Sec. 7606. Treat and Reduce Obesity Act
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Section 1861(ddd) of the Social Security Act ( 42 U.S.C. 1395x(ddd) ) is amended by adding at the end the following new paragraph: Subject to subparagraph (B), the Secretary may, in addition to qualified primary care physicians and other primary care practitioners, cover intensive behavioral therapy for obesity furnished by any of the following: A physician (as defined in subsection (r)(1)) who is not a qualified primary care physician. Any other appropriate health care provider (including a physician assistant, nurse practitioner, or clinical nurse specialist (as those terms are defined in subsection (aa)(5)), a clinical psychologist, a registered dietitian or nutrition professional (as defined in subsection (vv))).
An evidence-based, community-based lifestyle counseling program approved by the Secretary. In the case of intensive behavioral therapy for obesity furnished by a provider described in clause
(ii)or
(iii)of subparagraph (A), the Secretary may only cover such therapy if such therapy is furnished— upon referral from, and in coordination with, a physician or primary care practitioner operating in a primary care setting or any other setting specified by the Secretary; and in an office setting, a hospital outpatient department, a community-based site that complies with the Federal regulations concerning the privacy of individually identifiable health information promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, or another setting specified by the Secretary. In order to ensure a collaborative effort, the coordination described in subparagraph (B)(i) shall include the health care provider or lifestyle counseling program communicating to the referring physician or primary care practitioner any recommendations or treatment plans made regarding the therapy. . Section 1860D–2(e)(2)(A) of the Social Security Act ( 42 U.S.C. 1395w–102(e)(2)(A) ) is amended, in the first sentence— by striking and other than and inserting other than ; and by inserting after benzodiazepines), the following: and other than subparagraph
(A)of such section if the drug is used for the treatment of obesity (as defined in section 1861(yy)(2)(C)) or for weight loss management for an individual who is overweight (as defined in section 1861(yy)(2)(F)(i)) and has one or more related comorbidities, . The amendments made by paragraph
(1)shall apply to plan years beginning on or after the date that is 2 years after the date of the enactment of this section. Not later than the date that is 1 year after the date of the enactment of this section, and every 2 years thereafter, the Secretary of Health and Human Services shall submit a report to Congress describing the steps the Secretary has taken to implement the provisions of, and amendments made by, this section. Such report shall also include recommendations for better coordination and leveraging of programs within the Department of Health and Human Services and other Federal agencies that relate in any way to supporting appropriate research and clinical care (such as any interactions between physicians and other health care providers and their patients) to treat, reduce, and prevent obesity in the adult population.
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U.S. Code
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- 42 USC 1395w–102(e)(2)(A)
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