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.