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H.B. 225

             1     

MORBID OBESITY - INSURANCE COVERAGE

             2     
2007 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Steven R. Mascaro

             5     
Senate Sponsor: ____________

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Accident and Health Insurance part of the Insurance Code.
             10      Highlighted Provisions:
             11          This bill:
             12          .    defines morbid obesity; and
             13          .    requires the insurance commissioner to adopt rules requiring accident and health
             14      insurance coverage for treatment of morbid obesity.
             15      Monies Appropriated in this Bill:
             16          None
             17      Other Special Clauses:
             18          None
             19      Utah Code Sections Affected:
             20      ENACTS:
             21          31A-22-635, Utah Code Annotated 1953
             22     
             23      Be it enacted by the Legislature of the state of Utah:
             24          Section 1. Section 31A-22-635 is enacted to read:
             25          31A-22-635. Coverage for treatment of morbid obesity.
             26          (1) As used in this section:
             27          (a) "Body mass index" means a practical marker that is used to assess the degree of



             28      obesity and is calculated by dividing the weight in kilograms by the height in meters squared.
             29          (b) "Morbid obesity" means a body mass index that is:
             30          (i) greater than 40 kilograms per meter squared; or
             31          (ii) equal to or greater than 35 kilograms per meter squared with a comorbid medical
             32      condition, including:
             33          (A) hypertension;
             34          (B) a cardiopulmonary condition;
             35          (C) sleep apnea; or
             36          (D) diabetes.
             37          (2) The commissioner shall establish, by rule, minimum standards of coverage for
             38      morbid obesity for accident and health insurance policies that provide a health insurance
             39      benefit before July 1, 2007.
             40          (3) In making rules under Subsection (2), the commissioner shall require rules:
             41          (a) with durational limits, amount limits, deductibles, and coinsurance for the treatment
             42      of morbid obesity equitable or identical to coverage provided for the treatment of other
             43      illnesses or diseases; and
             44          (b) that provide coverage for surgical treatment of morbid obesity that is:
             45          (i) recognized by the National Institute of Health as effective for the long-term reversal
             46      of morbid obesity; and
             47          (ii) consistent with guidelines approved by the National Institute of Health.




Legislative Review Note
    as of 12-4-06 9:41 AM


Office of Legislative Research and General Counsel


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