Bill > HCR008

This concurrent resolution directs the Public Employees' Benefit Insurance Program (PEHP), Utah's state health insurance plan for public employees, to transform its existing bariatric surgery pilot program into a broader "Weight Management and Obesity Pilot Program" starting in the 2026 plan year. This new program will offer an alternative treatment pathway using GLP-1 drugs, a class of medications that have shown promise for weight loss, in addition to bariatric surgery. To manage costs and ensure responsible use, the GLP-1 pathway will be administered on a reimbursement basis with a 50% member cost-sharing requirement, a monthly pharmacy expense cap of $300 per member, and a 24-month coverage limit. Participants in the GLP-1 pathway will also need to meet the same health coaching and participation requirements as those undergoing bariatric surgery. Members can choose either bariatric surgery or the GLP-1 treatment pathway once, and if they stop GLP-1 treatment within six months, they can still opt for bariatric surgery. The program must operate within the existing adjusted annual budget of $1,050,000, and PEHP is required to report on the pilot program's results annually to the Health and Human Services Interim Committee until 2028.