HR4231-119

What This Bill Does

The Treat and Reduce Obesity Act responds to high obesity prevalence and costs among older adults by broadening Medicare treatment tools. It allows the Secretary of Health and Human Services to cover intensive behavioral therapy for obesity furnished not only by primary care physicians and practitioners, but also by other physicians, physician assistants, nurse practitioners, clinical nurse specialists, clinical psychologists, registered dietitians or nutrition professionals, and approved evidence-based community lifestyle counseling programs. Non-primary-care providers and programs must operate by referral from and coordination with a physician or primary care practitioner and in approved settings. The bill also changes Medicare Part D so drugs used to treat obesity, or weight-loss management for overweight individuals with related comorbidities, are not excluded as weight-loss drugs, applying to plan years starting two years after enactment. HHS must report to Congress within one year and every two years thereafter on implementation and coordination of obesity research and clinical-care programs.

Who Benefits and How

Medicare beneficiaries with obesity benefit because more provider types and community programs could furnish covered intensive behavioral therapy. Medicare beneficiaries using obesity medications benefit because Part D plans could cover qualifying obesity and weight-management drugs. Registered dietitians benefit because the Secretary may cover their intensive behavioral therapy services for obesity. Community lifestyle counseling programs benefit because evidence-based programs approved by HHS can become Medicare-covered therapy providers.

Who Bears the Burden and How

The Secretary of Health and Human Services must decide covered providers, approve programs, coordinate implementation, and report every two years. Medicare Part D plans must prepare to cover obesity medications for plan years beginning two years after enactment. Federal Medicare spending may rise as more therapy providers and obesity drugs become covered. Primary care practitioners must coordinate referrals and receive treatment plans from non-primary-care therapy providers or programs.

Key Provisions

• Authorizes HHS to cover intensive behavioral therapy for obesity furnished by additional clinicians and community lifestyle counseling programs.
• Requires referral from and coordination with physicians or primary care practitioners for non-primary-care obesity therapy providers.
• Expands Medicare Part D coverage to obesity-treatment medications and weight-loss management drugs for overweight beneficiaries with comorbidities.
• Requires HHS implementation reports within one year and every two years thereafter.