Medicare obesity bill expands providers and would require drug coverage

What does this do?

HR 4231 makes two changes to Medicare. It opens intensive behavioral therapy for obesity to more provider types beyond primary care doctors, including nurse practitioners, physician assistants, clinical psychologists, registered dietitians, and approved community-based programs. It also would require Medicare Part D to cover medications prescribed for obesity or weight loss in overweight patients with related conditions such as diabetes or high blood pressure, taking effect two years after enactment.

Who does it affect?

The bill primarily affects Medicare beneficiaries, mostly Americans 65 and older, who are dealing with obesity or being overweight. Healthcare providers who treat those patients, Medicare Part D insurance plans, and the federal government are also affected.

Why does it matter?

Expanding covered providers and requiring drug coverage would likely increase costs to the federal government and insurance plans participating in Medicare. The Secretary of Health and Human Services would be required to report to Congress every two years on how the changes are working.

What does it cost, and who pays?

• More providers eligible to bill Medicare
• Part D must cover obesity drugs
• Costs fall on federal gov't and plans