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HOUSE DOCKET, NO. 3858 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 1243
The Commonwealth of Massachusetts
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PRESENTED BY:
Jon Santiago
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to ensure access to the full range of treatment options for people with obesity.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Jon Santiago9th Suffolk1/17/2023 1 of 2
HOUSE DOCKET, NO. 3858 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 1243
By Representative Santiago of Boston, a petition (accompanied by bill, House, No. 1243) of Jon
Santiago for legislation to provide assistance for access to treatment options for people with
obesity. Health Care Financing.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act to ensure access to the full range of treatment options for people with obesity.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 "SECTION 1. Chapter 118E of the General Laws, as appearing in the 2020 Official
2Edition, is hereby amended by inserting after section 10N, the following section:-
3 Section 10O. Notwithstanding any general or special rule to the contrary, the division
4shall require comprehensive coverage for treatment of obesity. The term “comprehensive
5coverage for treatment of obesity” includes coverage for prevention and wellness, nutrition
6counseling, intensive behavioral therapy, bariatric surgery, and FDA-approved anti-obesity
7medication. The term ‘FDA-approved anti-obesity medication’ refers to any medication
8approved by the US Food and Drug Administration with an indication for chronic weight
9management in patients with obesity.
10 a) Coverage criteria for FDA-approved anti-obesity medications provided under this
11section shall not be more restrictive than the FDA-approved indications for those treatments. 2 of 2
12 b) Coverage under this section shall be neither different nor separate from coverage
13for any other illness, condition, or disorder for purposes of determining deductibles, lifetime
14dollar limits, copayment and coinsurance factors, and benefit year maximum for deductibles and
15copayment and coinsurance factors.
16 c) Nothing shall preclude the undertaking of utilization management to determine
17the medical necessity for treatment of obesity under this section, provided that all such
18appropriateness and medical necessity determinations are made in the same manner as those
19determinations are made for the treatment of any other illness, condition, or disorder covered by
20such policy, contract, or plan.
21 d) The division shall provide notice to its members regarding the coverage required
22by this section. The notice shall be in writing and prominently positioned in any literature or
23correspondence sent to members and shall be transmitted to members within calendar year when
24annual information is made available to members, or in any other mailing or communication to
25members."