LD 1241
pg. 9
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LR 1344
Item 1

 
(2)__Durable medical equipment when medically necessary
and appropriate, including rental or purchase of durable
medical equipment for therapeutic use, oxygen equipment
and hearing aids; and

 
(3)__Medical transportation, as appropriate, to the
nearest facility that can render necessary and
appropriate emergency medical treatment; and

 
J.__Prescription drugs, including prescription legend drugs,
prescribed nonlegend drugs, insulin and diabetic syringes
but excluding:

 
(1)__Experimental and investigational drugs unless
prescribed as part of an established clinical trial and
drugs prescribed as part of that trial that are covered
by another financing mechanism; and

 
(2)__Hair growth supplements, smoking deterrent agents,
weight control drugs, nonroutine immunization agents,
infertility treatments and nonprescription legend
vitamins with the exception of those used to supplement
the diets of pregnant women.

 
2.__Excluded services.__In addition to those exclusions in
subsection 1, the following benefits are excluded from coverage
under the plan:

 
A.__Experimental diagnostic and treatment services other
than those provided as part of an established clinical trial
and services provided as part of that trial that are covered
by another party;

 
B.__Infertility diagnosis and treatment and reversal of
sterilization;

 
C.__Cosmetic surgery except for congenital anomalies and
repair of injury resulting from an accident;

 
D.__Nonacute ventilator support provided solely for the
purpose of prolonging life;

 
E.__Personal comfort items; and

 
F.__Private rooms, except when medically necessary.

 
3.__Expansion or substitution of covered services.__The board
may expand benefits beyond those in subsection 1 upon finding
that the cost of the benefit is justified based


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