HB 3517
Requires a policy or certificate of health insurance or health care services contract offered by a health care service contractor in this state, state medical assistance and health benefit plans offered by the Public Employees' Benefit Board and the Oregon Educators Benefit Board to cover certain treatments for an obesity diagnosis with certain requirements.
Jurisdiction
Oregon
Session
2025 Regular Session
Committee
Behavioral Health and Health Care
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Sign in to take action- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill requires certain health insurers, including Oregon’s state medical assistance and health benefit plans (OHP, PEBB, and OEBB), to cover specific treatments for obesity diagnoses. These treatments include intensive health behavior and lifestyle treatment, metabolic and bariatric surgery, and obesity medication. The bill also establishes definitions for these treatments and outlines how coverage should be administered, potentially including telemedicine options and subject to standard utilization review processes. The provisions are set to take effect on January 1, 2026 for most plans and on January 1, 2027 for others.
Key provisions
- Defines ‘intensive health behavior and lifestyle treatment’ as evidence-based interventions for weight management.
- Defines ‘metabolic and bariatric surgery’ according to established guidelines.
- Defines ‘obesity medication’ as FDA-approved drugs for chronic weight management.
- Requires health insurance policies to cover diagnosis and treatment of obesity, including the specified treatments.
- Allows for coverage of obesity treatment under standard utilization review processes.
- Specifies that intensive health behavioral and lifestyle treatment can be provided through various settings, including in-office, community-based, and telemedicine.
- Amends ORS 414.761 to include coverage for obesity treatments for medical assistance recipients.
- Amends ORS 243.144 and 243.877 to align with the new coverage requirements for state employee benefit plans.
Who is affected
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