A. Any coverage that is offered by a contractor providing services to persons eligible pursuant to section 36-2901 and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or a registered nurse practitioner if:

Terms Used In Arizona Laws 36-2907.01

  • Contractor: means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers. See Arizona Laws 36-2901
  • Person: includes a corporation, company, partnership, firm, association or society, as well as a natural person. See Arizona Laws 1-215
  • Physician: means a person who is licensed pursuant to Title 32, Chapter 13 or 17. See Arizona Laws 36-2901

1. The person has been diagnosed with an eosinophilic gastrointestinal disorder.

2. The person is under the continuous supervision of a physician who is licensed pursuant to Title 32, Chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to Title 32, Chapter 15.

3. There is risk of a mental or physical impairment without the use of the formula.

B. This section does not apply to limited benefit coverage as defined in section 20-1137.

 

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