Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Healthcare Coverage topic
No spam. Unsubscribe anytime.
Committee adopts amendments and reports bill to require coverage for amino-acid elemental formula for infants
Summary
House Bill 467, sponsored by Representative Hilferty, was reported favorably after committee adoption of technical amendments clarifying that coverage is for children age 2 and younger and requires specialist confirmation of medical necessity.
House Bill 467, which would require health-insurance coverage for amino-acid–based elemental formulas for children with medical diagnoses that make standard formula unsuitable, was reported favorably from the House Insurance Committee after technical amendments clarifying scope and provider requirements.
Representative Sarah Hilferty told the committee the bill responds to constituent cases in which families pay expensive formula out-of-pocket. Hilferty said the formula can cost roughly $56 per can and the proposed coverage targets children age 2 and younger and requires diagnosis by a pediatric gastroenterologist or allergist.
Committee members adopted technical amendments (Amendment Set 1844) that changed the age limit in the printed amendment from “younger than 12” to “2 years and younger” and added the specialist diagnosis requirement the industry requested. The amendments were adopted without recorded opposition and the bill was reported favorably with amendments.
Why it matters: Supporters said treating medically necessary elemental formula as a covered benefit recognizes the formula as therapeutic rather than optional nutrition for affected infants; Department of Insurance staff and stakeholders worked on specialist verification language to limit coverage to medically necessary cases.
What’s next: HB 467 will advance to the House floor with the committee’s adopted technical amendments.
