SB 977 — AN ACT CONCERNING MEDICAL ASSISTANCE FOR SURGERY AND MEDICAL SERVICES RELATED TO TREATMENT OF OBESITY.

Substitute Senate GeneralBill Assembly File No.

672977 JanuaryPublic Session,Act 2023 Substitute Senate Bill No.

97723-94 Senate,AN MayACT 2,CONCERNING 2023MEDICAL TheASSISTANCE CommitteeFOR onSURGERY AppropriationsAND reportedMEDICAL throughSERVICES SEN.RELATED TO TREATMENT OF OBESITY.

OSTEN of the 19th Dist., Chairperson of the Committee on the part of the Senate, that the substitute bill ought to pass.

AN ACT CONCERNING MEDICAL ASSISTANCE FOR SURGERY AND MEDICAL SERVICES RELATED TO TREATMENT OF OBESITY.

sSB977(A) /Greater Filethan No.forty;

672or 1(B) sSB977Thirty-five Fileor more if an individual has been diagnosed with a Substitute Senate Bill No.

672977 (A)comorbid Greaterdisease thanor forty;condition, including, but not limited to, a cardiopulmonary condition, diabetes, hypertension or sleep apnea;

or (B) Thirty-five or more if an individual has been diagnosed with a comorbid disease or condition, including, but not limited to, a cardiopulmonary condition, diabetes, hypertension or sleep apnea;

ThisApproved actJune shall28, take2023 effectPublic asAct followsNo. and shall amend the following sections:

Section23-94 12 Julyof 1,2 2023 New section HS Joint Favorable Subst.

C/R APP APP Joint Favorable sSB977 / File No.

672 2 sSB977 File No.

672 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 24 $ FY 25 $ Social Services, Dept.

GF - Cost See Below See Below Note:

GF=General Fund Municipal Impact:

None Explanation The bill results in a cost to the Department of Social Services (DSS) associated with expanding Medicaid and HUSKY B coverage for certain obesity-related services.

The extent of the cost is unknown at this time.

Currently, surgical services are covered if necessary to treat morbid obesity that causes or aggravates another medical illness.

For context, morbid obesity involves a body mass index (BMI) of 40 or higher.

The bill requires (1) medical services for members with a BMI of over 35,and (2) bariatric surgery and related medical services for beneficiaries with severe obesity (BMI of at least 35 with a comorbid disease or condition, or a BMI of over 40).

Based on historical claims, there are approximately 120,000 adults and children who are reported as obese.

The bill will increasethenumberofindividualseligibleforbothsurgicalandmedical services, which will increase state costs.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to the utilization and cost of expanded services under the bill.

sSB977 / File No.

672 3 sSB977 File No.

672 OLR Bill Analysis sSB 977 AN ACT CONCERNING MEDICAL ASSISTANCE FOR SURGERY AND MEDICAL SERVICES RELATED TO TREATMENT OF OBESITY.

SUMMARY This bill requires the Department of Social Services (DSS) commissioner to cover bariatric surgery and specified medical services for Medicaid and HUSKY B beneficiaries with obesity under certain circumstances.

Under the bill, these medical services include (1) FDA- approved prescription drugs for outpatient treatment of obesity and (2) nutritional counseling from a registered dietitian-nutritionist.

Bariatric surgery is a procedure that makes changes to the digestive system to help a patient with obesity lose weight.

Specifically, as long as beneficiaries otherwise meet conditions set by the federal Centers for Medicare andMedicaid Services, the billrequires DSS to cover the following:

1.

medical services for beneficiaries with a body mass index (BMI) over 35, and 2.

bariatric surgery and related medical services for beneficiaries with severe obesity.

Under the bill, a person has severe obesity if he or she has a BMI of (1) at least 35 with a comorbid disease or condition (e.g., a cardiopulmonary condition, diabetes, hypertension, or sleep apnea) or (2) over 40.

A person has obesity if he or she has a BMI of 30 or higher.