SLS 15RS-511 ORIGINAL
2015 Regular Session
SENATE BILL NO. 173
BY SENATOR HEITMEIER
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
HEALTH CARE. Provides for treatment of morbid obesity. (10/1/15)
1 AN ACT
2 To enact R.S. 22:1055, relative to morbid obesity; to provide for health insurance coverage
3 for the treatment of morbid obesity; to provide for definitions; to provide for an
4 effective date; and to provide for related matters.
5 Be it enacted by the Legislature of Louisiana:
6 Section 1. R.S. 22:1055 is hereby enacted to read as follows:
7 ยง1055. Health insurance coverage for the treatment of morbid obesity;
8 definitions
9 A. As used in this Section , the following definitions shall apply:
10 (1) "Body mass index" means a practical marker used to assess the
11 degree of obesity and is calculated by dividing the weight in kilograms by the
12 height in meters squared.
13 (2) "Morbid obesity" means either one of the following:
14 (a) A body mass index equal to or greater than forty kilograms per meter
15 squared.
16 (b) A body mass index equal to or greater than thirty-five kilograms per
17 meter squared along with an associated comorbidity including but not limited
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 173
SLS 15RS-511 ORIGINAL
1 to hypertension, cardiopulmonary conditions, sleep apnea, or diabetes.
2 B.(1) Any hospital, health, or medical expense insurance policy, hospital
3 or medical service contract, health and accident insurance policy, or any other
4 contract of this type providing comprehensive major medical benefits, including
5 a group insurance plan, or any policy of family group, blanket, or association
6 health and accident insurance, a self-insurance plan, an employee welfare
7 benefit plan, or a health maintenance organization subscriber agreement which
8 is issued or renewed in this state on or after October 1, 2015, the office of group
9 benefits programs, or, notwithstanding the provisions of R.S. 22:1106, any
10 prepaid entity that participates in the Louisiana Medicaid Program shall
11 provide coverage for the medically necessary expenses of the diagnosis and
12 treatment of morbid obesity, including but not limited to bariatric surgery,
13 physician office visits, health and behavior assessments, nutrition education,
14 patient self-management education and training, and therapeutic exercises.
15 (2) The coverage required pursuant to this Section for bariatric surgery
16 shall be limited to facilities of surgical services that are accredited by the
17 Metabolic and Bariatric Surgery Accreditation and Quality Improvement
18 Program of the American College of Surgeons and American Society of
19 Metabolic Bariatric Surgery as a comprehensive bariatric facility.
20 Section 2. This Act shall become effective on October 1, 2015.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christopher D. Adams.
DIGEST
SB 173 Original 2015 Regular Session Heitmeier
Proposed law provides for health insurance coverage for the treatment of morbid obesity.
Proposed law defines "body mass index" to mean a practical marker used to assess the
degree of obesity and is calculated by dividing the weight in kilograms by the height in
meters squared.
Proposed law defines "morbid obesity" to mean either:
(a)A body mass index equal to or greater than forty kilograms per meter squared.
(b)A body mass index equal to or greater than thirty-five kilograms per meter squared
Page 2 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 173
SLS 15RS-511 ORIGINAL
along with an associated comorbidity including but not limited to hypertension,
cardiopulmonary conditions, sleep apnea, or diabetes.
Proposed law provides any hospital, health, or medical expense insurance policy, hospital
or medical service contract, health and accident insurance policy, or any other contract of
this type providing comprehensive major medical benefits, including a group insurance plan,
or any policy of family group, blanket, or association health and accident insurance, a
self-insurance plan, an employee welfare benefit plan, or a health maintenance organization
subscriber agreement which is issued or renewed in this state on or after October 1, 2015,
the office of group benefits programs, or, notwithstanding the provisions of present law, any
prepaid entity that participates in the Louisiana Medicaid Program shall provide coverage
for the medically necessary expenses of the diagnosis and treatment of morbid obesity,
including but not limited to bariatric surgery, physician office visits, health and behavior
assessments, nutrition education, patient self-management education and training, and
therapeutic exercises.
Proposed law provides the coverage required pursuant to proposed law for bariatric surgery
shall be limited to facilities of surgical services that are accredited by the Metabolic and
Bariatric Surgery Accreditation and Quality Improvement Program of the American College
of Surgeons and American Society of Metabolic Bariatric Surgery as a comprehensive
bariatric facility.
Effective October 1, 2015.
(Adds R.S. 22:1055)
Page 3 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.