THE BILL ITSELF
HB 977
Benefits for Obesity under the State Group Health Insurance Plan
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A bill to be entitled
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An act relating to benefits for obesity under the
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state group health insurance plan; amending s.
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110.12303, F.S.; requiring the Department of
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Management Services to provide coverage for the
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treatment and management of obesity for state group
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health insurance policies issued after a specified
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date; providing coverage criteria; requiring the
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department to adopt eligibility criteria by a
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specified date; providing definitions; providing
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reporting requirements; providing an effective date.
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Be It Enacted by the Legislature of the State of Florida: Section 1. Subsection (9) is added to section 110.12303,
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Florida Statutes, to read:
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110.12303 State group insurance program; additional
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benefits; price transparency program; reporting.—
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(9)(a) For state group health insurance plan policies
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issued on or after January 1, 2027, the department shall provide
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coverage for evidence-based treatment and management of obesity
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and related conditions, as prescribed by a professional health
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care provider, for:
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1. Intensive health behavioral and lifestyle treatment.
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2. United States Food and Drug Administration-approved
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weight management medications.
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(b) Coverage criteria for a United States Food and Drug
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Administration-approved weight management medication may not be
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more restrictive than the United States Food and Drug
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Administration indications for such medication. Coverage for
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intensive health behavioral and lifestyle treatment may include
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interventions certified by or recognized by the United States
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Centers for Disease Control and Prevention or recommended by
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current clinical standards of care. Services may be provided in
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person, virtually, or in community-based settings to support
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patient access and needs.
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(c) Before January 1, 2027, the department shall adopt
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eligibility criteria, which shall require patients to:
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1. Be enrolled in a PPO or HMO plans.
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2. Be 18 years of age or older.
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3. Be referred and supervised by an in-network licensed
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provider.
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4. Consent to provide personal and medical information to
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the department, including medical records documenting body mass
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index and weight related comorbidities.
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5. Have received a clinical diagnosis of obesity by an in-
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network licensed provider.
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6. Participate in intensive health, behavioral, and
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lifestyle intervention.
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(d) As used in this subsection, the term:
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1. "United States Food and Drug Administration-approved
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weight management medication" means any Glucagon-like peptide-1
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agonist medication approved by the United States Food and Drug
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Administration with an indication for chronic weight management
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in patients with an obesity diagnosis.
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2. "Intensive health behavioral and lifestyle treatment"
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means an evidence-based, intensive, multicomponent behavioral or
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lifestyle modification intervention that supports healthy weight
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management and is delivered in person or through telehealth as
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defined in s. 456.47(1).
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(e) On or before January 15, 2028, and annually
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thereafter, the department shall report to the Governor, the
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President of the Senate, and the Speaker of the House of
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Representatives on the participation level and cost savings to
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both the enrollee and the state resulting from this subsection.
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Section 2. This act shall take effect July 1, 2026.