ASSEMBLY INSURANCE COMMITTEE

 

STATEMENT TO

 

[First Reprint]

SENATE, No. 1887

 

with committee amendments

 

STATE OF NEW JERSEY

 

DATED: DECEMBER 11, 1997

 

 

      The Assembly Insurance Committee reports favorably and with committee amendments Senate Bill No. 1887 (1R).

      This bill, as amended by the committee, requires hospital, medical and health service corporations, individual, small employer and large group insurers, health maintenance organizations and the New Jersey State Health Benefits Program to provide coverage for the therapeutic treatment of inherited metabolic diseases, including the purchase of medical foods and low protein modified food products, when diagnosed and determined to be medically necessary by the covered person's physician.

      The bill defines "inherited metabolic disease" as a disease caused by an inherited abnormality of body chemistry for which testing is mandated pursuant to P.L.1977, c.321 (C.26:2-110 et seq.), such as phenylketonuria (PKU). "Low protein modified food product" is a food product that is specially formulated to have less than one gram of protein per serving and is intended to be used under the direction of a physician for the dietary treatment of an inherited metabolic disease, but does not include a natural food that is naturally low in protein, and "medical food" is a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered enterally under direction of a physician.

      As reported by the committee, this bill is identical to Assembly Bill No. 2506 (1R).