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| | 10400SB0692sam001 | - 2 - | LRB104 07052 KTG 36919 a |
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| 1 | | telehealth services as defined in the Telehealth Act. |
| 2 | | (b) Management and treatment of obesity; coverage |
| 3 | | required. The Department shall: |
| 4 | | (1) seek federal authorization to provide intensive |
| 5 | | health behavior and lifestyle treatment for the chronic |
| 6 | | disease of obesity; and |
| 7 | | (2) develop the criteria to cover all FDA-approved |
| 8 | | obesity medications. |
| 9 | | (c) Upon receiving federal authorization, the Department |
| 10 | | shall implement this Section and notify medical assistance |
| 11 | | enrollees in writing about the availability of treatment for |
| 12 | | the chronic disease of obesity as provided under this Section. |
| 13 | | (d) This Section does not prohibit the Department from |
| 14 | | applying utilization management to determine the medical |
| 15 | | necessity for treatment of the chronic disease of obesity if |
| 16 | | appropriateness and medical necessity determinations are made |
| 17 | | in the same manner as those determinations are made for the |
| 18 | | treatment of any other illness, condition, or disorder covered |
| 19 | | by a managed care contract. |
| 20 | | (e) Intensive health behavior and lifestyle treatment may |
| 21 | | include interventions certified by or recognized by the |
| 22 | | Centers for Disease Control and Prevention or recommended by |
| 23 | | current clinical standards of care. The services may be |
| 24 | | provided in office, virtual, or community-based settings to |
| 25 | | support patient access and needs. |
| 26 | | (f) Coverage criteria for FDA-approved obesity medications |