1.1    .................... moves to amend H. F. No. 529 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2006, section 62A.26, is amended to read:
1.462A.26 COVERAGE FOR PHENYLKETONURIA TREATMENT CERTAIN
1.5DIETARY FORMULAS.
1.6    Subdivision 1. Scope of coverage. This section applies to all policies of accident
1.7and health insurance regulated under chapter 62A, health maintenance contracts regulated
1.8under chapter 62D, health benefit certificates offered through a fraternal benefit society
1.9regulated under chapter 64B, and group subscriber contracts offered by nonprofit health
1.10service plan corporations regulated under chapter 62C, but does not apply to policies
1.11designed primarily to provide coverage payable on a per diem, fixed indemnity or
1.12nonexpense incurred basis, or policies that provide only accident coverage.
1.13    Subd. 2. Required coverage for special dietary formulas for inborn errors
1.14of metabolism. Every policy, plan, certificate, or contract referred to in subdivision
1.151 issued or renewed after August 1, 1985, must provide coverage for special dietary
1.16formulas essential to the treatment of inborn errors of metabolism, including treatment
1.17for phenylketonuria when recommended by a physician.
1.18    Subd. 3. Required coverage for amino-acid based elemental formulas for
1.19certain conditions. (a) Every policy, plan, certificate, or contract referred to in subdivision
1.201 issued or renewed after August 1, 2007, must provide coverage for amino-acid
1.21based elemental formulas when ordered by a physician for diagnosed cases of cystic
1.22fibrosis; amino acid, organic acid, and fatty acid metabolic and malabsorption disorders;
1.23IgE mediated allergies to food proteins; food protein-induced enterocolitis syndrome;
1.24eosinophilic esophagitis; eosinophilic gastroenteritis; and eosinophilic colitis, when those
1.25conditions are diagnosed by an allergist, gastroenterologist, or pediatrician. Coverage
2.1of amino-acid based elemental formulas for enrollees diagnosed with an IgE mediated
2.2condition is limited to enrollees age five years and under.
2.3    (b) A policy, plan, certificate, or contract described in paragraph (a) may require
2.4that an enrollee obtain prior authorization for the coverage described in this subdivision.
2.5When requesting coverage, ordering physicians may be required to submit documentation
2.6of diagnosis, expected course of treatment, and duration of use of amino-acid based
2.7elemental formulas. Coverage may be provided for up to 90 days when requested by a
2.8physician while actively seeking diagnosis. Documentation of symptoms and referral
2.9for diagnosis may be required.
2.10    (c) No special deductible, co-payment, waiting period, or other special restriction for
2.11the coverage specified in this subdivision may be imposed if not imposed under the policy,
2.12plan, certificate, or contract for nonpreventive treatment or prescription drugs in general.

2.13    Sec. 2. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
2.14subdivision to read:
2.15    Subd. 3g. Amino-based acid elemental formulas. Medical assistance covers
2.16amino-based acid elemental formulas on the same terms and conditions required of
2.17policies, plans, and certificates under section 62A.26."
2.18Delete the title and insert:
2.20relating to insurance; requiring coverage for amino-based acid elemental
2.21formulas; amending Minnesota Statutes 2006, sections 62A.26; 256B.0625, by
2.22adding a subdivision."