Elaine Berkovich
Legislative Project
HB 73: Georgia Medical Food Equity Act
I.
The legislation that I identified related to nutrition, wellness, health, or physical
activity introduced to the General Assembly was HB 73: Georgia Medical Food Equity
Act. The bill supports the amendment for insurance companies to cover costs
associated with medical foods for the management of rare diseases.
II.
The Honorable Edward Lindsey
1150 Angelo Court
Atlanta, GA 30319
Dear Edward Lindsey,
My name is Elaine Berkovich, and I have lived in Atlanta for many years. I am a
dietetic intern and graduate student at Georgia State University studying nutrition. I
am writing in regard to HB 73: Georgia Medical Food Equity Act. I am concerned about
the current regulations for reimbursement of medical foods for the treatment of rare
diseases. Since medical foods are not considered “prescription drugs” insurance
companies are not covering the costs associated. I ask that you vote in favor of
requiring insurance companies to cover life-saving medical foods. Due to the recently
passed law SB 17, HB 73 will be brought to the newly mandated Special Advisory
Commission on Mandated Health Insurance Benefits for a hearing within the next
couple of weeks.
I strongly support the amendment for insurance companies to cover costs
associated with medical foods. Medical foods help to manage rare diseases such as
inborn errors of metabolism and absorption disorders. By definition, medical foods are
foods scientifically proven for the management of diseases or conditions associated with
specific nutritional requirements used under the supervision of a physician and
administered enterally (Camp et al., 2012). According to the position of the Genetic
Metabolic Dietitians International (GMDI), medical foods are the most basic form of
treatment for individuals that suffer from genetic metabolic disorders (GMDI, 2011).
However in the state of Georgia, insurance companies are not required to cover the
costs of treatment. Instead, families that are paying premiums for their insurance are
denied reimbursement for life-saving medical foods. The average cost for families to
purchase medical foods ranges from $5,000-$12,000 per year. Without these medical
foods, individuals with these conditions can suffer developmental disabilities, cognitive
impairment, impaired growth, and even death (Camp et al., 2012). Currently, 38 states
have recognized the importance of medical foods for the treatment of rare diseases and
have passed legislation to require reimbursement from insurance companies. Your
support of this legislation is critical to provide families with the ability to manage these
life-threatening conditions. For dietitians, medical foods allow our patients/clients to
manage their medical conditions and help to maximize their health and well-being.
I strongly urge you to vote in favor of requiring insurance companies to
reimburse for medical foods. Medical foods are an essential part of the management of
rare diseases.
Sincerely,
Elaine Berkovich
III.
The organization that I identified as supporting the legislation is the Greater Atlanta
Dietetic Association. I contacted one of the board members of the organization
since she is a metabolic dietitian. The mission of the Greater Atlanta Dietetic
Association is to empower the Atlanta Dietetic Association members to be the local
food and nutrition experts by providing networking and professional development
opportunities. The goals of the association fit with the intent of the legislation
because as nutrition professionals, our support of this legislation is critical to provide
families with the ability to manage these life-threatening conditions. It is also
important for dietitians to be involved in legislation that is directly related to the
quality of care provided to our patients/clients.
Dear Ms. Cunto,
My name is Elaine Berkovich. I am a dietetic intern and graduate student at Georgia
State University studying nutrition. I am also a member of the Academy of Nutrition
and Dietetics and the Greater Atlanta Dietetic Association. I am writing in support of
HB 73: Georgia Medical Food Equity Act. I strongly support the amendment for
insurance companies to cover costs associated with medical foods for the
management of rare diseases. As nutrition professionals, our support of this
legislation is critical to provide families with the ability to manage these lifethreatening conditions. Medical foods allow our patients/clients to manage their
medical conditions and help to maximize their health and well-being.
Thank you for your support of HB 73: Georgia Medical Food Equity Act. Together we
will help families have the access to life-saving medical foods.
Sincerely,
Elaine Berkovich
IV.
The intent of the legislation is to mandate insurance companies to reimburse the
costs associated with medical foods for the treatment of rare diseases. Since
medical foods are not considered “prescription drugs” insurance companies are not
currently covering the costs associated. Without medical foods, patients with
metabolic disorders can suffer from brain damage, malnutrition, severe allergic
reactions, growth failure, death, or coma. Unfortunately, medical foods are very
expensive and can range from $5,000 to $12,000 a year. Even families that pay
premiums for their insurance coverage are being denied reimbursement which can
create a substantial financial burden. Management of these conditions is a life-long
process and these medical foods are designed to help children grow and prevent the
development of detrimental effects of the condition. The expected outcomes of the
legislation is that the FDA regulatory system will require insurance companies to
cover the costs associated with medical foods by treating them as prescription
drugs.
Once the legislation is passed, it will impact patients that suffer from metabolic
disorders, families that take on the financial burden of paying for medical foods, and
dietitians as well as other healthcare professionals. In addition to helping patients
and their families, making medical foods more affordable will help healthcare
professionals to work with their patients to maximize their health outcomes. Since
the legislation will impact a number of individuals it is that much more important to
be passed.
Originally, medical foods were considered prescription drugs, however, FDA created
a separate regulatory classification system to decrease the costs to the market and
to encourage the development of new products. As a result, insurance companies
do not cover medical foods since they are not considered “prescription drugs”.
There are currently 38 states that have created laws to bridge the gap to ensure that
insurance companies are covering costs of medical foods. The costs associated with
passing legislation would be about $5,000-$12,000 a year per patient/client;
depending on the individual’s condition, age, and other factors. These costs will be
incurred by insurance companies. Treating patients with metabolic disorders with
medical foods is much less than the costs associated with untreated patients which
can be up to $200,000 per year in the hospital.
V.
I was not able to attend a committee meeting regarding the bill. However, the
Georgia Medical Foods Coalition posted a video on the House Insurance hearing on
their facebook page that took place on February 5th. I did attend Legislative Day at
the capital where HB 73 was discussed briefly.
VI.
January/16/2013 – House Hopper
January/17/2013- House First Readers
January/28/2013- House Second Readers
VII.
The final outcome of the bill is that it reached the House Second Readers; which
means the bill was read a second time. Unfortunately, HB: 73 did not go further and
was not passed.
VIII.
I attended and participated in Legislative Day at the capital. There I spoke with my
representatives about current efforts to pass the bill to ensure that there are laws in
place for LD practice to promote public health and welfare of the public. The law
ensures that there is support for Licensed dietitians and that there is a certified
board that approves the appropriate qualifications for approving licensure.