A Bill for an Act
Page 1, Line 101Concerning the "Diabetes Prevention and Obesity Treatment
Page 1, Line 102Act".
Bill Summary
(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)
The bill requires private insurance companies to provide coverage for the treatment of the chronic disease of obesity and the treatment of pre-diabetes, including coverage for the national diabetes prevention program, medical nutrition therapy, intensive behavioral or lifestyle therapy, metabolic and bariatric surgery, and FDA-approved anti-obesity medication.
The bill requires the department of health care policy and financing (department) to seek federal authorization to provide treatment for the chronic disease of obesity and the treatment of pre-diabetes. Within existing appropriations and upon receiving federal authorization, the department is required to notify medicaid members in writing about the availability of the treatment.
This Unofficial Version Includes Committee
Amendments Not Yet Adopted on Second Reading
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. Short title. The short title of this act is the "Diabetes Prevention and Obesity Treatment Act".
Page 2, Line 3SECTION 2. Legislative declaration. (1) The general assembly finds and declares that:
Page 2, Line 4(a) In Colorado, the prevalence of the chronic disease of obesity
Page 2, Line 5is staggering. Obesity affects over 24% of Colorado adults, with
Page 2, Line 6disproportionately high rates in communities of color: 33.4% and 31% of
Page 2, Line 7Black and Latino Coloradans experience obesity, respectively. More than
Page 2, Line 8one in 4 youth ages 10 to 17 are either overweight or experiencing
Page 2, Line 9obesity, and 24.3% of children enrolled in the federal special
Page 2, Line 10supplemental nutrition program for women, infants, and children in 2020 were overweight or experiencing obesity.
Page 2, Line 11(b) The American Medical Association and the American
Page 2, Line 12Academy of Pediatrics declared obesity a chronic disease in 2013, and the
Page 2, Line 13American Diabetes Association has recognized obesity as a complex,
Page 2, Line 14progressive, serious, relapsing, and costly chronic disease. Obesity serves
Page 2, Line 15as a major risk factor for developing comorbid conditions, including heart
Page 2, Line 16disease, stroke, type 2 diabetes, renal disease, non-alcoholic
Page 2, Line 17steatohepatitis, and 13 types of cancer. Research shows that obesity and
Page 2, Line 18diabetes increase the risk of more severe coronavirus infection and
Page 2, Line 19hospitalization. Obesity also contributes to many chronic and costly
Page 3, Line 1conditions and increases risk of physical injury, including falls, sprains, strains, lower extremity fractures, and joint dislocation.
Page 3, Line 2(c) Strong and consistent evidence shows that effective weight
Page 3, Line 3management can delay the progression from pre-diabetes to type 2
Page 3, Line 4diabetes and is highly beneficial in treating type 2 diabetes. In people with
Page 3, Line 5type 2 diabetes who are also overweight or experiencing obesity, modest
Page 3, Line 6weight management clinically improves health, including reducing
Page 3, Line 7glycemia levels and reducing the need for glucose-lowering medications.
Page 3, Line 8Greater weight management substantially reduces A1C and fasting
Page 3, Line 9glucose levels and has been shown to support sustained diabetes remission for at least 2 years.
Page 3, Line 10(d) The 2023 American Academy of Pediatrics obesity guidelines
Page 3, Line 11recommend that comprehensive, evidence-based obesity treatment for
Page 3, Line 12youth should include anti-obesity medications and that this treatment
Page 3, Line 13option is safe and effective. Eight out of ten adolescents with obesity will
Page 3, Line 14continue to have obesity as adults. Treatment significantly improves an
Page 3, Line 15individual's health and quality of life and has the potential to significantly
Page 3, Line 16reduce health-care costs by preventing the development and progression of obesity-related complications, including diabetes.
Page 3, Line 17 SECTION 3. In Colorado Revised Statutes, 10-16-104, add (29) as follows:
Page 3, Line 1810-16-104. Mandatory coverage provisions - applicability -
Page 3, Line 19rules - definitions. (29) Treatment for obesity and pre-diabetes.
Page 3, Line 20(a) All large group healthbenefitplans issued or renewed in
Page 3, Line 21this state must provide coverage for the treatment of the
Page 3, Line 22chronic disease of obesity and the treatment of pre-diabetes,
Page 3, Line 23including coverage for a comparable program to the national
Page 4, Line 1diabetes prevention program, medical nutrition therapy,
Page 4, Line 2intensive behavioral or lifestyle therapy, and metabolic and bariatric surgery.
Page 4, Line 3(b) For a large group health benefit plan offered in this
Page 4, Line 4state, a carrier shall offer the policyholder the option to
Page 4, Line 5purchase coverage for FDA-approved anti-obesity medications,
Page 4, Line 6including at least one FDA-approved GLP-1 medication. This
Page 4, Line 7subsection (29) does not require a carrier to offer coverage for which premiums would not cover expected benefits.
Page 4, Line 8(c) The commissioner may adopt rules to implement this subsection (29).
Page 4, Line 9(d) As used in this subsection (29):
Page 4, Line 10(I) "FDA-approved anti-obesity medication" means a
Page 4, Line 11medication approved by the federal food and drug
Page 4, Line 12administration with an indication for weight management in patients with chronic obesity.
Page 4, Line 13(II) "FDA-approved GLP-1 medication" means a
Page 4, Line 14glucagon-like peptide-1 receptor agonist that is approved by the
Page 4, Line 15federal food and drug administration with an indication for regulating blood sugar levels and appetite.
Page 4, Line 16(III) "Intensive behavioral or lifestyle therapy" means an
Page 4, Line 17evidence-based, multi-component behavioral or lifestyle
Page 4, Line 18modification intervention designed to support healthy weight
Page 4, Line 19management as recommended by current clinical standards of
Page 4, Line 20care. Interventions include obesity screening, dietary
Page 4, Line 21assessment, and behavioral counseling and therapy aimed at
Page 4, Line 22weight loss through lifestyle modifications such as changes in
Page 5, Line 1diet and increased physical activity. Therapy for obesity must be
Page 5, Line 2consistent with the United States Preventive Services Task
Page 5, Line 3Force's 5-A behavioral counseling framework: Ask, advise,
Page 5, Line 4assess, assist, and arrange. Interventions may be provided
Page 5, Line 5in-office, virtually through telehealth, or in community-based settings to support patient access and needs.
Page 5, Line 6(IV) "Medical nutrition therapy" means the following
Page 5, Line 7nutrition care services that prevent, manage, or treat diseases
Page 5, Line 8or medical conditions, which services may be provided in-office or virtually through telehealth:
Page 5, Line 9(A) Nutrition assessment;
(B) Nutrition diagnosis;
Page 5, Line 10(C) Nutrition intervention; and
(D) Nutrition monitoring and evaluation.
Page 5, Line 11(V) "Metabolic and bariatric surgery" means metabolic
Page 5, Line 12and bariatric surgery recommended according to the guidelines
Page 5, Line 13published in the 2022 American Society for Metabolic and
Page 5, Line 14Bariatric Surgery and International Federation for the
Page 5, Line 15Surgery of Obesity and Metabolic Disorders: Indications for Metabolic and Bariatric Surgery.
Page 5, Line 16(VI) "National diabetes prevention program" means a
Page 5, Line 17structured, evidence-based lifestyle modification program
Page 5, Line 18designed to prevent or delay the onset of diabetes in individuals
Page 5, Line 19at high risk in accordance with 42 U.S.C. sec. 280g-14. The
Page 5, Line 20program follows a standardized curriculum and is focused on
Page 5, Line 21promoting healthy lifestyle changes, including weight loss,
Page 5, Line 22increased physical activity, and healthier eating habits, through individual and group intervention.
Page 6, Line 1SECTION 4. In Colorado Revised Statutes, 25.5-8-107, add (1)(a)(V) as follows:
Page 6, Line 225.5-8-107. Duties of the department - schedule of services -
Page 6, Line 3premiums - copayments - subsidies - purchase of childhood
Page 6, Line 4immunizations. (1) In addition to any other duties pursuant to this article 8, the department has the following duties:
Page 6, Line 5(a) (IV) The schedule of health-care services included in
Page 6, Line 6the plan must not include coverage pursuant to the mandatory coverage provisions of section 10-16-104 (29).
Page 6, Line 7SECTION 5. Act subject to petition - effective date -
Page 6, Line 8applicability. (1) This act takes effect January 1, 2027; except that, if a
Page 6, Line 9referendum petition is filed pursuant to section 1 (3) of article V of the
Page 6, Line 10state constitution against this act or an item, section, or part of this act
Page 6, Line 11within the ninety-day period after final adjournment of the general
Page 6, Line 12assembly, then the act, item, section, or part will not take effect unless
Page 6, Line 13approved by the people at the general election to be held in November
Page 6, Line 142026 and, in such case, will take effect January 1, 2027, or on the date of
Page 6, Line 15the official declaration of the vote thereon by the governor, whichever is later.
Page 6, Line 16(2) This act applies to large group health benefit plans issued or renewed on or after the applicable effective date of this act.