Senate Committee of Reference Report

Committee on Appropriations

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April 29, 2025

After consideration on the merits, the Committee recommends the following:

SB25-048     be amended as follows, and as so amended, be referred to the Committee of the Whole with favorable recommendation:

Page 1, Line 1Amend printed bill, page 3, strike lines 14 through 16 and substitute

Page 1, Line 2"youth should include anti-obesity medications and that this treatment

Page 1, Line 3option is safe and effective. Eight out of ten adolescents with".

Page 1, Line 4Page 3, strike lines 21 through 27.

Page 1, Line 5Strike pages 4 through 9.

Page 1, Line 6Page 10, strike lines 1 through 12 and substitute:

Page 1, Line 7"SECTION 3.  In Colorado Revised Statutes, 10-16-104, add (29)

Page 1, Line 8as follows:

Page 1, Line 910-16-104.  Mandatory coverage provisions - applicability -

Page 1, Line 10rules - definitions. (29)  Treatment for obesity and pre-diabetes.

Page 1, Line 11(a)  All individual and group health plans issued or renewed in

Page 1, Line 12this state must provide coverage for the treatment of the

Page 1, Line 13chronic disease of obesity and the treatment of pre-diabetes,

Page 1, Line 14including coverage for the national diabetes prevention

Page 1, Line 15program, medical nutrition therapy, intensive behavioral or

Page 1, Line 16lifestyle therapy, and metabolic and bariatric surgery.

Page 1, Line 17(b)  For a large group health benefit plan offered in this

Page 1, Line 18state, a carrier shall offer the policyholder the option to

Page 1, Line 19purchase coverage for FDA-approved anti-obesity medications,

Page 1, Line 20including at least one FDA-approved GLP-1 medication. This

Page 1, Line 21subsection (29) does not require a carrier to offer coverage for

Page 1, Line 22which premiums would not cover expected benefits.

Page 1, Line 23(c)  The commissioner may adopt rules to implement this

Page 1, Line 24subsection (29).

Page 1, Line 25(d)  As used in this subsection (29):

Page 2, Line 1(I)  "FDA-approved anti-obesity medication" means a

Page 2, Line 2medication approved by the federal food and drug

Page 2, Line 3administration with an indication for weight management in

Page 2, Line 4patients with chronic obesity.

Page 2, Line 5(II)  "FDA-approved GLP-1 medication" means a

Page 2, Line 6glucagon-like peptide-1 receptor agonist that is approved by the

Page 2, Line 7federal food and drug administration with an indication for

Page 2, Line 8regulating blood sugar levels and appetite.

Page 2, Line 9(III)  "Intensive behavioral or lifestyle therapy" means an

Page 2, Line 10evidence-based, multi-component behavioral or lifestyle

Page 2, Line 11modification intervention designed to support healthy weight

Page 2, Line 12management as recommended by current clinical standards of

Page 2, Line 13care. Interventions include obesity screening, dietary

Page 2, Line 14assessment, and behavioral counseling and therapy aimed at

Page 2, Line 15weight loss through lifestyle modifications such as changes in

Page 2, Line 16diet and increased physical activity. Therapy for obesity must be

Page 2, Line 17consistent with the United States Preventive Services Task

Page 2, Line 18Force's 5-A behavioral counseling framework: Ask, advise,

Page 2, Line 19assess, assist, and arrange. Interventions may be provided

Page 2, Line 20in-office, virtually through telehealth, or in community-based

Page 2, Line 21settings to support patient access and needs.

Page 2, Line 22(IV)  "Medical nutrition therapy" means the following

Page 2, Line 23nutrition care services that prevent, manage, or treat diseases

Page 2, Line 24or medical conditions, which services may be provided in-office

Page 2, Line 25or virtually through telehealth:

Page 2, Line 26(A)  Nutrition assessment;

Page 2, Line 27(B)  Nutrition diagnosis;

Page 2, Line 28(C)  Nutrition intervention; and

Page 2, Line 29(D)  Nutrition monitoring and evaluation.

Page 2, Line 30(V)  "Metabolic and bariatric surgery" means metabolic

Page 2, Line 31and bariatric surgery recommended according to the guidelines

Page 2, Line 32published in the 2022 American Society for Metabolic and

Page 2, Line 33Bariatric Surgery and International Federation for the

Page 2, Line 34Surgery of Obesity and Metabolic Disorders: Indications for

Page 2, Line 35Metabolic and Bariatric Surgery.

Page 2, Line 36(VI)  "National diabetes prevention program" means a

Page 2, Line 37structured, evidence-based lifestyle modification program

Page 2, Line 38designed to prevent or delay the onset of diabetes in individuals

Page 2, Line 39at high risk in accordance with 42 U.S.C. sec. 280g-14. The

Page 2, Line 40program follows a standardized curriculum and is focused on

Page 2, Line 41promoting healthy lifestyle changes, including weight loss,

Page 2, Line 42increased physical activity, and healthier eating habits,

Page 2, Line 43through individual and group intervention.

Page 3, Line 1SECTION 4.  In Colorado Revised Statutes, 25.5-8-107, add

Page 3, Line 2(1)(a)(V) as follows:

Page 3, Line 325.5-8-107.  Duties of the department - schedule of services -

Page 3, Line 4premiums - copayments - subsidies - purchase of childhood

Page 3, Line 5immunizations. (1)  In addition to any other duties pursuant to this article

Page 3, Line 68, the department has the following duties:

Page 3, Line 7(a) (IV)  The schedule of health-care services included in

Page 3, Line 8the plan must not include coverage pursuant to the mandatory

Page 3, Line 9coverage provisions of section 10-16-104 (29).".

Page 3, Line 10Renumber succeeding section accordingly.