Greenstein Bill Requiring Health Insurance Coverage for Certain Amino Acid Based Elemental Formula Clears Committee

Greenstein Budget

TRENTON – Today, legislation sponsored by Senator Linda Greenstein requiring insurance coverage of amino acid-based elemental formulas for treating eosinophilic disorder was approved by the Senate Commerce Committee.

 

“The eosinophilic condition is a life-altering disorder which can be treated with appropriate intervention,” said Senator Greenstein (D-Mercer/Middlesex). “Amino-acid based formulas, which are essential to so many with this condition, need to be covered and this legislation will make it less stressful for patients to get the food and the treatment they need to live healthy lives.”

 

The bill, S-1692, would require insurance coverage of amino acid-based elemental formulas for treating eosinophilic disorders. Under the bill, health insurers (health, hospital, and medical service corporations, commercial individual and group health insurers, health maintenance organizations, the State Health Benefits Program, and the School Employees’ Health Benefits Program) would be required to provide health benefits coverage for expenses incurred for the purchase and administration of amino acid-based elemental formulas, regardless of delivery method, for treating eosinophilic disorders that have been determined by a covered patient’s physician to be medically necessary.

 

Amino acid–based elemental formulas are complete nutrition formulas designed for individuals who have a dysfunctional or shortened gastrointestinal tract and are unable to tolerate and absorb whole foods or formulas composed of whole proteins, fats, and/or carbohydrates.

 

The bill would take effect on the 120th day after its enactment and would apply to policies or contracts issued or renewed on or after that date.

 

The bill was approved by the Senate Commerce Committee with a vote of (5-0).  It next heads to the Senate Budget and Appropriations Committee.