Maine Revised Statutes
Chapter 56: HEALTH MAINTENANCE ORGANIZATIONS
24-A §4238. Medical food coverage for inborn error of metabolism

§4238. Medical food coverage for inborn error of metabolism
1.  Inborn error of metabolism; special modified low-protein food product.  As used in this section, "inborn error of metabolism" means a genetically determined biochemical disorder in which a specific enzyme defect produces a metabolic block that may have pathogenic consequences at birth or later in life. As used in this section, "special modified low-protein food product" means food formulated to reduce the protein content to less than one gram of protein per serving and does not include foods naturally low in protein.  
[PL 1995, c. 369, §4 (NEW).]
2.  Required coverage.  All health maintenance organization individual and group contracts must provide coverage for metabolic formula and special modified low-protein food products that have been prescribed by a licensed physician for a person with an inborn error of metabolism. The contracts must reimburse:  
A. For metabolic formula; and   [PL 1995, c. 369, §4 (NEW).]
B. Up to $3,000 per year for special modified low-protein food products.   [PL 1995, c. 369, §4 (NEW).]
[PL 1995, c. 369, §4 (NEW).]
3.  Application.  The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1996. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.  
[PL 1995, c. 369, §4 (NEW).]
SECTION HISTORY
RR 1995, c. 1, §19 (RNU). PL 1995, c. 369, §4 (NEW).

Structure Maine Revised Statutes

Maine Revised Statutes

TITLE 24-A: MAINE INSURANCE CODE

Chapter 56: HEALTH MAINTENANCE ORGANIZATIONS

24-A §4201. Short title

24-A §4202. Definitions (REPEALED)

24-A §4202-A. Definitions

24-A §4203. Establishment of health maintenance organizations

24-A §4204. Issuance of certificate of authority

24-A §4204-A. Surplus requirements

24-A §4205. Powers of health maintenance organizations

24-A §4205-A. Continuity of licensure; business combinations

24-A §4206. Governing body

24-A §4207. Evidence of coverage and charges for health care services

24-A §4207-A. Point-of-service products

24-A §4208. Annual and interim reports

24-A §4209. Information to enrollees

24-A §4210. Open enrollment

24-A §4210-A. Continuity of health insurance coverage (REPEALED)

24-A §4211. Complaint system

24-A §4212. Prohibited practices

24-A §4213. Regulation of agents

24-A §4214. Powers of insurers and nonprofit hospital or medical service corporations

24-A §4215. Examinations

24-A §4216. Suspension or revocation of certificate of authority

24-A §4217. Rehabilitation, liquidation or conservation of health maintenance organizations

24-A §4218. Regulations

24-A §4218-A. Compliance with the Affordable Care Act

24-A §4219. Administrative procedures

24-A §4220. Fees

24-A §4221. Penalties and enforcement

24-A §4222. Statutory construction and relationship to other laws

24-A §4222-A. Rules

24-A §4222-B. Applicability

24-A §4223. Filings and reports as public documents

24-A §4224. Confidentiality; liability; access to records

24-A §4224-A. Loss information (REPEALED)

24-A §4225. Commissioner of Health and Human Services' authority to contract

24-A §4226. Federal legislation

24-A §4227. Choice of alternative coverage

24-A §4228. Utilization review data

24-A §4229. Acquired Immune Deficiency Syndrome

24-A §4230. Trade practices and frauds (REPEALED)

24-A §4231. Insolvency or withdrawal; alternative coverage

24-A §4232. Replacement coverage

24-A §4233. Registration, regulation and supervision of holding company systems

24-A §4233-A. Extension of coverage for dependent children

24-A §4233-B. Mandatory offer to extend coverage for dependent children up to 26 years of age

24-A §4233-C. Mandatory offer of coverage for certain adults with disabilities

24-A §4234. Child coverage

24-A §4234-A. Mental health services coverage

24-A §4234-B. Maternity and routine newborn care

24-A §4234-C. Newborn children coverage

24-A §4234-D. Off-label use of prescription drugs for cancer

24-A §4234-E. Off-label use of prescription drugs for HIV or AIDS

24-A §4234-F. Maternity and postpartum care

24-A §4235. Standardized claim forms

24-A §4236. Chiropractors in health maintenance organizations

24-A §4237. Coverage for breast cancer treatment

24-A §4237-A. Screening mammograms

24-A §4238. Medical food coverage for inborn error of metabolism

24-A §4239. Medical child support

24-A §4240. Coverage for diabetes supplies

24-A §4241. Gynecological and obstetrical services

24-A §4242. Coverage for Pap tests (REALLOCATED FROM TITLE 24-A, SECTION 4240)

24-A §4243. Limits on priority liens; subrogation

24-A §4244. Coverage for prostate cancer screening (REALLOCATED FROM TITLE 24-A, SECTION 4243)

24-A §4245. NCQA accreditation survey report

24-A §4246. Coverage for services provided by registered nurse first assistants

24-A §4247. Coverage for contraceptives (REALLOCATED FROM TITLE 24-A, SECTION 4245)

24-A §4248. Coverage for services of certified nurse practitioners; certified midwives; certified nurse midwives (REALLOCATED FROM TITLE 24-A, SECTION 4245)

24-A §4249. Mandated offer of domestic partner benefits

24-A §4250. Coverage for hospice care services (REALLOCATED FROM TITLE 24-A, SECTION 4249)

24-A §4251. Coverage for general anesthesia for dentistry (REALLOCATED FROM TITLE 24-A, SECTION 4249)

24-A §4252. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery

24-A §4253. Enrollment for individuals or families establishing eligibility for MaineCare

24-A §4254. Coverage for colorectal cancer screening

24-A §4255. Coverage for hearing aids (REALLOCATED FROM TITLE 24-A, SECTION 4253)

24-A §4256. Coverage for medically necessary infant formula (REALLOCATED FROM TITLE 24-A, SECTION 4254)

24-A §4257. Coverage for services provided by independent practice dental hygienist

24-A §4258. Coverage for children's early intervention services

24-A §4259. Coverage for the diagnosis and treatment of autism spectrum disorders (REALLOCATED FROM TITLE 24-A, §4258)

24-A §4260. Dental benefit waiting period