S 830 — Treat and Reduce Obesity Act of 2017

Summary

Treat and Reduce Obesity Act of 2017 This bill allows coverage, under Medicare, of intensive behavioral therapy for obesity furnished by providers other than primary care physicians and practitioners. Additionally, it allows coverage under Medicare's prescription drug benefit of drugs used for the treatment of obesity or for weight loss management for individuals who are overweight.

Bill Text

• Introduced Introduced in Senate Current html April 05, 2017

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill expands the types of healthcare providers eligible to deliver intensive behavioral therapy for obesity and modifies Medicare Part D coverage for obesity medications.

• 42 U.S.C. 1395x(ddd)

  (4)(A) Subject to subparagraph (B), the Secretary may, in addition to qualified primary care physicians and other primary care practitioners, cover intensive behavioral therapy for obesity furnished by any of the following: (i) A physician (as defined in subsection (r)(1)) who is not a qualified primary care physician. (ii) Any other appropriate health care provider (including a physician assistant, nurse practitioner, or clinical nurse specialist (as those terms are defined in subsection (aa)(5)), a clinical psychologist, a registered dietitian or nutrition professional (as defined in subsection (vv))). (iii) An evidence-based, community-based lifestyle counseling program approved by the Secretary. (B) In the case of intensive behavioral therapy for obesity furnished by a provider described in clause (ii) or (iii) of subparagraph (A), the Secretary may only cover such therapy if such therapy is furnished-- (i) upon referral from, and in coordination with, a physician or primary care practitioner operating in a primary care setting or any other setting specified by the Secretary; and (ii) in an office setting, a hospital out-patient department, a community-based site that complies with the Federal regulations concerning the privacy of individually identifiable health information promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, or another setting specified by the Secretary. (C) In order to ensure a collaborative effort, the coordination described in subparagraph (B)(i) shall include the health care provider or lifestyle counseling program communicating to the referring physician or primary care practitioner any recommendations or treatment plans made regarding the therapy.

  This allows more types of providers to offer intensive behavioral therapy for obesity under Medicare, improving access to treatment.

• 42 U.S.C. 1395w-102(e)(2)(A)

  and other than → other than

  This change clarifies the conditions under which obesity medications are not excluded from coverage under Medicare Part D.

• 42 U.S.C. 1395w-102(e)(2)(A)

  and other than subparagraph (A) of such section if the drug is used for the treatment of obesity (as defined in section 1861(yy)(2)(C)) or for weight loss management for an individual who is overweight (as defined in section 1861(yy)(2)(F)(i)) and has one or more related comorbidities,

  This allows Medicare Part D to cover certain medications used for the treatment and management of obesity.

Action History

1. April 05, 2017

   Introduced in Senate

2. April 05, 2017

   Read twice and referred to the Committee on Finance.

Sponsors

• Thomas R. Carper · Cosponsor
• Chuck Grassley · Cosponsor
• Christopher A. Coons · Cosponsor
• Lisa Murkowski · Cosponsor
• Martin Heinrich · Cosponsor
• Shelley Moore Capito · Cosponsor
• Amy Klobuchar · Cosponsor
• Richard Burr · Cosponsor
• Pat Roberts · Cosponsor
• Todd Young · Cosponsor
• Bill Cassidy · Primary

Subjects