TO: Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Inc. (BCBSMA) and Health Maintenance Organizations (HMO's)
FROM: Nonnie S. Burnes, Commissioner of Insurance
DATE: October 10, 2008
RE: Coverage for Inherited Diseases of Amino Acids and Organic Acids

The enactment of Chapter 214 of the Acts of 2008, An Act Increasing Coverage of Nonprescription Enteral Formulas, increases the mandated benefit coverage for food products modified to be low protein for individuals with inherited diseases of amino acids and organic acids, as codified at M.G.L. c. 175, §47I, M.G.L. c. 176A, §8L, M.G.L. c. 176B, §4K and M.G.L. 176G, §4D. The laws have increased the mandated annual benefit coverage for low protein food products from two thousand five hundred dollars ($2,500.00) to five thousand dollars ($5,000.00) in all existing and new contracts, effective October 28, 2008. Commercial insurers, BCBSMA and HMO's are required to comply with these increased mandates.

Carriers should update their internal claims handling and customer assistance systems, amend all affected policies, certificates, evidences of coverage and contracts to reflect the change, and notify policyholders, subscribers and members regarding these increased benefits and the effective date as soon as practicable.

Any questions regarding this bulletin should be directed to Erin Brennan Bagley, Counsel to the Commissioner, at 617-521-7385 or erin.b.bagley@state.ma.us.