BILL NUMBER: AB 859	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MARCH 26, 2015

INTRODUCED BY   Assembly Member Medina

                        FEBRUARY 26, 2015

   An act  to add Article 4.6 (commencing with Section 14146) to
Chapter 7 of Part 3 of Division 9 of, and to repeal Section 14146.1
of, the Welfare and Institutions Code,   relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 859, as amended, Medina. Medi-Cal: obesity treatment plans.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing law specifies the benefits
provided pursuant to the program. 
   This bill would declare the intent of the Legislature to enact
legislation to provide beneficiaries in the Medi-Cal program who have
been diagnosed by a physician and surgeon as obese or morbidly obese
with a comprehensive obesity treatment plan.  
   This bill would require the department, on or before December 31,
2016, to create an Obesity Treatment Action Plan to diagnose, treat,
and reduce the incidence of adult obesity in the Medi-Cal program.
The bill would require the department to report the plan to the
Legislature, along with any legislative recommendations to implement
the plan. The bill would require the plan to include evidence-based
principles and obesity treatment guidelines from specified provider
associations, a plan for identifying and screening patients for
obesity, and a review of coverage services to treat obesity. The bill
would provide that the plan apply only to noncapitated payment plans
in Medi-Cal. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Article 4.6 (commencing with Section
14146) is added to Chapter 7 of Part 3 of Division 9 of the 
 Welfare and Institutions Code   , to read:  

      Article 4.6.  Treatment and Reduction of Obesity Act


   14146.  The Legislature finds and declares all of the following:
   (a) Obesity is a chronic disease and increases the risk of, and
aggravates, cardiovascular disease, cancer, diabetes, and arthritis.
Obesity is the only chronic disease for which Americans face
prohibitions for access to treatment.
   (b) Twenty-five percent of California's population has obesity. Of
this population, 37.7 percent are African American and 31.3 percent
are Hispanic.
   (c) In the 2014 Medi-Cal Statistical Report, the department found
that the proportion of adults suffering with obesity was the highest
among adults enrolled in Medi-Cal, higher than the privately insured
market and the uninsured population.
   (d) Treatment of an individual with obesity should include an
individualized treatment plan and should be able to include
medications, very low calorie diets, surgery, and lifestyle changes
such as diet, exercise, and behavioral therapy.
   (e) In addition to the improved health of patients, by confronting
obesity and reducing the average Body Mass Index (BMI) by just 5
percent, significant savings can be achieved. Reducing the BMI by 5
percent in just five years could save California approximately $28.9
billion. By 2030, California's potential savings could be 7.6 percent
in overall health care spending.
   14146.1.  (a) On or before December 31, 2016, the department shall
create an Obesity Treatment Action Plan (OTAP) to diagnose, treat,
and reduce the incidence of adult obesity in the Medi-Cal program,
and shall report the plan to the Legislature along with any
legislative recommendations to implement the plan.
   (b) The OTAP shall apply only to noncapitated payment plans in
Medi-Cal.
   (c) The OTAP shall include evidence-based principles and obesity
treatment guidelines from nationally recognized provider
associations, including, but not limited to, the following:
   (1) The American Society of Bariatric Physicians.
   (2) The Endocrine Society.
   (3) The American Association of Clinical Endocrinologists.
   (4) The Academy of Nutrition and Dietetics and the American
Society of Metabolic and Bariatric Surgery.
   (5) The Obesity Society.
   (d) The OTAP shall include all of the following:
   (1) A plan for educating fee-for-service physicians regarding the
importance of screening for obesity and treatment options available
in Medi-Cal.
   (2) A plan for identifying and screening patients for obesity.
   (3) A review of current coverage of services to treat obesity and
recommendations with evidence-based rationale on the continuum of
coverage of additional obesity treatment services, including
nutritional, exercise, and lifestyle counseling and pharmacotherapy.
   (e) (1) A report to be submitted pursuant to subdivision (a) shall
be submitted in compliance with Section 9795 of the Government Code.

   (2) Pursuant to Section 10231.5 of the Government Code, this
section is repealed on January 1, 2021.  
       
  SECTION 1.    It is the intent of the Legislature
to enact legislation to provide beneficiaries in the Medi-Cal program
who have been diagnosed by a physician and surgeon as obese or
morbidly obese with a comprehensive obesity treatment plan.