First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 23-0473.01 Shelby Ross x4510
SENATE BILL 23-176
Senate Committees House Committees
Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING MEASURES TO IMPROV E OUTCOMES FOR INDIVIDUALS101
WITH AN EATING DISORDER .102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
The bill prohibits certain health benefit plans or the state medical
assistance program from utilizing the body mass index, ideal body weight,
or any other standard requiring an achieved weight when determining
medical necessity criteria or appropriate level of care for an individual
with a diagnosed eating disorder.
The bill prohibits a retail establishment from selling, transferring,
SENATE
Amended 2nd Reading
April 24, 2023
SENATE SPONSORSHIP
Moreno and Cutter,
HOUSE SPONSORSHIP
deGruy Kennedy,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. or otherwise furnishing dietary supplements for weight loss or
over-the-counter diet pills to any individual under 18 years of age without
a prescription.
The bill requires the behavioral health administration (BHA) to
promulgate rules concerning forced feeding tubes for individuals with an
eating disorder.
No later than July 1, 2024, the bill requires the BHA to require all
eating disorder treatment and recovery facilities to hold an appropriate
designation based on the level of care the facility provides.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add 10-16-1582
as follows:3
10-16-158. Prohibition on using the body mass index or ideal4
body weight - medical necessity criteria - rules. (1) (a) E
VERY HEALTH
5
BENEFIT PLAN SUBJECT TO PART 2, 3, OR 4 OF THIS ARTICLE 16, EXCEPT6
THOSE DESCRIBED IN SECTION 10-16-102 (32)(b), SHALL NOT UTILIZE THE7
BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY OTHER STANDARD8
REQUIRING AN ACHIEVED WEIGHT WHEN DETERMINING MEDICAL9
NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL10
DIAGNOSED WITH AN EATING DISORDER , INCLUDING BUT NOT LIMITED TO11
BULIMIA NERVOSA, ATYPICAL ANOREXIA NERVOSA , BINGE-EATING12
DISORDER, AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER , AND OTHER13
SPECIFIED FEEDING AND EATING DISORDERS AS DEFINED IN THE MOST14
RECENT EDITION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF15
M
ENTAL DISORDERS.
16
(b) S
UBSECTION (1)(a) OF THIS SECTION DOES NOT APPLY WHEN
17
DETERMINING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE18
FOR AN INDIVIDUAL DIAGNOSED WITH ANOREXIA NERVOSA , RESTRICTING19
SUBTYPE; HOWEVER, BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY20
176-2- OTHER STANDARD REQUIRING AN ACHIEVED BODY WEIGHT MUST NOT BE1
THE DETERMINING FACTOR WHEN ASSESSING MEDICAL NECESSITY OR THE2
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DI AGNOSED WITH3
ANOREXIA NERVOSA, RESTRICTING SUBTYPE.4
(2) T
HE FOLLOWING FACTORS , AT A MINIMUM , MUST BE
5
CONSIDERED WHEN DETERMINING MEDICAL NECESSITY OR THE6
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH AN7
EATING DISORDER:8
(a) T
HE INDIVIDUAL'S EATING BEHAVIORS;
9
(b) T
HE INDIVIDUAL'S NEED FOR SUPERVISED MEALS AND SUPPORT
10
INTERVENTIONS;11
(c) L
ABORATORY RESULTS, INCLUDING BUT NOT LIMITED TO, THE
12
INDIVIDUAL'S HEART RATE, RENAL OR CARDIOVASCULAR ACTIVITY , AND13
BLOOD PRESSURE;14
(d) T
HE RECOVERY ENVIRONMENT ; AND
15
(e) C
O-OCCURRING DISORDERS THE INDIVIDUAL MAY HAVE .
16
SECTION 2. In Colorado Revised Statutes, add 25.5-5-334 as17
follows:18
25.5-5-334. Prohibition on using the body mass index or ideal19
body weight - medical necessity criteria. (1) (a) B
EGINNING JULY 1,
20
2023,
THE STATE MEDICAL ASSISTANCE PROGRAM SHALL NOT UTILIZE THE
21
BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY OTHER STANDARD22
REQUIRING AN ACHIEVED WEIGHT WHEN DETERMINING MEDICAL23
NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL24
DIAGNOSED WITH AN EATING DISORDER , INCLUDING BUT NOT LIMITED TO,25
BULIMIA NERVOSA, ATYPICAL ANOREXIA NERVOSA , BINGE-EATING26
DISORDER, AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER , AND OTHER27
176
-3- SPECIFIED FEEDING AND EATING DISORDERS AS DEFINED IN THE MOST1
RECENT EDITION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF2
M
ENTAL DISORDERS.
3
(b) S
UBSECTION (1)(a) OF THIS SECTION DOES NOT APPLY WHEN
4
DETERMINING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE5
FOR AN INDIVIDUAL DIAGNOSED WITH ANOREXIA NERVOSA , RESTRICTING6
SUBTYPE; HOWEVER, BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY7
OTHER STANDARD REQUIRING AN ACHIEVED BODY WEIGHT MUST NOT BE8
THE DETERMINING FACTOR WHEN ASSESSING MEDICAL NECESSITY OR THE9
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DI AGNOSED WITH10
ANOREXIA NERVOSA, RESTRICTING SUBTYPE.11
(2) T
HE FOLLOWING FACTORS , AT A MINIMUM , MUST BE
12
CONSIDERED WHEN DETERMINING MEDICAL NECESSITY OR THE13
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH AN14
EATING DISORDER:15
(a) T
HE INDIVIDUAL'S EATING BEHAVIORS;
16
(b) T
HE INDIVIDUAL'S NEED FOR SUPERVISED MEALS AND SUPPORT
17
INTERVENTIONS;18
(c) L
ABORATORY RESULTS, INCLUDING BUT NOT LIMITED TO, THE
19
INDIVIDUAL'S HEART RATE, RENAL OR CARDIOVASCULAR ACTIVITY , AND20
BLOOD PRESSURE;21
(d) T
HE RECOVERY ENVIRONMENT ; AND
22
(e) C
O-OCCURRING DISORDERS THE INDIVIDUAL MAY HAVE .
23
24
SECTION 3. In Colorado Revised Statutes, add part 7 to article25
280 of title 12 as follows:26
176
-4- PART 71
REGULATION OF DIETARY SUPPLEMENTS2
FOR WEIGHT LOSS3
12-280-701. Definitions. A
S USED IN THIS PART 7, UNLESS THE
4
CONTEXT OTHERWISE REQUIRES :5
6
(1) (a) "OVER-THE-COUNTER DIET PILL" MEANS A CLASS OF DRUGS7
THAT ARE LABELED AND MARKETED UNDER THE "FEDERAL FOOD, DRUG,8
AND COSMETIC ACT", 21 U.S.C. SEC. 301 ET SEQ., FOR THE PURPOSE OF9
ACHIEVING WEIGHT LOSS THAT ARE LAWFULLY SOLD , TRANSFERRED, OR10
OTHERWISE FURNISHED WITHOUT A PRESCRIPTION .11
(b) "O
VER-THE-COUNTER DIET PILL" INCLUDES PRODUCTS12
MARKETED WITH A DRUG FACTS PANEL PURSUANT TO FEDERAL13
REGULATIONS THAT CONTAIN EITHER APPROVED DRUG INGREDIENTS OR14
INGREDIENTS DEEMED ADULTERATED PURSUANT TO 21 U.S.C. SEC. 342,15
OR BOTH.16
(2)
"RETAIL ESTABLISHMENT" MEANS ANY VENDOR THAT, IN THE17
REGULAR COURSE OF BUSINESS, SELLS OVER-THE-COUNTER DIET PILLS18
AT RETAIL DIRECTLY TO THE PUBLIC, INCLUDING BUT NOT LIMITED TO,19
PHARMACIES, GROCERY STORES, OTHER RETAIL STORES, AND VENDORS20
THAT ACCEPT ORDERS PLACED BY MAIL , TELEPHONE, ELECTRONIC MAIL,21
INTERNET WEBSITE, ONLINE CATALOG, OR SOFTWARE APPLICATION.22
12-280-702. Over-the-counter diet pills - prohibition on selling23
to persons under eighteen years of age - rules. (1) (a) A RETAIL24
ESTABLISHMENT SHALL NOT SELL , TRANSFER, OR OTHERWISE FURNISH25
OVER-THE-COUNTER DIET PILLS TO ANY PERSON UNDER EIGHTEEN YEARS26
OF AGE.27
176
-5- (b) A RETAIL ESTABLISHMENT SHALL REQUEST VALID1
IDENTIFICATION FROM ANY PERSON WHO ATTEMPTS TO PURCHASE 2
OVER-THE-COUNTER DIET PILLS IF THAT PERSON REASONABLY APPEARS TO3
THE RETAIL ESTABLISHMENT TO BE UNDER EIGHTEEN YEARS OF AGE .4
5
SECTION 4. Effective date. This act takes effect upon passage;6
except that section 1 of this act takes effect January 1, 2024, and section7
3 of this act takes effect July 1, 2024.8
SECTION 5. Safety clause. The general assembly hereby finds,9
determines, and declares that this act is necessary for the immediate10
preservation of the public peace, health, or safety.11
176
-6-