Bill H.1999

HOUSE DOCKET, NO. 1411 FILED ON: 1/16/2019

HOUSE . . . . . . . . . . . . . . . No. 1999

By Mr. Roy of Franklin, a petition (accompanied by bill, House, No. 1999) of Jeffrey N. Roy for legislation to establish a task force (including members of the General Court) and pilot program to examine the impact of obesity in the Commonwealth. Public Health.

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-First General Court
(2019-2020)

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An Act creating an obesity task force and pilot program.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. There is hereby established a Task Force on the Impacts on Obesity. The task force shall be chaired by the president of the senate or their designee and the speaker of the house of representatives or their designee, and shall consist of the following members: the senate chair of the joint committee on health care finance, the house chair of the joint committee on health care finance, the senate chair of the joint committee on public health, the house chair of the joint committee on public health committee, the Secretary of health and human services or their designee, the commissioner of public health or their designee, the executive director of the group insurance commission or their designee, the executive director of the health policy commission or their designee, a representative of the Massachusetts health and hospitals association, a representative of the American cancer society cancer action network, a representative of the American heart and stroke association, a representative of the Massachusetts health council, a representative of the alliance of ymca’s, a representative of the Massachusetts medical society, a representative of the Massachusetts nurses association, a representative of the massachusetts health council, a representative of the Massachusetts public health association, a representative of associated industries of massachuetts and a representative of the Massachusetts business roundtable.

The commission shall:

1.examine the impact of obesity in the commonwealth including but not limited to the cost implications for employer and employee premiums and out of pocket expenses, lost productivity, impacts on wellness and health, co-morbidities and on the overall costs to the health care system.

2.Make recommendations for guidelines and protocols relative to:

a.The proper screening and assessment of obesity

b.Education, prevention and wellness programs

c.Proper approded FDA treatment, medicatins and therapies

d.Eliminating barriers to prevention and wellness programs, education and treatment programs and FDA approved medications

e.Understanding the society and behavorial impacts of addressing obesity in the workplace and other settings

3.Examine the impacts on the prevalance of co-morbidities such as cancer, cardiovascular and other diseases

Understanding the social

SECTION 2. There is hereby established a pilot program to provide coverage for the assessment, identification, treatment and management of obesity and related conditions, including medications  and counseling.

(a) Beginning six months after the effective date of this act the group insurance commission shall  conduct a two-year pilot program to provide coverage for the assessment and identification of, treatment and management of obesity and related conditions, including medications  and counseling. The commission shall  be authorized to enter into an agreement with a postsecondary institution in this state for   pilot program management, data collection, patient engagement, and other activities related  to the pilot program. The pilot program will provide coverage of all federal Food and Drug  Administration approved medications for chronic weight management for eligible  participants in conjunction with obesity prevention, screening, and counseling benefits.  

(b) Participation in the pilot program shall be limited to no more than 500 individuals per  year, to be selected in a manner determined by the commission.  

(c) Any person who has elected coverage under a state health insurance plan shall be eligible to be selected to participate in the pilot program in accordance with criteria  established by the commission which shall include, but not be limited to:  

(1) Completion of a health risk assessment through a state health insurance plan;  

(2) A body mass index:  

(a) Greater than or equal to 27 with comorbidities related to obesity; or  

(b) Greater than or equal to 30 without such comorbidities.  

(3) Consent to provide personal and medical information to a state health insurance plan;  and  

(4) An agreement to enroll in a department approved wellness program during the plan  year.  

(d) Eligible individuals must apply to participate in the pilot program. The individual and  his or her physician shall complete and submit an obesity treatment program application  to the department no later than February 1 for each year of the pilot program. The  commission shall review the applications and based on  the criteria contained in subsection (d) of this section, shall determine qualified  applicants for the pilot program.  

(e) All health care services provided pursuant to the pilot program shall be subject to the  health insurance carrier's plan of benefits and policy provisions. Participants shall be  responsible for all applicable copayments, coinsurance, deductibles, and out-of-pocket  expenses exceeding maximum limits.  

(f) Participants must agree to comply with any and all terms and conditions of the pilot  program including, but not limited to, participation and reporting requirements.  

Participants must also agree to comply with any and all requests by the department for  medical and productivity information, and such agreement shall survive his or her  participation in a state health insurance plan.  

(g) The commission shall review the results and outcomes of the pilot program beginning  six months after program initiation, and shall conduct subsequent reviews every six months  for the remainder of the pilot program. The commission shall provide a final report by  December 15 of the last year of the pilot program to the chairpersons of the joint committee on health care finance, the joint committee on public health, the senate committee on ways and means and the house committee on ways and means.

The report shall include, at a minimum:  

(1) Whether patients in the pilot program experienced a reduction in body mass index, and if so, the average amount of reduction; 

(2) Whether patients in the pilot program experienced reduction or elimination of comorbidities, and if so, which comorbidities were reduced or eliminated;

(3) The total number of individuals who applied to participate in the pilot program;

(4) The total number of participants who enrolled in the pilot program; 

(5) The average cost to the state health insurance plan on a per-member per-month basis;

(6) The total cost of each participant's annual health care costs

(7) Recommendations on how to reduce, manage, and treat obesity in the population under a state health insurance plan.

(h) In the event that sufficient funds become available as determined by the commission to  provide coverage for the treatment and management of obesity and related conditions,  including coverage of all federal Food and Drug Administration approved medication for chronic weight management in conjunction with obesity prevention, screening, and  counseling benefits, the commission shall provide such coverage to any eligible individuals  who have elected coverage under a state health insurance plan and the pilot program shall  be terminated by the department.  

Name:	District/Address:	Date Added:
Jeffrey N. Roy	10th Norfolk	1/14/2019