House Bill No. 467, introduced by Representative Hilferty, mandates that health insurance providers, including Medicaid, cover amino acid-based elemental formulas for infants and children aged two years or younger when deemed medically necessary. The bill specifies that coverage is contingent upon a diagnosis from a board-certified allergist or gastroenterologist, along with a written order from the treating physician. The conditions for which these formulas are covered include various food protein allergies, severe food protein-induced enterocolitis syndrome, eosinophilic disorders, and impaired nutrient absorption due to gastrointestinal issues.

The legislation also allows health plans and Medicaid providers to implement annual deductibles, coinsurance, and copayments consistent with their existing coverage structures. It requires that the coverage for these formulas be no less favorable than that for prescription drugs and related services. Additionally, the bill stipulates that any new health coverage plans issued after January 1, 2026, must comply with these provisions, while existing plans must adjust to meet the new requirements by January 1, 2027.