Bill > SB2729

This bill expands Medicaid coverage in Texas to provide reimbursement for comprehensive obesity and diabetes prevention treatments. Specifically, the bill requires the state's Health and Human Services Commission to cover three key obesity treatment services: intensive behavioral and lifestyle interventions, metabolic and bariatric surgery, and anti-obesity medications. These services can be delivered in-person or through telehealth, and must align with current clinical standards. For diabetes prevention, the bill mandates reimbursement for structured prevention program sessions provided by recognized diabetes prevention program suppliers, with eligibility criteria including not having previously participated in such a program. The bill defines technical terms like "anti-obesity medication" (FDA-approved prescription medications for chronic weight management) and establishes that utilization management for these services must be consistent with other Medicaid healthcare services. Additionally, the bill requires the executive commissioner to establish medical necessity criteria for anti-obesity medications that are not more restrictive than FDA-approved indications. The Health and Human Services Commission must also provide written notice to Medicaid recipients about the new obesity treatment options, and the bill will take effect either immediately with a two-thirds legislative vote or on September 1, 2025.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB2729