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State Laws and Policies
This list includes laws and policies known to National PKU News and is not a
comprehensive list. It does include all laws passed since 1994. Information
about policies in some states is incomplete.
We would be delighted if people would send us information about the situation in
their state, correct us if any of this information is incorrect, and add
missing information! We hope to keep this list as updated as possible, for the
benefit of everyone. Please write to: National PKU News, 6869 Woodlawn Ave. NE
#116, Seattle, WA 98115. E-mail: schuett@pkunews.org
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|
Bill/Date Adopted
|
Diet Coverage
|
Coverage
|
Metabolic Disorders
|
Limitations
|
|
State |
|
Formula |
Foods |
State |
Insurance |
PKU |
Others |
$ for food, per person |
Age (years) |
| Alabama |
|
No19 |
No |
No |
No |
NA |
NA |
NA |
NA |
| Alaska |
SB 313/May 91 |
Yes |
No |
No |
Yes |
Yes |
No |
NA |
No |
| Arizona |
HB 2043/April 00 |
Yes |
Yes |
No |
Yes |
Yes |
Select |
50% up to $5000 |
No |
| Arkansas |
HB 183/April 99 |
Yes |
Yes |
No |
Yes |
Yes |
Yes20 |
$2400 annual tax credit per child (food or formula) |
Yes1 |
| California |
SB 148/Jan. 99 |
Yes |
Yes |
No 2 |
Yes 3 |
Yes |
No |
No |
No |
| Colorado |
HB 01-1156/June 01
|
Yes |
No |
No |
Yes |
Yes |
Yes |
NA |
Formula age limit: 21 for males, 35 for females. Food limitations: None.
|
| Connecticut |
HB 7040/Oct. 97,
SB 524/Oct. 01 |
Yes |
Yes |
No |
Yes |
Yes |
Select |
No |
No |
| Delaware |
SB 78/July 08 |
Yes |
Yes |
Yes |
No |
Yes |
? |
|
Women through child bearing age, Men to age 21. |
| Florida |
HB 853/May 95 |
Yes4 |
Yes4 |
Yes5 |
Yes |
Yes |
Select |
$2,500
|
24 |
| Georgia |
|
Yes |
|
|
|
|
|
|
|
| Hawaii |
HB 326/Jan 99 |
Yes |
Yes |
No |
Yes |
Yes |
Yes6 |
No |
No |
| Idaho |
IDAPA 16.02.26 / July 97 |
Yes |
No |
Yes |
Not mandated, some cover. Medicaid covers. |
Yes |
No |
No |
No |
| Illinois |
|
Yes |
No |
Yes |
No |
Yes |
Yes |
NA |
No |
| Indiana |
|
No |
No |
Yes 7 |
No8 |
NA |
NA |
NA |
NA |
| Iowa |
|
Yes |
No |
based on income |
some |
Yes |
? |
No |
No |
| Kansas |
HB 2255/April 97 |
Yes |
Yes |
No |
No |
Yes |
MSUD |
$1,500 9
|
18 |
| Kentucky |
HB 395/April 02 |
Yes |
Yes |
Yes |
Yes |
Yes |
All |
$4,00010 |
No |
| Louisiana |
Act 1013/Jan 01 |
Yes 17 |
Yes 17 |
Yes |
Yes |
Yes |
Yes |
$200/month |
None |
| Maine |
HB 401/Feb 95 |
Yes |
Yes |
No 11 |
Yes |
Yes |
Select |
$3,000
|
No |
| Maryland |
HB 509/May 95 |
Yes |
Yes |
No |
Yes |
Yes |
Select |
No |
No |
| Massachusetts |
HB 5622/Nov 93 |
Yes |
Yes |
No |
Yes |
Yes |
Select |
$2,500
|
No |
| Michigan |
|
Yes |
No |
Yes |
No |
Yes |
? |
NA |
No |
| Minnesota |
256B.0625/? |
Yes |
Yes12 |
No |
Yes |
Yes |
No |
No |
No |
| Mississippi |
|
Yes |
No |
Yes 13 |
No |
Yes |
No |
NA |
18 |
| Missouri |
SB1026/June 02 |
Yes |
Yes |
Yes |
Yes 14 |
Yes |
Yes |
$5000 for food |
6 |
| Montana |
HB 266/April 99 |
Yes |
Yes |
No |
Yes |
Yes |
Yes |
No |
No |
| Nebraska |
LB 610/April 98 |
Yes |
Yes |
Yes |
Yes |
Yes |
Select |
$2,000
|
No |
| Nevada |
AB 394/July 97 |
Yes |
Yes |
Yes |
Yes |
Yes |
Select |
$2,500
|
21 |
| New Hampshire |
HB 1431/Aug 95 |
Yes |
Yes |
Yes |
Yes |
Yes |
Select |
$1,800
|
No |
| New Jersey |
SB 1887/Dec 97 |
Yes |
Yes |
No |
Yes |
Yes |
All |
No |
No |
| New Mexico |
HB 0289/July 03 |
Yes |
Yes |
Yes |
Yes, but limited |
Yes |
No |
NA |
None |
| New York |
AB 352B/1997 |
Yes |
Yes |
No |
Yes |
Yes |
All |
$2,500
|
No |
| North Carolina |
130A-125, S.L./July 97 |
Yes |
No |
Yes |
No |
Yes |
All |
NA |
No |
| North Dakota |
SB 2239,
HB 1012/Aug 01 |
Yes 15 |
Yes |
Yes 15 |
Yes |
Yes |
MSUD |
$3,000 food and formula |
Yes15
|
| Ohio |
Legislation pending |
Yes |
No |
Yes |
No |
Yes |
Homocystinuria |
NA |
No |
| Oklahoma |
|
Yes |
No |
Yes |
No |
Yes |
Select |
NA |
21 |
| Oregon |
HB 2388/May 97,
SB74/July 03 |
Yes |
Yes |
No |
Yes |
Yes |
All |
No |
No |
| Pennsylvania |
SB 7059/Dec 96 |
Yes |
No |
No |
Yes |
Yes |
MSUD/Select |
NA |
21 for males |
| Rhode Island |
|
Yes |
Yes |
Yes |
No |
Yes |
? |
? |
? |
| South Carolina |
Legislation pending |
Yes |
No |
Yes |
No |
Yes |
Select |
No |
No |
| South Dakota |
SB 89/Mar 92 |
Yes |
No |
No |
Yes |
Yes |
? |
NA |
No |
| Tennessee |
HB 165/July 96 |
Yes |
No |
No |
Yes |
Yes |
Select |
NA |
No |
| Texas |
TX Insurance Code Article 3.79/Sep 89, amended Apr 99 |
Yes |
No |
No |
Yes |
Yes |
No |
$3500 (formula) |
No |
| Utah |
HB 205/Feb 98 |
Yes16
|
Yes16
|
No |
Yes |
Yes |
Select |
No |
No |
| Vermont |
SB 253/Oct 98 |
Yes |
Yes |
No |
Yes |
Yes |
? |
$2,500
|
No |
| Virginia |
HB 0452/March 00 |
No |
No18
|
No |
No |
Yes |
? |
$2,000
|
18 (but pregnant women any age), College age for food. |
| Washington |
|
Yes |
No |
Yes |
No |
Yes |
Select |
NA |
No |
| West Virginia |
|
Yes |
No |
Yes |
No |
Yes |
Galactosemia |
NA |
No |
| Wisconsin |
Act 157/Mar 83 |
Yes |
Yes |
Yes |
No |
Yes |
Yes |
No |
No |
1 Arkansas: State funds limited to those 21 years old or
less with some exceptions.
2 California: The state has other programs, such as CA
Children's Services and the Genetically Handicapped Persons Program, that
provide food and formula if the person has no insurance or has a policy that
does not cover them, based on income.
3 California: Required to cover costs of food and
formula to the extent that the cost exceeds cost for a "normal" diet.
4 Florida: Only available with special rider and
increased premium on insurance. Not covered by HMO's.
5 Florida: The state provides a number of medical foods
free of charge to all PKU patients regardless of age.
6 Hawaii: Disorders of amino acids, organic acids,
carbohydrate and fat metabolism.
7 Indiana: State sliding fee scale, cap of $1000 out of
pocket.
8 Indiana: MCOs cover formula some of the time, not most
of the time. Medicaid, WIC and Children's Special Health Care Services all
cover formula but not food.
9 Kansas: $1500 limitation for food applies if making
less than $300 over national guidelines for poverty.
10 Kentucky: Cap on food: $4000; Cap on formula:
$25,000; All metabolic disorders covered.
11 Maine: No state coverage except for those under age
18 and income eligible; also limited support for those not covered by state or
insurance.
12 Minnesota: Not specified in statute but the law has
been interpreted by the Minnesota Depts. of Commerce and Health to cover low
protein foods.
13 Mississippi: Requires financial qualification for
Children's Medical Program.
14 Missouri: State law exempts all private insurance
companies. If your insurance company denies coverage, the state has income
restrictions.
15 North Dakota: insurance law covers anyone born after
Dec. 31, 1962. Up to age 21, or for maternal PKU, formula is already provided
under a state program. The Dept. of Human Services will provide formula free of
charge for all males through age 21 and all females through age 44. Formula can
be purchased at cost by individuals over the approved age limit. The Dept. will
provide some low-protein foods, only for persons with Medicaid/Medicare
coverage.
16 Utah: Deductible and co-pay for major medical
insurance.
17 Louisiana: Formula is covered by insurance, Medicaid,
and an additional state program. A state law only mandates coverage of food by
insurance. The state program does not cover food.
18 Virginia: State program helps pay for food.
19 Alabama: Alabama Medicaid pays for formula but not
low protein foods.
20 Arkansas: PKU, galactosemia, organic acidemias or
disorders of amino acid metabolism are specifically covered.
Last update: October 2008
National PKU News: www.pkunews.org
E-mail: schuett@pkunews.org
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