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General Assembly Substitute Bill No. 1474
January Session, 2025
AN ACT CONCERNING THE DEPARTMENT OF SOCIAL SERVICES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 17b-278l of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective from passage): 2
(a) (1) As used in this section, "bariatric surgery" means surgical 3
changes to the digestive system to help a patient with obesity to lose 4
weight; 5
(2) "Body mass index", or "BMI", means the number calculated by 6
dividing an individual's weight in kilograms by the individual's height 7
in meters squared; 8
(3) "Medical services" means (A) prescription drugs approved by the 9
federal Food and Drug Administration for the treatment of obesity on 10
an outpatient basis, and (B) nutritional counseling provided by a 11
registered dietitian-nutritionist certified pursuant to section 20-206n; 12
(4) "Severe obesity" means a body mass index that is: 13
(A) Greater than forty; or 14
(B) Thirty-five or more if an individual has been diagnosed with a 15
comorbid disease or condition, including, but not limited to, a 16
cardiopulmonary condition, diabetes, hypertension or sleep apnea; 17 Substitute Bill No. 1474
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[and] 18
(5) "Obesity" means a body mass index of thirty or higher; and 19
(6) "Weight loss drugs" means glucagon-like peptide 1 (GLP-1) 20
prescription drugs approved by the federal Food and Drug 21
Administration for weight loss or commonly used for weight loss. 22
(b) The Commissioner of Social Services shall provide medical 23
assistance for (1) bariatric surgery and related medical services for 24
Medicaid and HUSKY B beneficiaries with severe obesity, and (2) 25
medical services for Medicaid and HUSKY B beneficiaries with a body 26
mass index greater than thirty-five, [provided such beneficiaries 27
otherwise meet conditions set by the Centers for Medicare and Medicaid 28
Services for such surgery and medical services] including weight loss 29
drugs. The commissioner shall continue to provide Medicaid coverage 30
for beneficiaries treated with weight loss drugs if their BMI drops below 31
thirty-five and a licensed physician certifies in writing that their BMI 32
would increase above thirty-five if such drugs were discontinued. If 33
necessary, the commissioner may amend the Medicaid state plan and 34
the state plan for the Children's Health Insurance Program to implement 35
the provisions of this section. 36
Sec. 2. Section 17b-8 of the general statutes is amended by adding 37
subsection (e) as follows (Effective July 1, 2025): 38
(NEW) (e) Notwithstanding the provisions of subsection (a) of this 39
section, the Commissioner of Social Services shall submit any Medicaid 40
state plan amendment not subject to the legislative approval process of 41
this section to the joint standing committee of the General Assembly 42
having cognizance of matters relating to human services. Said 43
committee shall schedule a vote on such state plan amendment not later 44
than thirty days after receipt of such amendment. The commissioner 45
shall not submit such state plan amendment for federal approval unless 46
said committee votes to approve it. If the committee approves such state 47
plan amendment with amendments, the commissioner shall submit 48
such state plan amendment as amended by the committee. 49 Substitute Bill No. 1474
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Sec. 3. (NEW) (Effective July 1, 2025) (a) As used in this section, (1) 50
"prescribing practitioner" means a physician, dentist, podiatrist, 51
optometrist, physician assistant, advanced practice registered nurse or 52
nurse-midwife enrolled as a Medicaid provider who is licensed by the 53
state and authorized to prescribe opioid drugs within the scope of such 54
person's practice, and (2) "opioid drug" has the same meaning as 55
provided in section 20-14o of the general statutes. 56
(b) The Commissioner of Social Services shall require a prescribing 57
practitioner, as a condition for the receipt of Medicaid reimbursement 58
for prescribing an opioid drug to a Medicaid recipient, to complete 59
training in effective pain management, including, but not limited to: (1) 60
Appropriate, available nonopioid alternatives for the treatment of pain, 61
and (2) the advantages and disadvantages of the use of nonopioid 62
treatment alternatives, considering a patient's risk of substance misuse. 63
(c) The commissioner may adopt regulations in accordance with the 64
provisions of chapter 54 of the general statutes to implement the 65
provisions of this section. 66
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 17b-278l
Sec. 2 July 1, 2025 17b-8(e)
Sec. 3 July 1, 2025 New section
Statement of Legislative Commissioners:
In Section 3(b), "as a condition of Medicaid reimbursement for
prescribing opioid drugs to Medicaid recipients" was changed to "as a
condition for the receipt of Medicaid reimbursement for prescribing an
opioid drug to a Medicaid recipient", for clarity.
HS Joint Favorable Subst. -LCO