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General Assembly Committee Bill No. 317
January Session, 2019
LCO No. 5663
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
AN ACT REQUIRING HEA LTH INSURANCE COVERAGE F OR
CERTAIN SURGICAL PRO CEDURES PERFORMED TO TREAT
SEVERE OBESITY.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective January 1, 2020) (a) For the purposes of 1
this section: 2
(1) "Body mass index" means the number calculated by dividing an 3
individual's weight in kilograms by the individual's height in meters 4
squared; and 5
(2) "Severe obesity" means a body mass index that is: 6
(A) Greater than forty kilograms per meter squared; or 7
(B) Not less than thirty-five kilograms per meter squared if an 8
individual has been diagnosed with a comorbid disease or condition, 9
including, but not limited to, a cardiopulmonary condition, diabetes, 10
hypertension or sleep apnea. 11
(b) Each individual health insurance policy providing coverage of 12
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the type specified in subdivisions (1), (2), (4), (11) and (12) of section 13
38a-469 of the general statutes delivered, issued for delivery, renewed, 14
amended or continued in this state on or after January 1, 2020, shall 15
provide coverage for each surgical procedure that is: 16
(1) Performed to treat severe obesity, including, but not limited to, 17
gastric bypass, sleeve gastrectomy and duodenal switch; 18
(2) Recognized by the National Institutes of Health, American 19
Society for Metabolic and Bariatric Surgery and American College of 20
Surgeons as providing long-term weight loss; and 21
(3) Consistent with guidelines issued by the National Institutes of 22
Health. 23
(c) The benefits required by this section shall be subject to the same 24
terms and conditions that apply to all other benefits covered under a 25
policy that is subject to this section. 26
Sec. 2. (NEW) (Effective January 1, 2020) (a) For the purposes of this 27
section: 28
(1) "Body mass index" means the number calculated by dividing an 29
individual's weight in kilograms by the individual's height in meters 30
squared; and 31
(2) "Severe obesity" means a body mass index that is: 32
(A) Greater than forty kilograms per meter squared; or 33
(B) Not less than thirty-five kilograms per meter squared if an 34
individual has been diagnosed with a comorbid disease or condition, 35
including, but not limited to, a cardiopulmonary condition, diabetes, 36
hypertension or sleep apnea. 37
(b) Each group health insurance policy providing coverage of the 38
type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-39
469 of the general statutes delivered, issued for delivery, renewed, 40
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amended or continued in this state on or after January 1, 2020, shall 41
provide coverage for each surgical procedure that is: 42
(1) Performed to treat severe obesity, including, but not limited to, 43
gastric bypass, sleeve gastrectomy and duodenal switch; 44
(2) Recognized by the National Institutes of Health, American 45
Society for Metabolic and Bariatric Surgery and American College of 46
Surgeons as providing long-term weight loss; and 47
(3) Consistent with guidelines issued by the National Institutes of 48
Health. 49
(c) The benefits required by this section shall be subject to the same 50
terms and conditions that apply to all other benefits covered under a 51
policy that is subject to this section. 52
This act shall take effect as follows and shall amend the following
sections:
Section 1 January 1, 2020 New section
Sec. 2 January 1, 2020 New section
Statement of Purpose:
To require health insurance coverage for certain surgical procedures
performed to treat severe obesity.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]
Co-Sponsors: SEN. BERTHEL, 32nd Dist.
S.B. 317