Mandatory Coverage for Medical Foods and Formulas in Federal Health Programs
This act mandates coverage for specialized medical foods, vitamins, and amino acids essential for treating severe metabolic and digestive disorders under Medicare, Medicaid, and CHIP. This change relieves thousands of families and adult patients from the full financial burden of these often life-saving products. The legislation aims to improve patient health outcomes and prevent costly hospitalizations.
Key points
Federal health programs (Medicare, Medicaid, CHIP, and FEHBP) must cover medically necessary food and formulas for patients diagnosed with specific metabolic and digestive conditions.
Coverage includes vitamins, individual amino acids, and the necessary equipment for administering the food, whether taken orally or via a feeding tube.
The law ensures patients, particularly children, receive essential dietary treatment, preventing severe health consequences like brain damage or developmental delays.
The bill expresses the view that all private health insurance plans should also adopt similar coverage standards.
Introduced
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