Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H1243 Compare Versions

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

Old	New	Differences
1	1	1 of 1
2	2	HOUSE DOCKET, NO. 3858 FILED ON: 1/20/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 1243
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Jon Santiago
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act to ensure access to the full range of treatment options for people with obesity.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Jon Santiago9th Suffolk1/17/2023 1 of 2
16	16	HOUSE DOCKET, NO. 3858 FILED ON: 1/20/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 1243
18	18	By Representative Santiago of Boston, a petition (accompanied by bill, House, No. 1243) of Jon
19	19	Santiago for legislation to provide assistance for access to treatment options for people with
20	20	obesity. Health Care Financing.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act to ensure access to the full range of treatment options for people with obesity.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 "SECTION 1. Chapter 118E of the General Laws, as appearing in the 2020 Official
30	30	2Edition, is hereby amended by inserting after section 10N, the following section:-
31	31	3 Section 10O. Notwithstanding any general or special rule to the contrary, the division
32	32	4shall require comprehensive coverage for treatment of obesity. The term “comprehensive
33	33	5coverage for treatment of obesity” includes coverage for prevention and wellness, nutrition
34	34	6counseling, intensive behavioral therapy, bariatric surgery, and FDA-approved anti-obesity
35	35	7medication. The term ‘FDA-approved anti-obesity medication’ refers to any medication
36	36	8approved by the US Food and Drug Administration with an indication for chronic weight
37	37	9management in patients with obesity.
38	38	10 a) Coverage criteria for FDA-approved anti-obesity medications provided under this
39	39	11section shall not be more restrictive than the FDA-approved indications for those treatments. 2 of 2
40	40	12 b) Coverage under this section shall be neither different nor separate from coverage
41	41	13for any other illness, condition, or disorder for purposes of determining deductibles, lifetime
42	42	14dollar limits, copayment and coinsurance factors, and benefit year maximum for deductibles and
43	43	15copayment and coinsurance factors.
44	44	16 c) Nothing shall preclude the undertaking of utilization management to determine
45	45	17the medical necessity for treatment of obesity under this section, provided that all such
46	46	18appropriateness and medical necessity determinations are made in the same manner as those
47	47	19determinations are made for the treatment of any other illness, condition, or disorder covered by
48	48	20such policy, contract, or plan.
49	49	21 d) The division shall provide notice to its members regarding the coverage required
50	50	22by this section. The notice shall be in writing and prominently positioned in any literature or
51	51	23correspondence sent to members and shall be transmitted to members within calendar year when
52	52	24annual information is made available to members, or in any other mailing or communication to
53	53	25members."