Bill > H4937

This bill mandates that various health insurance plans in Massachusetts, including those for state employees, individual accident and sickness policies, group blanket policies, hospital service plans, medical service agreements, and health maintenance contracts, must cover the cost of enteral formulas for home use. These formulas, whether taken orally or via tube feeding, will be covered if a physician issues a written order stating they are medically necessary and proven effective for treating specific diseases that can lead to malnutrition, chronic physical or intellectual disability, or death. The bill clarifies that these medically necessary enteral formulas are distinct from elective nutritional supplements and lists examples of qualifying conditions such as inherited metabolic diseases, eosinophilic gastrointestinal disorders, Crohn's Disease, severe reflux with failure to thrive, motility disorders, and multiple severe food allergies.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H4937