SB 1007 Summary

• Defines "severe obesity" as a body mass index (BMI) greater than 40, or 35 or more if diagnosed with comorbid conditions including cardiopulmonary disease, diabetes, hypertension, or sleep apnea.

• Requires individual and group health insurance policies to cover bariatric surgical procedures (gastric bypass, sleeve gastrectomy, duodenal switch) that are recognized by the National Institutes of Health and American Society for Metabolic and Bariatric Surgery as providing long-term weight loss, effective January 1, 2022.

• Requires health insurance policies to cover FDA-approved outpatient prescription drugs for treating severe obesity if the policy includes outpatient prescription drug coverage, effective January 1, 2022.

• Requires Connecticut Medicaid to reimburse for bariatric surgical procedures and FDA-approved prescription drugs for severe obesity treatment, effective July 1, 2021, with the Commissioner of Social Services authorized to seek federal approval through state plan amendments or waivers.

• Mandates that obesity treatment benefits be subject to the same terms and conditions as all other covered benefits under affected insurance policies and Medicaid.