West Virginia Code § 33-16-3bb

Coverage for amino acid-based formulas
Open in Lexace · Ask the AI about this section
(a) A policy, plan, or contract that is issued or renewed on or after January 1, 2019, and that
is subject to this article shall provide coverage, through the age of 20, for amino acid-based
formula for the treatment of severe protein-allergic conditions or impaired absorption of
nutrients caused by disorders affecting the absorptive surface, function, length, and motility
of the gastrointestinal tract. This includes the following conditions, if diagnosed as related to
the disorder by a physician licensed to practice in this state pursuant to either §30-3-1 et
seq. or §30-14-1 et seq. of this code:
(1) Immunoglobulin E and Nonimmunoglobulin E-medicated allergies to multiple food
proteins;
(2) Severe food protein-induced enterocolitis syndromea;
(3) Eosinophilic disorders as evidenced by the resullts of a biopsy; and
(4) Impaired absorption of nutrients caused by disorders affecting the absorptive surface,
function, length, and motility of the gastrointestinal tract (short bowel).
(b) The coverage required by §33-16-3bb(a) of this code shall include medical foods for home
use for which a physician has issued a prescription and has declared them to be medically
necessary, regardless of methodology of delivery.
(c) For purposes of this Lsection, "medically necessary foods" or "medical foods" shall mean
prescription amino acid-based elemental formulas obtained through a pharmacy: Provided,
That these foods are specifically designated and manufactured for the treatment of severe
allergic conditions or short bowel.
(d) The provisions of this section shall not apply to persons with an intolerance for lactose or
soyW.

‹ Prev All West Virginia sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.