NOTE: The governor signed this measure on 6/1/2016.
      
      
      HOUSE BILL 16-1387
      
      
      BY REPRESENTATIVE(S) Primavera, Fields, Ginal, Lontine, Ryden,
      Singer, Tyler, Winter, Hullinghorst;
      also SENATOR(S) Woods, Aguilar, Carroll, Crowder, Kefalas,
      Martinez Humenik, Merrifield, Newell, Steadman, Todd.
      
      
      Concerning health insurance coverage for severe protein
           allergic conditions.
      
      
      Be it enacted by the General Assembly of the State of Colorado:
      
           SECTION 1.  In Colorado Revised Statutes, 10-16-104, amend (1)
      (c) (III) (A) and (1) (c) (III) (C) as follows:
      
           10-16-104.  Mandatory coverage provisions - definitions - rules.
      (1)  Newborn children. (c) (III) (A)  Coverage for inherited enzymatic
      disorders caused by single gene defects involved in the metabolism of
      amino, organic, and fatty acids shall include, but not be limited to as well
      as severe protein allergic conditions includes, without
      limitation, the following diagnosed conditions: Phenylketonuria; maternal
      phenylketonuria; maple syrup urine disease; tyrosinemia; homocystinuria;
      histidinemia; urea cycle disorders; hyperlysinemia; glutaric acidemias;
      methylmalonic acidemia; and propionic acidemia; immunoglobulin E
      and nonimmunoglobulin E-mediated allergies to multiple food
      proteins; severe food protein induced enterocolitis syndrome;
      eosinophilic disorders as evidenced by the results of a biopsy; and
      impaired absorption of nutrients caused by disorders affecting
      the absorptive surface, function, length, and motility of the
      gastrointestinal tract. Covered care and treatment of such conditions
      shall include, to the extent medically necessary, medical foods for home use
      for which a physician who is a participating provider has issued a written,
      oral, or electronic prescription.
      
           (C)  As used in this subparagraph (III), "medical foods" means
      prescription metabolic formulas and their modular counterparts and amino
      acid-based elemental formulas, obtained through a pharmacy, that are
      specifically designated and manufactured for the treatment of inherited
      enzymatic disorders caused by single gene defects involved in the
      metabolism of amino, organic, and fatty acids and for severe allergic
      conditions, if diagnosed by a board-certified allergist or
      board-certified gastroenterologist, for which medically standard
      methods of diagnosis, treatment, and monitoring exist. Such formulas are
      specifically processed or formulated to be deficient in one or more
      nutrients. and The formulas for severe food allergies contain only
      singular form elemental amino acids. The formulas are to be
      consumed or administered enterally either via tube or oral route under the
      direction of a physician who is a participating provider. This
      sub-subparagraph (C) shall not be construed to apply to cystic fibrosis
      patients or lactose- or soy-intolerant patients.
      
           SECTION 2.  Act subject to petition - effective date. This act
      takes effect January 1, 2018; except that, if a referendum petition is filed
      pursuant to section 1 (3) of article V of the state constitution against this act
      or an item, section, or part of this act within the ninety-day period after
      final adjournment of the general assembly, then the act, item, section, or
      part will not take effect unless approved by the people at the general
      election to be held in November 2016 and, in such case, will take effect on
      January 1, 2018, or on the date of the official declaration of the vote
      thereon by the governor, whichever is later.
      
      
      
      
      ________________________________________________________
      Dickey Lee Hullinghorst                Bill L. Cadman
      SPEAKER OF THE HOUSE                     PRESIDENT OF
      OF REPRESENTATIVES                         THE SENATE
      
      
      
      
      
      
      ____________________________  ____________________________
      Marilyn Eddins                            Effie Ameen
      CHIEF CLERK OF THE HOUSE                 SECRETARY OF
      OF REPRESENTATIVES                         THE SENATE
      
      
      
      
                  APPROVED________________________________________
      
      
      
      
      
                                    _________________________________________
                                    John W. Hickenlooper
                                    GOVERNOR OF THE STATE OF COLORADO