The proposed legislation, General Assembly Raised Bill No. 1474, aims to enhance Medicaid coverage for weight loss treatments and establish new requirements for opioid prescribers. Key provisions include the expansion of medical assistance for bariatric surgery and related services for Medicaid and HUSKY B beneficiaries with severe obesity, as well as the inclusion of weight loss drugs approved by the FDA. The bill removes the previous requirement that beneficiaries must meet specific conditions set by the Centers for Medicare and Medicaid Services for these services. Additionally, it allows continued Medicaid coverage for beneficiaries using weight loss drugs even if their BMI falls below thirty-five, provided a licensed physician certifies that their BMI would increase without the medication.

Furthermore, the bill introduces a new requirement for prescribing practitioners to complete training in effective pain management, focusing on nonopioid alternatives, as a condition for Medicaid reimbursement when prescribing opioid drugs. It mandates that any Medicaid state plan amendments not subject to legislative approval must be submitted to the relevant joint standing committee for a vote before federal approval can be sought. This legislative change is designed to improve oversight and ensure that practitioners are equipped with the necessary knowledge to manage pain effectively while minimizing the risk of substance misuse.

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