE FOR SPECIAL DIETARY FORMULAS FOR 1-7 INDIVIDUALS WITH PHENYLKETONURIA OR OTHER HERITABLE DISEASES 1-8 Sec. 1. DEFINITIONS. In this article: 1-9 (1) "Health insurance policy" means any group policy, 1-10 contract, or certificate of health insurance or evidence of 1-11 coverage delivered, issued for delivery, or renewed in this state 1-12 by an insurance company, including a group hospital service 1-13 corporation under Chapter 20 of this code and a health maintenance 1-14 organization under the Texas Health Maintenance Organization Act 1-15 (Chapter 20A, Vernon's Texas Insurance Code). 1-16 (2) "Heritable disease" means an inherited disease 1-17 that may result in mental or physical retardation or death. 1-18 (3) "Medical food" means a food that is formulated to 1-19 be consumed and administered enterally under the supervision of a 1-20 physician and that is intended for the specific dietary management 1-21 of a disease or condition for which distinctive nutritional 1-22 requirements, based on recognized scientific principles, are 1-23 established by medical evaluation. 1-24 (4) "Phenylketonuria" means an inherited condition 2-1 that may cause severe mental retardation if not treated. 2-2 Sec. 2. COVERAGE REQUIRED. Each health insurance policy 2-3 shall include coverage for formulas and medical foods necessary for 2-4 the treatment of phenylketonuria or other heritable diseases to the 2-5 same extent as for drugs available only on the orders of a 2-6 physician. 2-7 SECTION 2. This Act takes effect September 1, 1999, and 2-8 applies only to an insurance policy that is delivered, issued for 2-9 delivery, or renewed on or after January 1, 2000. A policy 2-10 delivered, issued for delivery, or renewed before January 1, 2000, 2-11 is governed by the law as it existed immediately before the 2-12 effective date of this Act. 2-13 SECTION 3. The importance of this legislation and the 2-14 crowded condition of the calendars in both houses create an 2-15 emergency and an imperative public necessity that the 2-16 constitutional rule requiring bills to be read on three several 2-17 days in each house be suspended, and this rule is hereby suspended.