indiana law on obesity

[jillrn 0]

I found this on Indiana law website anyone good at interpreting the law?? It seems to me this says they have to approve me.

February 4, 2005

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<!-- End of font TimesNewRomanRegular with size 10 --><!-- Font changed to TimesNewRomanRegular with size 19 -->SENATE BILL No. 360

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DIGEST OF SB 360 <!-- End of font TimesNewRomanRegular with size 12 --><!-- Font changed to TimesNewRomanRegular with size 9 -->(Updated February 2, 2005 11:21 am - DI 104) <!-- End of font TimesNewRomanRegular with size 9 --><!-- Font changed to TimesNewRomanRegular with size 12 -->

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Citations Affected: IC 5-10; IC 27-8; IC 27-13; noncode.

Synopsis: Coverage of surgery for morbid obesity. Removes language in the morbid obesity definition that refers to weight guidelines in the Metropolitan Life Insurance table. Prohibits: (1) the state employee insurance plan; (2) an insurer that issues an accident and sickness insurance policy; and (3) a health maintenance organization that provides basic health care services; from providing coverage for surgical treatment of morbid obesity for an individual who is less than 19 years of age unless two physicians determine that the surgery is necessary to save the life of the individual.

Effective: July 1, 2005.

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Miller

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<!-- End of font TimesNewRomanRegular with size 19 --><!-- Font changed to TimesNewRomanRegular with size 8 --> January 11, 2005, read first time and referred to Committee on Health and Provider Services.

February 3, 2005, amended, reported favorably _ Do Pass.

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February 4, 2005

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First Regular Session 114th General Assembly (2005)

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PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in <STRIKE>this</STRIKE> <STRIKE>style</STRIKE> <STRIKE>type.</STRIKE>

Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.

Conflict reconciliation: Text in a statute in this style type or <STRIKE>this</STRIKE> <STRIKE>style</STRIKE> <STRIKE>type</STRIKE> reconciles conflicts between statutes enacted by the 2004 Regular Session of the General Assembly.

<!-- End of font TimesNewRomanRegular with size 8 --><!-- Font changed to TimesNewRomanRegular with size 19 -->SENATE BILL No. 360

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<!-- End of font TimesNewRomanRegular with size 19 --><!-- Font changed to TimesNewRomanRegular with size 10 --> A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Be it enacted by the General Assembly of the State of Indiana:

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SOURCE: IC 5-10-8-7.7; (05)SB0360.1.1. --> SECTION 1. IC 5-10-8-7.7 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2005]: Sec. 7.7. (a) As used in this section, "covered individual" means an individual who is:

(1) covered under a self-insurance program established under section 7( of this chapter to provide group health coverage; or

(2) entitled to services under a contract with a prepaid health care delivery plan that is entered into or renewed under section 7© of this chapter.

<STRIKE>(a)</STRIKE> ( As used in this section, "health care plan" means:

(1) a self-insurance program established under section 7( of this chapter to provide group health coverage; or

(2) a contract entered into under section 7© of this chapter to provide health services through a prepaid health care delivery plan.

<STRIKE>(</STRIKE> © As used in this section, "health care provider" means a:

(1) physician licensed under IC 25-22.5; or <HR> (2) hospital licensed under IC 16-21;

that provides health care services for surgical treatment of morbid obesity.

<STRIKE>©</STRIKE> (d) As used in this section, "morbid obesity" means:

<STRIKE>(1)</STRIKE> <STRIKE>a</STRIKE> <STRIKE>weight</STRIKE> <STRIKE>of</STRIKE> <STRIKE>at</STRIKE> <STRIKE>least</STRIKE> <STRIKE>two</STRIKE> <STRIKE>(2)</STRIKE> <STRIKE>times</STRIKE> <STRIKE>the</STRIKE> <STRIKE>ideal</STRIKE> <STRIKE>weight</STRIKE> <STRIKE>for</STRIKE> <STRIKE>frame,</STRIKE> <STRIKE>age,</STRIKE> <STRIKE>height,</STRIKE> <STRIKE>and</STRIKE> <STRIKE>gender,</STRIKE> <STRIKE>as</STRIKE> <STRIKE>specified</STRIKE> <STRIKE>in</STRIKE> <STRIKE>the</STRIKE> <STRIKE>1983</STRIKE> <STRIKE>Metropolitan</STRIKE> <STRIKE>Life</STRIKE> <STRIKE>Insurance</STRIKE> <STRIKE>tables;</STRIKE>

<STRIKE>(2)</STRIKE> (1) a body mass index of at least thirty-five (35) kilograms per meter squared, with comorbidity or coexisting medical conditions such as hypertension, cardiopulmonary conditions, sleep apnea, or diabetes; or

<STRIKE>(3)</STRIKE> (2) a body mass index of at least forty (40) kilograms per meter squared without comorbidity.

For purposes of this subsection, body mass index is equal to weight in kilograms divided by height in meters squared.

<STRIKE>(d)</STRIKE> (e) Except as provided in subsection (f), the state shall provide coverage for nonexperimental, surgical treatment by a health care provider of morbid obesity:

(1) that has persisted for at least five (5) years; and

(2) for which nonsurgical treatment that is supervised by a physician has been unsuccessful for at least eighteen (18) consecutive months.

(f) The state may not provide coverage for surgical treatment of morbid obesity for a covered individual who is less than nineteen (19) years of age unless two (2) physicians licensed under IC 25-22.5 determine that the surgery is necessary to save the life of the individual.

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SOURCE: IC 27-8-14.1-3; (05)SB0360.1.2. --> SECTION 2. IC 27-8-14.1-3 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2005]: Sec. 3. As used in this chapter, "morbid obesity" means:

<STRIKE>(1)</STRIKE> <STRIKE>a</STRIKE> <STRIKE>weight</STRIKE> <STRIKE>of</STRIKE> <STRIKE>at</STRIKE> <STRIKE>least</STRIKE> <STRIKE>two</STRIKE> <STRIKE>(2)</STRIKE> <STRIKE>times</STRIKE> <STRIKE>the</STRIKE> <STRIKE>ideal</STRIKE> <STRIKE>weight</STRIKE> <STRIKE>for</STRIKE> <STRIKE>frame,</STRIKE> <STRIKE>age,</STRIKE> <STRIKE>height,</STRIKE> <STRIKE>and</STRIKE> <STRIKE>gender,</STRIKE> <STRIKE>as</STRIKE> <STRIKE>specified</STRIKE> <STRIKE>in</STRIKE> <STRIKE>the</STRIKE> <STRIKE>1983</STRIKE> <STRIKE>Metropolitan</STRIKE> <STRIKE>Life</STRIKE> <STRIKE>Insurance</STRIKE> <STRIKE>tables;</STRIKE>

<STRIKE>(2)</STRIKE> (1) a body mass index of at least thirty-five (35) kilograms per meter squared, with comorbidity or coexisting medical conditions such as hypertension, cardiopulmonary conditions, sleep apnea, or diabetes; or

<STRIKE>(3)</STRIKE> (2) a body mass index of at least forty (40) kilograms per meter squared without comorbidity.

For purposes of this section, body mass index is equal to weight in kilograms divided by height in meters squared.

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SOURCE: IC 27-8-14.1-4; (05)SB0360.1.3. --> SECTION 3. IC 27-8-14.1-4 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2005]: Sec. 4. (a) Except as provided in subsection (, an insurer that issues an accident and sickness insurance policy shall offer coverage for nonexperimental, surgical treatment by a health care provider of morbid obesity:

(1) that has persisted for at least five (5) years; and

(2) for which nonsurgical treatment that is supervised by a physician has been unsuccessful for at least eighteen (18) consecutive months.

( An insurer that issues an accident and sickness insurance policy may not provide coverage for a surgical treatment of morbid obesity for an insured who is less than nineteen (19) years of age unless two (2) physicians licensed under IC 25-22.5 determine that the surgery is necessary to save the life of the individual.

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SOURCE: IC 27-13-7-14.5; (05)SB0360.1.4. --> SECTION 4. IC 27-13-7-14.5 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2005]: Sec. 14.5. (a) As used in this section, "health care provider" means a:

(1) physician licensed under IC 25-22.5; or

(2) hospital licensed under IC 16-21;

that provides health care services for surgical treatment of morbid obesity.

( As used in this section, "morbid obesity" means:

<STRIKE>(1)</STRIKE> <STRIKE>a</STRIKE> <STRIKE>weight</STRIKE> <STRIKE>of</STRIKE> <STRIKE>at</STRIKE> <STRIKE>least</STRIKE> <STRIKE>two</STRIKE> <STRIKE>(2)</STRIKE> <STRIKE>times</STRIKE> <STRIKE>the</STRIKE> <STRIKE>ideal</STRIKE> <STRIKE>weight</STRIKE> <STRIKE>for</STRIKE> <STRIKE>frame,</STRIKE> <STRIKE>age,</STRIKE> <STRIKE>height,</STRIKE> <STRIKE>and</STRIKE> <STRIKE>gender</STRIKE> <STRIKE>as</STRIKE> <STRIKE>specified</STRIKE> <STRIKE>in</STRIKE> <STRIKE>the</STRIKE> <STRIKE>1983</STRIKE> <STRIKE>Metropolitan</STRIKE> <STRIKE>Life</STRIKE> <STRIKE>Insurance</STRIKE> <STRIKE>tables;</STRIKE>

<STRIKE>(2)</STRIKE> (1) a body mass index of at least thirty-five (35) kilograms per meter squared with comorbidity or coexisting medical conditions such as hypertension, cardiopulmonary conditions, sleep apnea, or diabetes; or

<STRIKE>(3)</STRIKE> (2) a body mass index of at least forty (40) kilograms per meter squared without comorbidity.

For purposes of this subsection, body mass index equals weight in kilograms divided by height in meters squared.

© Except as provided in subsection (d), a health maintenance organization that provides coverage for basic health care services under a group contract shall offer coverage for nonexperimental, surgical treatment by a health care provider of morbid obesity:

(1) that has persisted for at least five (5) years; and

(2) for which nonsurgical treatment that is supervised by a physician has been unsuccessful for at least eighteen (18) consecutive months.

(d) A health maintenance organization that provides coverage for basic health care services may not provide coverage for surgical treatment of morbid obesity for an enrollee who is less than nineteen (19) years of age unless two (2) physicians licensed under IC 25-22.5 determine that the surgery is necessary to save the life of the individual.

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SOURCE: ; (05)SB0360.1.5. --> SECTION 5. [EFFECTIVE JULY 1, 2005] (a) IC 5-10-8-7.7(f), as added by this act, applies to a self-insurance program or a contract with a prepaid health care delivery plan that is established, entered into, delivered, amended, or renewed after June 30, 2005.

( IC 27-8-14.1-4(, as added by this act, applies to an accident and sickness insurance policy that is issued, delivered, amended, or renewed after June 30, 2005.

© IC 27-13-7-14.5(d), as added by this act, applies to a health maintenance organization contract that is entered into, delivered, amended, or renewed after June 30, 2005.

[Wheetsin 714]

Are you a public employee?

[jillrn 0]

NO I am not I am privately insured but this does not indicate it is for public employees at the top it even says "to amend Indiana code concerning insurance"

[Wheetsin 714]

I'm sorry if it's not what you want to hear, but I'm just trying to help.

What you're seeing does not indicate it's for public employees because you are not seeing the full version, you are seeing a very very small piece of a larger document.

5-10-8 is a provision for "Group Insurance for Public Employees." The part that I believe has interested you, "...the state shall provide coverage for nonexperimental, surgical treatment by a health care provider of morbid obesity" is part of Chapter 8 - for public employees.

You can find Chapter 8 (title intact) here.

[jillrn 0]

Thank you-- I am just wanting to know the facts whether I want to hear it or not! =) Jill