1.1 A bill for an act
1.2 relating to health insurance; requiring health plans to cover the management and
1.3 treatment of obesity; amending Minnesota Statutes 2024, section 256B.0625, by
1.4 adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter
1.5 62Q.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. [62Q.474] MANAGEMENT AND TREATMENT OF OBESITY.
1.8 Subdivision 1.Definitions.(a) For purposes of this section, the terms defined in this
1.9subdivision have the meanings given.
1.10 (b) "Intensive health behavior and lifestyle treatment" means an evidence-based, intensive,
1.11multicomponent behavioral or lifestyle modification intervention that supports healthy
1.12weight management and is delivered in-person or through telehealth, as defined in section
1.1362A.673.
1.14 (c) "FDA-approved obesity medication" means any medication approved by the United
1.15States Food and Drug Administration (FDA) with an indication for chronic weight
1.16management in patients with an obesity diagnosis.
1.17 (d) "Metabolic and bariatric surgery" means any surgical intervention included in the
1.18most current American Society for Metabolic and Bariatric Surgery and International
1.19Federation for the Surgery of Obesity and Metabolic Disorders Guidelines on Indications
1.20for Metabolic and Bariatric Surgery.
1.21 Subd. 2.Management and treatment of obesity; coverage required.(a) A health plan
1.22must include coverage to diagnose and treat the chronic disease of obesity, including but
1.23not limited to:
1Section 1.
25-00546 as introduced12/24/24 REVISOR RSI/BM
SENATE
STATE OF MINNESOTA
S.F. No. 2075NINETY-FOURTH SESSION
(SENATE AUTHORS: MANN)
OFFICIAL STATUSD-PGDATE
Introduction and first reading03/03/2025
Referred to Commerce and Consumer Protection 2.1 (1) intensive health behavioral and lifestyle treatment;
2.2 (2) metabolic and bariatric surgery; and
2.3 (3) FDA-approved obesity medication.
2.4 (b) Coverage criteria for FDA-approved obesity medications must not be more restrictive
2.5than the FDA-approved indications for FDA-approved obesity medications.
2.6 (c) Coverage under this section must not be different or separate from coverage for any
2.7other illness, condition, or disorder for purposes of determining deductibles, co-payment
2.8and coinsurance factors, benefit year maximums for deductibles and co-payment, and
2.9coinsurance.
2.10 (d) This section does not prohibit a plan from applying utilization management to
2.11determine the medical necessity for chronic disease of obesity treatment under this section
2.12if the appropriateness and medical necessity determinations are made in the same manner
2.13as appropriateness and medical necessity determinations are made to treat any other illness,
2.14condition, or disorder covered by a contract.
2.15 (e) Intensive health behavior and lifestyle treatment may include interventions certified
2.16by or recognized by the Centers for Disease Control and Prevention or recommended by
2.17current clinical standards of care. The services may be provided in office, virtual, or
2.18community-based settings to support patient access and needs.
2.19 EFFECTIVE DATE.This section is effective January 1, 2027, and applies to health
2.20plans offered, issued, or renewed on or after that date.
2.21 Sec. 2. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
2.22to read:
2.23 Subd. 77.Management and treatment of obesity.Medical assistance covers obesity
2.24management and treatment. Medical assistance must meet the same requirements that apply
2.25to a health plan under section 62Q.474.
2.26 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
2.27whichever is later.
2Sec. 2.
25-00546 as introduced12/24/24 REVISOR RSI/BM