First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
REREVISED
This Version Includes All Amendments
Adopted in the Second House
LLS NO. 23-0473.01 Shelby Ross x4510
SENATE BILL 23-176
Senate Committees House Committees
Health & Human Services Public & Behavioral 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,
HOUSE
3rd Reading Unamended
May 7, 2023
HOUSE
Amended 2nd Reading
May 6, 2023
SENATE
Amended 3rd Reading
April 25, 2023
SENATE
Amended 2nd Reading
April 24, 2023
SENATE SPONSORSHIP
Moreno and Cutter, Buckner, Coleman, Exum, Fenberg, Hansen, Kolker, Marchman,
Mullica, Priola, Roberts, Winter F.
HOUSE SPONSORSHIP
deGruy Kennedy and Bradley, Amabile, Bird, Boesenecker, Brown, Dickson, Duran,
Froelich, Jodeh, Kipp, Lieder, Lindsay, McCluskie, McCormick, Michaelson Jenet, Ricks,
Sirota, Snyder, Story, Titone, Valdez, Young
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, OR BINGE-EATING/PURGING SUBTYPE; HOWEVER, BODY MASS20
176-2- INDEX, IDEAL BODY WEIGHT, OR ANY OTHER STANDARD REQUIRING AN1
ACHIEVED BODY WEIGHT MUST NOT BE THE DETERMINING FACTOR WHEN2
ASSESSING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR3
AN INDIVIDUAL DIAGNOSED WITH ANOREXIA NERVOSA , RESTRICTING4
SUBTYPE, OR BINGE-EATING/PURGING SUBTYPE.5
(2) T
HE FOLLOWING FACTORS , AT A MINIMUM , MUST BE
6
CONSIDERED WHEN DETERMINING MEDICAL NECESSITY OR THE7
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH AN8
EATING DISORDER:9
(a) T
HE INDIVIDUAL'S EATING BEHAVIORS;
10
(b) T
HE INDIVIDUAL'S NEED FOR SUPERVISED MEALS AND SUPPORT
11
INTERVENTIONS;12
(c) L
ABORATORY RESULTS, INCLUDING BUT NOT LIMITED TO, THE
13
INDIVIDUAL'S HEART RATE, RENAL OR CARDIOVASCULAR ACTIVITY , AND14
BLOOD PRESSURE;15
(d) T
HE RECOVERY ENVIRONMENT ; AND
16
(e) C
O-OCCURRING DISORDERS THE INDIVIDUAL MAY HAVE .
17
(3) T
HE COMMISSIONER MAY PROMULGATE RULES AS NECESSARY
18
TO IMPLEMENT AND ENFORCE THIS SECTION .19
SECTION 2. In Colorado Revised Statutes, add 25.5-5-334 as20
follows:21
25.5-5-334. Prohibition on using the body mass index or ideal22
body weight - medical necessity criteria. (1) (a) B
EGINNING JULY 1,
23
2023,
THE STATE MEDICAL ASSISTANCE PROGRAM SHALL NOT UTILIZE THE
24
BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY OTHER STANDARD25
REQUIRING AN ACHIEVED WEIGHT WHEN DETERMINING MEDICAL26
NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL27
176
-3- DIAGNOSED WITH AN EATING DISORDER , INCLUDING BUT NOT LIMITED TO,1
BULIMIA NERVOSA, ATYPICAL ANOREXIA NERVOSA , BINGE-EATING2
DISORDER, AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER , AND OTHER3
SPECIFIED FEEDING AND EATING DISORDERS AS DEFINED IN THE MOST4
RECENT EDITION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF5
M
ENTAL DISORDERS.
6
(b) S
UBSECTION (1)(a) OF THIS SECTION DOES NOT APPLY WHEN
7
DETERMINING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE8
FOR AN INDIVIDUAL DIAGNOSED WITH ANOREXIA NERVOSA , RESTRICTING9
SUBTYPE; HOWEVER, BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY10
OTHER STANDARD REQUIRING AN ACHIEVED BODY WEIGHT MUST NOT BE11
THE DETERMINING FACTOR WHEN ASSESSING MEDICAL NECESSITY OR THE12
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH13
ANOREXIA NERVOSA, RESTRICTING SUBTYPE.14
(2) T
HE FOLLOWING FACTORS , AT A MINIMUM , MUST BE
15
CONSIDERED WHEN DETERMINING MEDICAL NECESSITY OR THE16
APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DI AGNOSED WITH AN17
EATING DISORDER:18
(a) T
HE INDIVIDUAL'S EATING BEHAVIORS;
19
(b) T
HE INDIVIDUAL'S NEED FOR SUPERVISED MEALS AND SUPPORT
20
INTERVENTIONS;21
(c) L
ABORATORY RESULTS, INCLUDING BUT NOT LIMITED TO, THE
22
INDIVIDUAL'S HEART RATE, RENAL OR CARDIOVASCULAR ACTIVITY , AND23
BLOOD PRESSURE;24
(d) T
HE RECOVERY ENVIRONMENT ; AND
25
(e) C
O-OCCURRING DISORDERS THE INDIVIDUAL MAY HAVE .
26
27
176
-4- 1
SECTION 3. In Colorado Revised Statutes, add article 26 to title2
6 as follows:3
ARTICLE 264
Regulation Of Dietary Supplements For Weight Loss5
6-26-101. Definitions. AS USED IN THIS ARTICLE 26, UNLESS THE6
CONTEXT OTHERWISE REQUIRES :7
8
(1) (a) "OVER-THE-COUNTER DIET PILL" MEANS A CLASS OF DRUGS9
THAT ARE LABELED AND MARKETED UNDER THE "FEDERAL FOOD, DRUG,10
AND COSMETIC ACT", 21 U.S.C. SEC. 301 ET SEQ., FOR THE PURPOSE OF11
ACHIEVING WEIGHT LOSS THAT ARE LAWFULLY SOLD , TRANSFERRED, OR12
OTHERWISE FURNISHED WITHOUT A PRESCRIPTION .13
(b) "O
VER-THE-COUNTER DIET PILL" INCLUDES PRODUCTS14
MARKETED WITH A DRUG FACTS PANEL PURSUANT TO FEDERAL15
REGULATIONS THAT CONTAIN EITHER APPROVED DRUG INGREDIENTS OR16
INGREDIENTS DEEMED ADULTERATED PURSUANT TO 21 U.S.C. SEC. 342,17
OR BOTH.18
(2)
"RETAIL ESTABLISHMENT" MEANS ANY VENDOR THAT, IN THE19
REGULAR COURSE OF BUSINESS, SELLS OVER-THE-COUNTER DIET PILLS20
AT RETAIL DIRECTLY TO THE PUBLIC, INCLUDING BUT NOT LIMITED TO,21
PHARMACIES, GROCERY STORES, OTHER RETAIL STORES, AND VENDORS22
THAT ACCEPT ORDERS PLACED BY MAIL , TELEPHONE, ELECTRONIC MAIL,23
INTERNET WEBSITE, ONLINE CATALOG, OR SOFTWARE APPLICATION.24
6-26-102. Over-the-counter diet pills - prohibition on selling25
to persons under eighteen years of age - deceptive trade practice - 26
rules. (1) (a) A
RETAIL ESTABLISHMENT SHALL NOT SELL, TRANSFER, OR27
176
-5- OTHERWISE FURNISH OVER-THE-COUNTER DIET PILLS TO ANY PERSON1
UNDER EIGHTEEN YEARS OF AGE .2
(b) A
RETAIL ESTABLISHMENT SHALL REQUEST VALID3
IDENTIFICATION FROM ANY PERSON WHO ATTEMPTS TO PURCHASE
4
OVER-THE-COUNTER DIET PILLS IF THAT PERSON REASONABLY APPEARS TO5
THE RETAIL ESTABLISHMENT TO BE UNDER EIGHTEEN YEARS OF AGE .6
(2) A VIOLATION OF THIS ARTICLE 26 IS A DECEPTIVE TRADE7
PRACTICE PURSUANT TO SECTION 6-1-105 (1)(uuu).8
SECTION 4. In Colorado Revised Statutes, 6-1-105, add9
(1)(uuu) as follows:10
6-1-105. Unfair or deceptive trade practices. (1) A person11
engages in a deceptive trade practice when, in the course of the person's12
business, vocation, or occupation, the person:13
(uuu) SELLS OR OFFERS FOR SALE A PRODUCT THAT IS14
AGE-RESTRICTED TO A PERSON WHO DOES NOT MEET THE AGE15
RESTRICTION.16
17
SECTION 5. Effective date. This act takes effect upon passage;18
except that section 1 of this act takes effect January 1, 2024, and section19
3 of this act takes effect July 1, 2024.20
SECTION 6. Safety clause. The general assembly hereby finds,21
determines, and declares that this act is necessary for the immediate22
preservation of the public peace, health, or safety.23
176
-6-