Insurance, Administration

Rule R590-194

Coverage of Dietary Products for Inborn Errors of Amino Acid or Urea Cycle Metabolism

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 33031
Filed: 10/08/2009 12:18:09 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

This rule is promulgated pursuant to Subsections 31A-2-201(1) and 31A-2-201(3)(a) in which the commissioner is empowered to administer and enforce this title and to make rules to implement the provisions of this title. The authority to set minimum standards by rule for coverage of dietary products for inborn errors of amino acid or urea cycle metabolism is provided by Subsection 31A-22-623(2).

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The department has not received any written comments regarding this rule in the past five years.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule establishes minimum standards of coverage for dietary products, including formulas and low protein modified food products, which are required to be covered by insurers and are used for the treatment of inborn errors of amino acid or urea cycle metabolism. This coverage will be provided at levels consistent with the major medical benefit provided under a disability insurance policy. This rule entails the identification of a uniform billing code standard to be used by health insurers to expedite the processing of claims covering dietary formulas in conjunction with the treatment of these specific inborn metabolic errors. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

• Jilene Whitby at the above address, by phone at 801-538-3803, by FAX at 801-538-3829, or by Internet E-mail at jwhitby@utah.gov

Effective:

10/08/2009

Authorized by:

Jilene Whitby, Information Specialist