Plain English Breakdown
The official text states 'at least one specified anti-obesity medication' but does not define which medications are included in this summary.
Obesity Prevention Treatment Parity Act
Starting January 1, 2026, health plans that cover outpatient prescription drugs must include coverage for at least one specified anti-obesity medication and intensive behavioral therapy without requiring prior authorization.
What This Bill Does
- Requires individual or group health care service plan contracts and insurance policies issued, amended, or renewed on or after January 1, 2026 to cover specific obesity treatments if they already provide outpatient prescription drug benefits.
- Mandates coverage for at least one specified anti-obesity medication.
- Mandates coverage for intensive behavioral therapy used to treat obesity.
- Prohibits insurers from requiring prior authorization before providing the required medication and therapy.
Who It Names or Affects
- Health care service plans regulated by the Department of Managed Health Care.
- Disability and health insurers regulated by the Department of Insurance.
- Individuals or groups with qualifying policies issued, amended, or renewed on or after January 1, 2026.
Terms To Know
- Prior authorization
- A requirement for a patient to get approval from their insurer before receiving treatment or medication.
- Intensive behavioral therapy
- Therapy designed to treat obesity, which must be covered by qualifying plans without prior authorization.
Limits and Unknowns
- The official text does not list the specific names of the anti-obesity medications that must be covered.
- This law applies only to policies issued, amended, or renewed on or after January 1, 2026.