Section 304.17A-139 - Family or dependents coverage to apply to newly born child from moment of birth and to include inherited metabolic diseases - Requirement for notification and payment of premium - Coverage for milk fortifiers to prevent enterocolitis(1) A health benefit plan that provides coverage for a family or dependent shall provide coverage of a newly born child of the insured from the moment of birth.(2) Coverage for a newly born child shall consist of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.(3) If payment of a specific premium or fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child and payment of the required premium or fees must be furnished to the insurer within thirty-one (31) days after the date of birth in order to have the coverage continue beyond that thirty-one (31) day period.(4)(a) For the purposes of this subsection:1. "Milk fortifier" means a commercially prepared human milk fortifier made from concentrated one hundred percent (100%) human milk; and2. "One hundred percent (100%) human diet" means the supplementation of a mother's expressed breast milk or donor milk with a milk fortifier.(b) A health benefit plan that provides prescription drug coverage shall provide that coverage for a one hundred percent (100%) human diet, if the one hundred percent (100%) human diet and supplemented milk fortifier products are prescribed for the prevention of necrotizing enterocolitis and associated comorbidities, and are administered under the direction of a physician. Coverage under this subsection may be subject to a cap of fifteen thousand dollars ($15,000) per infant, for each plan year, subject to annual inflation adjustments.(5) The requirements of this section shall apply to all health benefit plans delivered or issued for delivery on or after June 25, 2013.Amended by 2013 Ky. Acts ch. 118,§ 11, eff. 6/24/2013.Effective:7/15/2008
Amended 2008, Ky. Acts ch. 119, sec. 3, effective7/15/2008. -- Amended 2002, Ky. Acts ch. 195, sec. 1, effective 7/15/2002. -- Created 2000, Ky. Acts ch. 457, sec. 4, effective 7/14/2000.