Coverage of elemental formulas for severe digestive disorders passes House 94-0, heads for enrollment

03/19/2016 04:26 PM

FRANKFORT — Legislation that would mandate coverage of amino-acid-based formulas for eosinophilic and other digestive disorders is a step closer to Gov. Matt Bevin’s desk after passing the House of Representatives on a 94-0 vote Friday.

Senate Bill 193, sponsored by Sen. Ralph Alvarado, is named “Noah’s Law” after 9-year-old Noah Greenhill, of Pike County, who suffers from eosinophilic esophagitis. His condition requires him to eat an amino-acid formula through a feeding tube four times a day because of severe food allergies.

SB 193, which passed the Senate on a 34-1 vote, is an expansion of House Bill 353, adding coverage of food protein allergies and food-protein induced enterocolitis syndrome. HB 353, sponsored by House Speaker Greg Stumbo, called for mandatory coverage of eosinophilic disorders and short-bowel syndrome.

Stumbo, in a floor speech, said the legislation “shows that this body can in fact come together and use its wisdom collectively and its expertise collectively and formulate policies that do make a difference in the lives of a lot of Kentuckians.”

“Dr. Alvarado used his expertise and recognized that this probably should be expanded to cover others,” said Stumbo, D-Prestonsburg. “He testified that there were in his judgment maybe 300 or 400 families in the commonwealth that would be affected by this.”

Alvarado, R-Winchester, said he was glad to see SB 193 pass the 2016 General Assembly.

“Despite the inaction of our medical insurance community to fix this problem, I am ultimately happy that the children and families who suffer with severe absorptive gastrointestinal disorders will have the ability to access elemental formulas that will permit them to survive nutritionally,” Alvarado said in a statement.

A health mandate analysis of SB 193 shows that expenses and use of the increased insurance coverage of elemental formula is expected to cost between .07 and .16 percent more, or $6.4 million to $15.2 million annually for insured policies in the state. That’s projected to cost members 29 to 69 cents per month, according to the analysis.

By comparison, HB 353 was expected to cost $200,000 to $500,000 more in covering eosinophilic disorders and short-bowel syndrome, or 1 to 2 cents per member per month, according to that legislation’s health mandate.

SB 193 heads back to the Senate to begin enrollment proceedings.


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