Requires certain health insurance policies to include coverage for the cost of certain infant and baby formulas

1 Co-sponsor

• Marc Panepinto

BILL NUMBER:S2043

Title of bill

An act to amend the insurance law, in relation to requiring certain health insurance policies to include coverage for the cost of certain infant and baby formulas

Purpose

To allow parents to affordably provide medically necessary formulas for infants who would become malnourished or suffer from disorders if these particular formulas were made unavailable to them. These disorders, if left untreated, may cause chronic physical disability, mental retardation or death.

Summary of specific provisions

This bill would require that coverage by any policy which provides coverage for prescription drugs must provide coverage for the cost of infant and baby formulas which are proven effective as a disease-specific regimen. Such formulas must be prescribed by a physician or other license health care professional. Coverage for certain infant and baby formulas for any twelve months shall not be less than $3000.

Justification

Many infants have been prescribed medically necessary formulas which have been proven effective as a disease-specific treatment regimen for infants who are, or will become, malnourished or suffer from disorders, which, if left untreated, may cause chronic physical disability, mental retardation or death. Specific diseases for which infant formulas have been proven effective include: inherited diseases of amino acid; Crohn's disease; gastroesophageal reflux with failure to thrive; and multiple, severe food allergies. Symptoms of such allergies may also include: loose stools, which may contain blood; vomiting; hives; diarrhea; abdominal cramps; coughing or wheezing; runny nose; watery eyes; itchy skin rash, often around the mouth; and colic.

Infant and baby formulas, which must be purchased to prevent symptoms from occurring, are often more expensive than regular formulas. Especially during these difficult economic times, parents need help to provide the food that is best and safest for their infants. Currently, in New York State, insurance companies are not required to cover these medically necessary formulas. However, other states, such as Arizona, Colorado, Louisiana, and Massachusetts do have provisions which require insurance companies to cover such infant formulas.

Legislative history

Senate: 2009-10: S.8326 - Referred to Rules Assembly: 2009-10: A.10450 (Meng) - Passed Assembly

Effective date

First of January next succeeding the date it becomes a law.