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PA Bulletin, Doc. No. 20-1748



Bureau of Family Health Metabolic Formula Program

[50 Pa.B. 7109]
[Saturday, December 12, 2020]

 The Department of Health, Bureau of Family Health, Metabolic Formula Program (Program) currently provides metabolic formula coverage through 21 years of age and for women 22 years of age or older who are either pursuing pregnancy or are pregnant without any insurance stipulations. Because the Medical Foods Insurance Coverage Act of 1996 (40 P.S. §§ 3901—3909), amended October 22, 2014 (P.L. 2564, No. 158), requires health insurance policies to cover the cost of formulas necessary for the treatment of phenylketonuria and other disorders, and due to the availability of Medical Assistance (MA), the Program will begin requiring that formula be obtained through private insurance and durable medical equipment coverage, or through enrollment in MA.

 Effective November 1, 2020, all new applicants and renewal applicants will be required to submit either a letter of denial of coverage from their insurance and MA or submit a signed insurance or MA refusal form due to religious objection in order to be considered for eligibility under the Program.

 For additional information, contact David Hiester, Administrative Officer, Division of Newborn Screening and Genetics, at (717) 783-8143. Speech and/or hearing-impaired persons use V/TT (717) 783-6514 or the Pennsylvania AT&T Relay Service at (800) 654-5984 (TT).


[Pa.B. Doc. No. 20-1748. Filed for public inspection December 11, 2020, 9:00 a.m.]

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