N.D. Admin. Code 75-03-35-01
For purposes of this chapter:
1. "At cost" means the actual cost of the medical food plus vendor shipping and handling charges and postage costs incurred by the department.
2. "Department" means the North Dakota department of human services.
3. "Government program" includes North Dakota medicaid, healthy steps, children's health insurance plan, and women, infants, and children nutrition program.
4. "Low-protein modified food product" means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be used under the direction of a physician for the dietary treatment of a metabolic disease. The term does not include a food that is naturally low in protein.
5. "Maple syrup urine disease" means an inborn error of metabolism, referred to as MSUD.
6. "Medicaid" means a program implemented pursuant to North Dakota Century Code chapter 50-24.1 and 42 U.S.C. 1396 et seq. to furnish medical assistance, as defined in 42 U.S.C. 1396(d)(a), to persons determined to be eligible.
7. "Medical food" means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered under the direction of a physician.
8. "Medically necessary" means use of low-protein modified food products for the treatment of phenylketonuria or maple syrup urine disease, which is recommended based on standards of accepted medical practice.
9. "Phenylketonuria" means an inborn error of metabolism, referred to as PKU.
10. "Qualified health care provider" means a physician who is licensed to practice medicine, a multidisciplinary metabolic clinic team, or a licensed, registered dietitian.
11. "Resident" means an individual with phenylketonuria or maple syrup urine disease who lives within the state of North Dakota with the intent to make it a fixed and permanent abode and manifests the genuineness of that intent by establishing an ongoing physical presence within the state with indicia that such presence is something other than merely transitory in nature.
12. "Treatment services" means provision of medical food and low-protein modified food products.
N.D. Admin Code 75-03-35-01
General Authority: NDCC 25-17-02
Law Implemented: NDCC 25-17-00.1, 25-17-03