(a) (a) As used in this section:(1) “Bureau” means the bureau of TennCare;(2) “Enrollee” means an individual enrolled in TennCare; and(3) “Kleefstra syndrome” means a rare genetic disorder resulting from a mutation in the euchromatic histone methyltransferase 1 (EHMT1) gene or a deletion of a region of chromosome 9 that includes the EHMT1 gene that affects multiple organs and functions of the body, including the face, brain, heart, and kidneys, and that is characterized by features, including, but not limited to:(A) Developmental delay;(B) Intellectual disability;(C) Distinctive facial features;(D) Speech and hearing disorders;(E) Seizures;(F) Gastrointestinal disorders;(G) Respiratory infections;(H) Autism;(I) Obesity; and(J) Organ defects.(b) The bureau may provide coverage and benefits on behalf of an enrollee for the diagnosis, including genetic testing, and treatment of Kleefstra syndrome in the same manner and to the same extent that the bureau provides coverage for autism spectrum disorder, Trisomy 21 or Down syndrome, and other similar or related genetic disorders, when determined to be medically necessary pursuant to § 71-5-144.(c) Coverage and benefits under subsection (b) may include early intervention and promoting improvements to the enrollee's quality of life and development throughout the life of the enrollee through:(1) Appropriate modalities of therapy;(2) Appropriate medications; and(3) Other interventive programs, education, treatments, clothing, devices, and equipment.(d) The director of TennCare may apply for a federal waiver as the director deems necessary to effectuate this section.
(a) As used in this section:(1) “Bureau” means the bureau of TennCare;(2) “Enrollee” means an individual enrolled in TennCare; and(3) “Kleefstra syndrome” means a rare genetic disorder resulting from a mutation in the euchromatic histone methyltransferase 1 (EHMT1) gene or a deletion of a region of chromosome 9 that includes the EHMT1 gene that affects multiple organs and functions of the body, including the face, brain, heart, and kidneys, and that is characterized by features, including, but not limited to:(A) Developmental delay;(B) Intellectual disability;(C) Distinctive facial features;(D) Speech and hearing disorders;(E) Seizures;(F) Gastrointestinal disorders;(G) Respiratory infections;(H) Autism;(I) Obesity; and(J) Organ defects.
(1) “Bureau” means the bureau of TennCare;
(2) “Enrollee” means an individual enrolled in TennCare; and
(3) “Kleefstra syndrome” means a rare genetic disorder resulting from a mutation in the euchromatic histone methyltransferase 1 (EHMT1) gene or a deletion of a region of chromosome 9 that includes the EHMT1 gene that affects multiple organs and functions of the body, including the face, brain, heart, and kidneys, and that is characterized by features, including, but not limited to:(A) Developmental delay;(B) Intellectual disability;(C) Distinctive facial features;(D) Speech and hearing disorders;(E) Seizures;(F) Gastrointestinal disorders;(G) Respiratory infections;(H) Autism;(I) Obesity; and(J) Organ defects.
(A) Developmental delay;
(B) Intellectual disability;
(C) Distinctive facial features;
(D) Speech and hearing disorders;
(E) Seizures;
(F) Gastrointestinal disorders;
(G) Respiratory infections;
(H) Autism;
(I) Obesity; and
(J) Organ defects.
(b) The bureau may provide coverage and benefits on behalf of an enrollee for the diagnosis, including genetic testing, and treatment of Kleefstra syndrome in the same manner and to the same extent that the bureau provides coverage for autism spectrum disorder, Trisomy 21 or Down syndrome, and other similar or related genetic disorders, when determined to be medically necessary pursuant to § 71-5-144.
(c) Coverage and benefits under subsection (b) may include early intervention and promoting improvements to the enrollee's quality of life and development throughout the life of the enrollee through:(1) Appropriate modalities of therapy;(2) Appropriate medications; and(3) Other interventive programs, education, treatments, clothing, devices, and equipment.
(1) Appropriate modalities of therapy;
(2) Appropriate medications; and
(3) Other interventive programs, education, treatments, clothing, devices, and equipment.
(d) The director of TennCare may apply for a federal waiver as the director deems necessary to effectuate this section.