State Health Plans and Medicaid May Soon Be Required to Cover Anti-Obesity Medications (Update)

Assembly Bill 5259, introduced and referred to the Assembly Health Committee on February 28, 2023, would require the State Health Benefits Program (SHBP), the School Employees Health Benefits Program (SEHBP), the State Medicaid program, and the NJ FamilyCare program to provide coverage for anti-obesity medications for subscribers or enrollees. Health professionals would be able to prescribe anti-obesity medications for patients with obesity-related health problems that have not been mitigated by diet and exercise alone. These programs would cover anti-obesity medication when there is a diagnosis of obesity or an obesity-related medical condition; anti-obesity medication is prescribed; and the prescribed anti-obesity medication is dispensed by an approved pharmacy.

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