Florida 2025 Regular Session

Florida House Bill H0713 Compare Versions

Only one version of the bill is available at this time.

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3	3	HB 713 2025
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7	7	CODING: Words stricken are deletions; words underlined are additions.
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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to obesity treatment and diabetes 2
16	16	prevention; creating s. 381.73531, F.S.; providing 3
17	17	definitions; requiring the Agency for Health Care 4
18	18	Administration to provide certain treatments for the 5
19	19	chronic disease of obesity; providing for coverage of 6
20	20	and access to such treatments; authoriz ing rulemaking; 7
21	21	providing construction; requiring the agency to 8
22	22	provide coverage through Medicaid reimbursement for 9
23	23	the diabetes prevention program under certain 10
24	24	circumstances; authorizing the Department of Health to 11
25	25	apply for a state plan amendment under certain 12
26	26	circumstances; providing an effective date. 13
27	27	14
28	28	Be It Enacted by the Legislature of the State of Florida: 15
29	29	16
30	30	Section 1. Section 381.73531, Florida Statutes, is created 17
31	31	to read: 18
32	32	381.73531 Obesity treatment and d iabetes prevention.— 19
33	33	(1) DEFINITIONS.—For purposes of this section, the term: 20
34	34	(a) "Agency" means the Agency for Health Care 21
35	35	Administration. 22
36	36	(b) "Diabetes prevention program" means structured 23
37	37	behavioral health changes provided to an eligible individual by 24
38	38	a diabetes prevention progra m supplier for the purpose of 25
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40	40	HB 713 2025
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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49	49
50	50
51	51	preventing or delaying the onset of Type 2 diabetes which 26
52	52	follows a curriculum approved by the Centers for Disease Control 27
53	53	and Prevention. 28
54	54	(c) "Diabetes prevention program supplier" means an entity 29
55	55	that is recognized under t he Diabetes Prevention Recognition 30
56	56	Program of the Centers for Disease Control and Prevention and 31
57	57	offers a program through an allowable Diabetes Prevention 32
58	58	Recognition Program delivery mode including in -person or through 33
59	59	telehealth as defined in s. 456.47(1 ). 34
60	60	(d) "FDA-approved obesity medication" means any medication 35
61	61	approved by the federal Food and Drug Administration (FDA) with 36
62	62	an indication for chronic weight management in patients with an 37
63	63	obesity diagnosis. 38
64	64	(e) "Intensive health behavior and lifestyl e treatment" 39
65	65	means an evidence-based, intensive, multi -component behavioral 40
66	66	or lifestyle modification intervention that supports healthy 41
67	67	weight management and is delivered in -person or through 42
68	68	telehealth as defined in s. 456.47(1). 43
69	69	(f) "Metabolic and bar iatric surgery" means any surgical 44
70	70	intervention included in the most current American Society for 45
71	71	Metabolic and Bariatric Surgery and International Federation for 46
72	72	the Surgery of Obesity and Metabolic Disorders (ASMBS-IFSO) 47
73	73	guidelines on indications for met abolic and bariatric surgery. 48
74	74	(2)(a) The agency shall provide treatments for the chronic 49
75	75	disease of obesity, which shall include, but not be limited to, 50
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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88	88	all of the following: 51
89	89	1. Intensive health behavior and lifestyle treatment. 52
90	90	2. Metabolic and bari atric surgery. 53
91	91	3. FDA-approved obesity medications. 54
92	92	(b) Coverage criteria for FDA -approved obesity medications 55
93	93	may not be more restrictive than the FDA -approved indications 56
94	94	for those treatments. 57
95	95	(c) Intensive health behavior and lifestyle treatment may 58
96	96	include interventions certified by or recognized by the Centers 59
97	97	for Disease Control and Prevention or recommended by current 60
98	98	clinical standards of care. The services may be provided in -61
99	99	person or through telehealth as defined in s. 456.47(1). 62
100	100	(d) The agency shall adopt rules to implement this 63
101	101	subsection and notify health care providers in writing about the 64
102	102	coverage of treatment for the chronic disease of obesity 65
103	103	provided pursuant to this subsection. 66
104	104	(e) This subsection does not prohibit the Departmen t of 67
105	105	Health from applying utilization management review procedures to 68
106	106	determine the medical necessity for treatment of the chronic 69
107	107	disease of obesity under this section if appropriateness and 70
108	108	medical necessity determinations are made in the same manner as 71
109	109	those determinations are made for the treatment of any other 72
110	110	illness, condition, or disorder covered by a contract. 73
111	111	(3)(a) The agency shall provide coverage for the diabetes 74
112	112	prevention program. 75
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125	125	(b) Beginning July 1, 2025, Medicaid shall reimburse a 76
126	126	provider for an enrollee's participation in the diabetes 77
127	127	prevention program if the enrollee: 78
128	128	1. Meets the program eligibility requirements. 79
129	129	2. Has not previously participated in the program while 80
130	130	enrolled in Medicaid. 81
131	131	(c) The department may apply for a state plan amendment if 82
132	132	necessary to implement this section. 83
133	133	Section 2. This act shall take effect July 1, 2025. 84