new text begin [62Q.474] OBESITY MANAGEMENT AND TREATMENT.
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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.
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new text begin (b) "Intensive behavioral or lifestyle therapy" means an evidence-based, intensive,
multicomponent behavioral or lifestyle modification intervention that supports healthy
weight management.
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new text begin (c) "FDA-approved antiobesity 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.
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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.
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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 obesity, including but not limited to:
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new text begin (1) intensive behavioral or lifestyle therapy;
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new text begin (2) metabolic and bariatric surgery; and
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new text begin (3) FDA-approved antiobesity medication.
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new text begin (b) Coverage criteria for FDA-approved antiobesity medications must not be more
restrictive than the FDA-approved indications for antiobesity treatments.
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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 cost-sharing, including but not limited
to determining deductibles, co-payment and coinsurance factors, and benefit year maximums
for deductibles, co-payment, and coinsurance.
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new text begin (d) This section does not prohibit a health plan from applying utilization management
to determine the medical necessity for obesity treatment if medical necessity determinations
are made in the same manner as determinations are made to treat any other illness, condition,
or disorder covered by the health plan.
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new text begin (e) Intensive behavioral or lifestyle therapy 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.
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