HF 690

as introduced - 94th Legislature (2025 - 2026) Posted on 02/13/2025 02:47pm

A bill for an act
relating to health insurance; requiring health plans to cover the management and
treatment of obesity; amending Minnesota Statutes 2024, section 256B.0625, by
adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter
62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.474] MANAGEMENT AND TREATMENT OF OBESITY.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end

new text begin (b) "Intensive health behavior and lifestyle treatment" means an evidence-based, intensive,
multicomponent behavioral or lifestyle modification intervention that supports healthy
weight management and is delivered in-person or through telehealth, as defined in section
62A.673.
new text end

new text begin (c) "FDA-approved obesity medication" means any medication approved by the United
States Food and Drug Administration (FDA) with an indication for chronic weight
management in patients with an obesity diagnosis.
new text end

new text begin (d) "Metabolic and bariatric surgery" means any surgical intervention included in the
most current American Society for Metabolic and Bariatric Surgery and International
Federation for the Surgery of Obesity and Metabolic Disorders Guidelines on Indications
for Metabolic and Bariatric Surgery.
new text end

new text begin Subd. 2. new text end

new text begin Management and treatment of obesity; coverage required. new text end

new text begin (a) A health plan
must include coverage to diagnose and treat the chronic disease of obesity, including but
not limited to:
new text end

new text begin (1) intensive health behavioral and lifestyle treatment;
new text end

new text begin (2) metabolic and bariatric surgery; and
new text end

new text begin (3) FDA-approved obesity medication.
new text end

new text begin (b) Coverage criteria for FDA-approved obesity medications must not be more restrictive
than the FDA-approved indications for FDA-approved obesity medications.
new text end

new text begin (c) Coverage under this section must not be different or separate from coverage for any
other illness, condition, or disorder for purposes of determining deductibles, co-payment
and coinsurance factors, benefit year maximums for deductibles and co-payment, and
coinsurance.
new text end

new text begin (d) This section does not prohibit a plan from applying utilization management to
determine the medical necessity for chronic disease of obesity treatment under this section
if the appropriateness and medical necessity determinations are made in the same manner
as appropriateness and medical necessity determinations are made to treat any other illness,
condition, or disorder covered by a contract.
new text end

new text begin (e) Intensive health behavior and lifestyle treatment may include interventions certified
by or recognized by the Centers for Disease Control and Prevention or recommended by
current clinical standards of care. The services may be provided in office, virtual, or
community-based settings to support patient access and needs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 77. new text end

new text begin Management and treatment of obesity. new text end

new text begin Medical assistance covers obesity
management and treatment. Medical assistance must meet the same requirements that apply
to a health plan under section 62Q.474.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later.
new text end