CT
Connecticut Senate Bill SB00317

Connecticut 2019 Regular Session

Connecticut Senate Bill SB00317 Compare Versions

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7-General Assembly Substitute Bill No. 317
4+LCO No. 5663 1 of 3
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6+General Assembly Committee Bill No. 317
87 January Session, 2019
8+LCO No. 5663
9+
10+
11+Referred to Committee on INSURANCE AND REAL ESTATE
12+
13+
14+Introduced by:
15+(INS)
916
1017
1118
1219 AN ACT REQUIRING HEA LTH INSURANCE COVERAGE F OR
1320 CERTAIN SURGICAL PRO CEDURES PERFORMED TO TREAT
1421 SEVERE OBESITY.
1522 Be it enacted by the Senate and House of Representatives in General
1623 Assembly convened:
1724
1825 Section 1. (NEW) (Effective January 1, 2020) (a) For the purposes of 1
1926 this section: 2
2027 (1) "Body mass index" means the number calculated by dividing an 3
2128 individual's weight in kilograms by the individual's height in meters 4
2229 squared; and 5
2330 (2) "Severe obesity" means a body mass index that is: 6
24-(A) Greater than forty; or 7
25-(B) Thirty-five or more if an individual has been diagnosed with a 8
26-comorbid disease or condition, including, but not limited to, a 9
27-cardiopulmonary condition, diabetes, hypertension or sleep apnea. 10
28-(b) Each individual health insurance policy providing coverage of 11
29-the type specified in subdivisions (1), (2), (4), (11) and (12) of section 12
30-38a-469 of the general statutes delivered, issued for delivery, renewed, 13
31-amended or continued in this state on or after January 1, 2020, shall 14
32-provide coverage for each surgical procedure that is: 15
33-(1) Performed to treat severe obesity, including, but not limited to, 16 Substitute Bill No. 317
31+(A) Greater than forty kilograms per meter squared; or 7
32+(B) Not less than thirty-five kilograms per meter squared if an 8
33+individual has been diagnosed with a comorbid disease or condition, 9
34+including, but not limited to, a cardiopulmonary condition, diabetes, 10
35+hypertension or sleep apnea. 11
36+(b) Each individual health insurance policy providing coverage of 12
37+Committee Bill No. 317
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40-gastric bypass, sleeve gastrectomy and duodenal switch; 17
41-(2) Recognized by the National Institutes of Health, American 18
42-Society for Metabolic and Bariatric Surgery and American College of 19
43-Surgeons as providing long-term weight loss; and 20
44-(3) Consistent with guidelines issued by the National Institutes of 21
45-Health. 22
46-(c) The benefits required by this section shall be subject to the same 23
47-terms and conditions that apply to all other benefits covered under a 24
48-policy that is subject to this section. 25
49-Sec. 2. (NEW) (Effective January 1, 2020) (a) For the purposes of this 26
50-section: 27
51-(1) "Body mass index" means the number calculated by dividing an 28
52-individual's weight in kilograms by the individual's height in meters 29
53-squared; and 30
54-(2) "Severe obesity" means a body mass index that is: 31
55-(A) Greater than forty; or 32
56-(B) Thirty-five or more if an individual has been diagnosed with a 33
57-comorbid disease or condition, including, but not limited to, a 34
58-cardiopulmonary condition, diabetes, hypertension or sleep apnea. 35
59-(b) Each group health insurance policy providing coverage of the 36
60-type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-37
61-469 of the general statutes delivered, issued for delivery, renewed, 38
62-amended or continued in this state on or after January 1, 2020, shall 39
63-provide coverage for each surgical procedure that is: 40
64-(1) Performed to treat severe obesity, including, but not limited to, 41
65-gastric bypass, sleeve gastrectomy and duodenal switch; 42
66-(2) Recognized by the National Institutes of Health, American 43 Substitute Bill No. 317
42+the type specified in subdivisions (1), (2), (4), (11) and (12) of section 13
43+38a-469 of the general statutes delivered, issued for delivery, renewed, 14
44+amended or continued in this state on or after January 1, 2020, shall 15
45+provide coverage for each surgical procedure that is: 16
46+(1) Performed to treat severe obesity, including, but not limited to, 17
47+gastric bypass, sleeve gastrectomy and duodenal switch; 18
48+(2) Recognized by the National Institutes of Health, American 19
49+Society for Metabolic and Bariatric Surgery and American College of 20
50+Surgeons as providing long-term weight loss; and 21
51+(3) Consistent with guidelines issued by the National Institutes of 22
52+Health. 23
53+(c) The benefits required by this section shall be subject to the same 24
54+terms and conditions that apply to all other benefits covered under a 25
55+policy that is subject to this section. 26
56+Sec. 2. (NEW) (Effective January 1, 2020) (a) For the purposes of this 27
57+section: 28
58+(1) "Body mass index" means the number calculated by dividing an 29
59+individual's weight in kilograms by the individual's height in meters 30
60+squared; and 31
61+(2) "Severe obesity" means a body mass index that is: 32
62+(A) Greater than forty kilograms per meter squared; or 33
63+(B) Not less than thirty-five kilograms per meter squared if an 34
64+individual has been diagnosed with a comorbid disease or condition, 35
65+including, but not limited to, a cardiopulmonary condition, diabetes, 36
66+hypertension or sleep apnea. 37
67+(b) Each group health insurance policy providing coverage of the 38
68+type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-39
69+469 of the general statutes delivered, issued for delivery, renewed, 40
70+Committee Bill No. 317
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73-Society for Metabolic and Bariatric Surgery and American College of 44
74-Surgeons as providing long-term weight loss; and 45
75-(3) Consistent with guidelines issued by the National Institutes of 46
76-Health. 47
77-(c) The benefits required by this section shall be subject to the same 48
78-terms and conditions that apply to all other benefits covered under a 49
79-policy that is subject to this section. 50
75+amended or continued in this state on or after January 1, 2020, shall 41
76+provide coverage for each surgical procedure that is: 42
77+(1) Performed to treat severe obesity, including, but not limited to, 43
78+gastric bypass, sleeve gastrectomy and duodenal switch; 44
79+(2) Recognized by the National Institutes of Health, American 45
80+Society for Metabolic and Bariatric Surgery and American College of 46
81+Surgeons as providing long-term weight loss; and 47
82+(3) Consistent with guidelines issued by the National Institutes of 48
83+Health. 49
84+(c) The benefits required by this section shall be subject to the same 50
85+terms and conditions that apply to all other benefits covered under a 51
86+policy that is subject to this section. 52
8087 This act shall take effect as follows and shall amend the following
8188 sections:
8289
8390 Section 1 January 1, 2020 New section
8491 Sec. 2 January 1, 2020 New section
8592
86-Statement of Legislative Commissioners:
87-In Section 1(a)(2)(A) and Section 2(a)(2)(A), "kilograms per meter
88-squared" was deleted to avoid repetition; and Section 1(a)(2)(B) and
89-Section 2(a)(2)(B) were rewritten for clarity.
93+Statement of Purpose:
94+To require health insurance coverage for certain surgical procedures
95+performed to treat severe obesity.
96+[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
97+except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
98+not underlined.]
9099
91-INS Joint Favorable Subst. -LCO
100+Co-Sponsors: SEN. BERTHEL, 32nd Dist.
101+
102+S.B. 317
103+
92104