08-03-2023_BoardBook

OMA 2023

OMA Board of Trustees Board Meeting Book

August 3, 2023 CONTENT CONFIDENTIAL – DO NOT SHARE CONTENT OUTSIDE OMA

Board of Trustees (BOT) Meeting August 3, 2023 5:00--7:00 PM EDT

Zoom Information: https://obesitymedicine-org.zoom.us/j/86288809712?pwd=Ym9MUjcrL0NXQVNHVjVxMXdpODRsUT09 Meeting ID: 862 8880 9712 Passcode: 058906 Dial-In Information: 719-359-4580; 86288809712# Presiding Officer: Dr. Angela Fitch Time Topic Lead Action 5:00 PM Call to Order & Opening Remarks Fitch 5:02 PM Roll Call Censani 5:04 PM Approval of the Agenda Fitch Vote 5:06 PM Conflict of Interest Disclosures Fitch Discussion 5:08 PM Approval of the Consent Agenda and Supporting Documents Fitch Vote 5:10 PM BOT Policy Review: Bylaws BOT Travel Policy Position Statement Proposal Lazarus/Fitch/Wilson Fraker Lazarus/Fitch Discussion, Vote

Treat or Refer Campaign Updates, PRIME CME Collaboration + Adding Project Manager to OMA Staffing Standards Development Work and International Obesity Collaborative Updates Dr. Bill McCarthy Recognition Placement of OMA's Annual Awards and Installation of Officers Ceremony in Spring Main Meeting IT & Marketing Department Updates Call to Adjourn and Closing Remarks

6:00 PM

Fraker, Fitch, Primack

Discussion, Vote

6:15 PM

Fitch

Discussion

6:25 PM

Fraker, Fitch

Discussion

6:40 PM

Fraker

Discussion

6:50 PM

Fraker

Discussion

7:00 PM

Fitch

Product

Company

Description

Type

Relationship

Board Member

CinRX is a biotech company founded in 2015 that is focused on the drug development sector.

Angela Fitch

Pharmaceuticals

CinRX

Pharmaceutical

Eli Lilly and Company discovers, develops, manufactures, and markets pharmaceutical products worldwide Drug Manufacturers—General

Pharmaceutical

Eli Lilly

Advisory Board

Gelesis is a biotechnology company developing first-in-class therapeutics to safely treat obese, overweight, and diabetic patients. Knownwell Inc. is a healthcare delivery company Merck & Co., Inc. is a global health care company. The Company offers health solutions through its prescription medicines, vaccines, biologic therapies and animal health products. Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Sidekick is a social health game. It is designed to motivate and engage people towards a healthy lifestyle. Sidekick allows people to communicate, collaborate and compete with friends and colleagues, while improving their lifestyle. Suvie builds a multi-zone cool to cook kitchen robot that makes 5 star meals with zero effort. Ms.Medicine is an innovative health care organization whose mission is to raise the standard of care of women’s health. Diet Program

Biotechnology, Medical Device, diabetes

Pharmaceuticals

Gelesis

Advisory Board

Pharmaceuticals

Knownwell Inc.

Biotechnology

Stock Ownership

Pharmaceuticals

Biotechnology, pharmaceutical

Merck

Editor

Pharmaceuticals

NovoNordisk

Biotechnology, pharmaceutical

Advisory Board

Biotechnology

Behavior App

Sidekick Health

Nutrition

Jenny Craig

Food and beverage

Science Advisory Board

Nutrition

Suvie

Food and beverage

Advisor

Turn-Key Business Solutions MsMedicine

Health Care

Advisory Board

FoundHealth.com offers information to help patients discover a range of treatments for their health challenges Health Care

Turn-Key Business Solutions Found Health

Advisory Board

This course covers critical topics in the prevention and treatment of obesity and related disorders presented by authorities from the country’s leading obesity treatment centers.

Harvard Blackburn Obesity Medicine

Education

Education

Co-Director

The American College of Physicians (ACP) is a national organization of internists, who specialize in the diagnosis, treatment, and care of adults Association

501C-6 / 501C-3 Organizations

American College of Physicians (ACP)

Member

The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest national society for this specialty. The vision of the Society is to improve public health and well being by lessening the burden of the disease of obesity and related diseases throughout the world. The Obesity Society (TOS) is the leading scientific society dedicated to the study of obesity.

501C-6 / 501C-3 Organizations 501C-6 / 501C-3 Organizations

American Society of Metabolic and Bariatric Surgery (ASMBS)

Association

Member

General Member, planning committee

The Obesity Society (TOS)

Association

Company Description

Type

Relationship

Product

Company

Board Member

Currax Pharmaceuticals LLC is a patient-first pharmaceutical company focused on the number one and number two preventable deaths in the United States: smoking addiction and obesity.

Ethan Lazarus

Pharmaceutical

Currax

Pharmaceutical

Speaker, Advisory Board

Eli Lilly and Company discovers, develops, manufactures, and markets pharmaceutical products worldwide Drug Manufacturers—General

Advisory Board - MAY 18th and 19th 2023

Pharmaceutical

Eli Lilly

Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Rhythm Pharmaceuticals is a commercial-stage biopharmaceutical company committed to transforming the care for patients living with rare genetic diseases of obesity.

Speakers Bureau

Pharmaceutical

NovoNordisk

Biotechnology, pharmaceutical

Consultant in development of hyperphagia assessment tool

Pharmaceutical

Rhythm Pharmaceuticals

Biotechnology, pharmaceutical

Nestlé Health Science is a leader in the field of nutritional science, committed to redefining the management of health. We offer an extensive portfolio of science-based consumer health, medical nutrition and supplement brands. This course covers critical topics in the prevention and treatment of obesity and related disorders presented by authorities from the country’s leading obesity treatment centers. The American Academy of Family Physicians (AAFP) was founded in 1947 to promote and maintain high quality standards for family medicine, an offshoot of the classical general practitioner. The Obesity Society (TOS) is the leading scientific society dedicated to the study of obesity. The American Medical Association (AMA) is an organization of American physicians, the objective of which is “to promote the science and art of medicine and the betterment of public health.” The Colorado Medical Society (CMS) is the largest group of organized physicians in Colorado. This nonprofit organization is 89bio is a clinical-stage biopharmaceutical company focused on the development and commercialization of innovative therapies for the treatment of liver and cardio-metabolic diseases. Allergan plc is an American, Irish domiciled pharmaceutical company that acquires, develops, manufactures and markets brand name drugs and medical devices in the areas of medical aesthetics, eye care, central nervous system, and gastroenterology. Medical devices in major areas (e.g. cardiovascular, neurology, orthopedic) Minimally invasive – surgery technologies including robotics and tracking Medical equipment: therapeutic and diagnostic Health and personal Care products Medical IT and healthcare web applications Aesthetic-medical technologies Altimmune is a clinical-stage biopharmaceutical company focused on the development of novel peptide based therapeutics for the treatment of obesity and liver diseases. Amgen Inc. is an American multinational biopharmaceutical company headquartered in Thousand Oaks, California Anji Pharma is a clinical-stage biotech company with operations in the U.S., Beijing, and Shanghai. AstraZeneca is a global, science-led biopharmaceutical company that focuses on the discovery, development and commercialization of prescription medicines. Company Description Company Description

Nutrition

Food and beverage

Nestle Nutrition

Advisory Board/Speaker

Harvard Blackburn Obesity Medicine

Education

Education

Presenter

501C-6 / 501C-3 Organizations 501C-6 / 501C-3 Organizations

American Academy of Family Physicians

Association

Member

The Obesity Society (TOS)

Association

Member/Speaker

501C-6 / 501C-3 Organizations

American Medical Association (AMA)

Association

Member, Delegate for OMA

composed of physicians, residents and medical students. It was founded in 1871 to promote the art and science of medicine and to improve public health. Association

501C-6 / 501C-3 Organizations

Colorado Medical Society

Member

Product

Company

Type

Relationship

Board Member Lydia Alexander

Type

Relationship

Product

Company

Board Member

Received Grant, Consultant/Advisor

Harold Bays

Pharmaceuticals

89Bio

Biopharmaceutical

Pharmaceuticals

Allergan

Pharmaceutical

Received Grant

Pharmaceuticals

Alon Medteck/Epitomee

Devices, therapeutics

Received Grant

Pharmaceuticals

Altimmune

Biopharmaceutical

Received Grant

Received Grant, Consultant/Advisor

Pharmaceuticals

Amgen

Biopharmaceutical

Pharmaceuticals

Anji Pharma

Biotech

Received Grant

Pharmaceuticals

AstraZeneca

Biopharmaceutical

Received Grant

Axsome Therapeutics, Inc. is a biopharmaceutical company developing novel therapies for central nervous system (CNS) conditions that have limited treatment options. Biohaven is a clinical-stage biopharmaceutical company with proven leadership in industry and academic settings. Bionime was established in April 2003 with the goal of improving the lives of people with diabetes through better self-monitoring. Bionime is focused on designing and manufacturing accurate medical testing equipment. Boehringer Ingelheim is a pharmaceutical company that develops innovative healthcare products for both human & animal needs. CinCor is a clinical-stage biopharmaceutical company targeting cardiovascular, metabolic and kidney diseases CSL Behring is a biopharmaceutical company, manufacturing plasma derived and recombinant therapeutic products Esperion Therapeutics, Inc. is a public American pharmaceutical company focused on the development of bempedoic acid, an orally available small molecule designed to lower elevated levels of LDL-C. Evidera provides evidence-based solutions to demonstrate the real-world effectiveness, safety, and value of biopharmaceutical and biotechnology products Gan & Lee Pharmaceuticals is a leading pharmaceutical company in China specializing in the development, production, and commercialization of recombinant insulin analogs and injection pens,* with plans to expand globally. Madrigal is a clinical-stage biopharmaceutical company pursuing novel therapeutics for fatty liver diseases. Matinas Biopharma Holdings, Inc. is a biopharmaceutical company. The Company is focused on redefining the intracellular delivery of nucleic acids and small molecules through its lipid nanocrystal (LNC) drug delivery platform. Merck & Co., Inc. is a global health care company. The Company offers health solutions through its prescription medicines, vaccines, biologic therapies and animal health products. NewAmsterdam Pharma is a clinical stage company focused on the research and development of transformative therapies for cardio-metabolic diseases.

Pharmaceuticals

Biopharmaceutical

Axsome

Received Grant

Pharmaceuticals

Biopharmaceutical

Received Grant

BioHaven

Pharmaceuticals

Biotechnology

Received Grant

Bionime

Biotechnology, Medical, Pharmac eutical

Pharmaceuticals

Boehringer Ingelheim

Received Grant

Pharmaceutical

CinCor

Biopharmaceutical

Received Grant

Pharmaceutical

CSL Behring

Biopharmaceutical

Received Grant

Eli Lilly and Company discovers, develops, manufactures, and markets pharmaceutical products worldwide Drug Manufacturers—General

Pharmaceutical

Eli Lilly

Received Grant

Received Grant, Consultant/Advisor

Pharmaceutical

Esperion

Pharmaceutical

Biopharmaceutical, biotechnology

Pharmaceutical

Evidera

Received Grant

Pharmaceutical

Gan and Lee

Pharmaceutical

Received Grant

Pharmaceutical

Madrigal

Biopharmaceutical

Received Grant

Pharmaceutical

Matinas

Biopharmaceutical

Received Grant

Pharmaceutical

Merck

Biotechnology, pharmaceutical

Received Grant

Pharmaceutical

New Amsterdam

Pharmaceutical

Received Grant

Novartis AG is a Switzerland-based pharmaceutical company. The Company develops, manufactures, and markets branded and generic prescription drugs, active pharmaceutical ingredients (APIs), biosimilars and ophthalmic products. Pharmaceutical

Pharmaceutical

Novartis

Received Grant

Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Pfizer is a pharmaceuticals and biotechnology company. Regerenron is a leading biotechnology company that invents life-transforming medicines for people with serious diseases

Pharmaceutical

NovoNordisk

Biotechnology, pharmaceutical

Received Grant

Pharmaceutical

Pfizer

Biotechnology, pharmaceutical

Received Grant

Pharmaceutical

Regerenron

Biotechnology

Received Grant

Sanofi S.A. is a French multinational pharmaceutical and healthcare company headquartered in Paris, France. We are a clinical-stage biopharmaceutical company dedicated to bringing novel treatments to people who suffer from migraine and other debilitating conditions. Selecta Biosciences is a clinical stage biotechnology company with a commitment to solving the challenges associated with autoimmunity and unwanted immunogenicity through our pioneering ImmTOR® precision immune tolerance platform. VIVUS, Inc. is a biopharmaceutical company developing therapies for obesity, sleep apnea, diabetes and sexual health. Home Access Health Corporation, which is now a subsidiary of Everly Metavante Technologies, Inc., through its subsidiary, Metavante Corporation, provided financial technology services, software and financial services regulatory advice and consulting to its customers, consisting primarily of small to large sized financial institutions. An Academic Research Organization of Brigham & Women's Hospital and An Affiliate of Harvard Medical School The Obesity Society (TOS) is the leading scientific society dedicated to the study of obesity. The ASPC, founded in 1985, represents a multidisciplinary group of healthcare practitioners and researchers who share an interest in and a passion for preventive cardiology. Endocrine Society is a global community of endocrine investigators and clinicians focused on improving patient care, advancing research, shaping effective policy, and ensuring the future of endocrinology. Practice Management Software The American College of Cardiology, a 49,000-member nonprofit medical society, enhances the lives of cardiovascular patients through continuous quality improvement, patient-centered care, payment innovation, and professionalism. The ADA's mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. The National Lipid Association is a 501(c)(3) organization formed in 2008 to serve as a patient education organization in the field of clinical lipidology.

Pharmaceutical

Sanofi

Pharmaceutical

Received Grant

Pharmaceutical

Biopharmaceutical

Received Grant

Satsuma

Pharmaceutical

Biotechnology

Received Grant

Selecta

Pharmaceutical

Vivus

Biopharmaceutical

Received Grant

Health, was founded to provide customers with health information through simple, self-collected lab tests Health Care

Laboratory Testing Legal Technology

Home Access

Received Grant Received Grant

Lexicon

Legal Technology

Technology

Metavant

Business Tools

Received Grant

501C-6 / 501C-3 Organizations 501C-6 / 501C-3 Organizations

TIMI

Education

Received Grant

General Member, Fellow, Speaker

The Obesity Society (TOS)

Association

The American Society of Preventative Cardiology (ASPC)

501C-6 / 501C-3 Organizations

Association

Board Member, Fellow, Speaker

501C-6 / 501C-3 Organizations

The Endocrine Society

Association

Member

AACE is the organization focused on endocrinology, diabetes and metabolism that is most: Recognized worldwide for its clinical leadership Association

American Association of Clinical Endocrinologists (AACE)

501C-6 / 501C-3 Organizations

Member

501C-6 / 501C-3 Organizations 501C-6 / 501C-3 Organizations

American College of Cardiology (ACC)

Association

Member, Fellow, Speaker

American Diabetes Association (ADA)

Association

Member

501C-6 / 501C-3 Organizations

The National Lipid Association

Association

Producing a joint statement

Product

Company

Type

Relationship

Board Member

Company Description

Endocrine Society is a global community of endocrine investigators and clinicians focused on improving patient care, advancing research, shaping effective policy, and ensuring the future of endocrinology.

501C-6 / 501C-3 Organization+A69s

Marisa Censani

Member

The Endocrine Society

Association

The Pediatric Endocrine Society invites members to form Special Interest Groups (SIGs). SIGs provide a venue for members to network with other colleagues sharing similar interests, to provide a forum to discuss issues concerning topics relevant to the SIGs, and work towards goals that will benefit our patients and the membership of the Pediatric Endocrine Society at large. Currax Pharmaceuticals LLC is a patient-first pharmaceutical company focused on the number one and number two preventable deaths in the United States: smoking addiction and obesity. Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Phenomix is a drug discovery and development company building a portfolio of novel therapeutics for the treatment of major human diseases VIVUS, Inc. is a biopharmaceutical company developing therapies for obesity, sleep apnea, diabetes and sexual health. Nestlé Health Science is a leader in the field of nutritional science, committed to redefining the management of health. We offer an extensive portfolio of science-based consumer health, medical nutrition and supplement brands. Illinois Obesity Society is a group of health care professionals dedicated to improving the treatment of Obesity in Illinois. Company Description

501C-6 / 501C-3 Organization+A69s

Pediatric Endocrine Society (SIG)

Member, completed a three-year term as co-chair

Association

Type

Relationship

Product

Company

Board Member

Anthony Auriemma

Pharmaceuticals

Currax

Pharmaceutical

Speakers Bureau

Pharmaceuticals

NovoNordisk

Biotechnology, pharmaceutical

Speakers Bureau

Pharmaceuticals

Phenomix

Biotechnology, pharmaceutical

Consulting

Pharmaceuticals

Vivus

Biopharmaceutical

Speaker Bureau

Nutrition

Nestle Nutrition

Food and beverage

Consulting

501C-6 / 501C-3 Organizations

Illinois Obesity Society

Association

Board of Trustee Member

Type

Product

Company

Relationship

Board Member

Company Description

Eli Lilly and Company discovers, develops, manufactures, and markets pharmaceutical products worldwide Drug Manufacturers—General

Sandra Christensen

Pharmaceuticals

Eli Lilly

Advisory Board

Gelesis is a biotechnology company developing first-in-class therapeutics to safely treat obese, overweight, and diabetic patients. Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. The Obesity Society (TOS) is the leading scientific society dedicated to the study of obesity.

Biotechnology, Medical Device, diabetes

Pharmaceuticals

Gelesis

Advisory Board

Pharmaceuticals

NovoNordisk

Biotechnology, pharmaceutical

Speakers Bureau

501C-6 / 501C-3 Organization+A69s

The Obesity Society (TOS)

Association

General Member

The Washington Obesity Society is a coalition dedicated to creating a community resource for providers in the growing field of obesity medicine. Association

501C-6 / 501C-3 Organization+A69s

Washington Obesity Society

Trustee

AANP empowers all NPs to advance accessible, person-centered, equitable, high-quality health care for diverse communities through practice, education, advocacy, research and leadership.

501C-6 / 501C-3 Organization+A69s

the American Association of Nurse Practitioners (AANP).

Member, speaker

Association

Product

Company

Type

Relationship

Board Member

Company Description

Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Rhythm Pharmaceuticals is a commercial-stage biopharmaceutical company committed to transforming the care for patients living with rare genetic diseases of obesity. The American Academy of Pediatrics (AAP) and its member pediatricians dedicate their efforts and resources to the health, safety and well-being of infants, children, adolescents and young adults.

Suzanne Cuda

Pharmaceutical

NovoNordisk

Biotechnology, pharmaceutical

Advisory Board

Pharmaceutical

Rhythm Pharmaceuticals

Biotechnology, pharmaceutical

Gold Faculty

501C-6 / 501C-3 Organization+A69s

American Academy of Pediatrics

Association

Member

The Obesity Society (TOS) is the leading scientific society dedicated to the study of obesity.

501C-6 / 501C-3 Organization+A69s

The Obesity Society (TOS)

Association

General Member

Product

Company

Type

Relationship

Board Member

Company Description

Course and consulting business to help physicians start obesity medicine practices The American Medical Association (AMA) is an organization of American physicians, the objective of which is “to promote the science and art of medicine and the betterment of public health.”

Carolynn Francavilla Brown

Education

Weight Care Consulting

Health Care

Owner

501C-6 / 501C-3 Organization+A69s

American Medical Association (AMA)

Governing Council for private practice physicians

Association

Type

Relationship

Product

Company

Board Member

Company Description

Michelle Freshwater Board Member

Product

Company

Type

Relationship

Company Description

Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Product sales in obesity medicine practice

Sylvia Gonsahn-Bollie

Pharmaceuticals

NovoNordisk

Biotechnology, pharmaceutical

Consulting

Education

Shaklee Corporation

Health Care

Ambassador

Physicians.com

Medical director

Relationship

Product

Company

Type

Board Member Bharti K. Shetye

Company Description

Type

Relationship

Product

Company

Company Description

Board Member

Currax Pharmaceuticals LLC is a patient-first pharmaceutical company focused on the number one and number two preventable deaths in the United States: smoking addiction and obesity. Gelesis is a biotechnology company developing first-in-class therapeutics to safely treat obese, overweight, and diabetic patients. Phenomix is a drug discovery and development company building a portfolio of novel therapeutics for the treatment of major human diseases. Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. Medical educational company The Obesity Society (TOS) is the leading scientific society dedicated to the study of obesity. The American Medical Association (AMA) is an organization of American physicians, the objective of which is “to promote the science and art of medicine and the betterment of public health.”

Craig Primack

Pharmaceuticals

Currax

Pharmaceutical

Speakers Bureau

Biotechnology, Medical Device, diabetes

Pharmaceuticals

Gelesis

Advisory Board

Pharmaceuticals

Phenomix

Biotechnology, pharmaceutical

Advisor

Nutrition Education Education

Nestle Nutrition

Food and beverage

Co-Medical Director

Paradigm Pri-Med

Education

Faculty

Continuing medical education (CME) Education

CME Speaker

501C-6 / 501C-3 Organization+A69s

The Obesity Society (TOS)

Association

General Member

501C-6 / 501C-3 Organization+A69s

American Medical Association (AMA)

Association

Member

Rules of Order Policy Board Approved September 2017

Rules of Order for Board Meetings Quorum: Our bylaws state that a quorum is present if the majority of the board is present.

Order of the day: Each meeting will have an agenda which will include points to discuss, old business and new business. The leader of the meeting is referred to as the “Chair.” This may be the chairman of the board, the president, or the highest-ranking officer present at the meeting. Items to discuss: All board members may submit items to discuss. These items must be submitted at least 2 weeks prior to the scheduled meeting. Items must be submitted electronically as editable Microsoft word documents. Items must include: the person (or persons, committee, etc.) introducing the item and the date of submission. Items should be marked as informational items (board updates), discussion items (not asking for action), or action items. For action items, the specific action being requested by the board should be clearly indicated. Late items: From time to time, items of critical importance may need to be introduced within 2 weeks of the board meeting. These items will be marked in the board book as “Late” and will only be discussed after a majority vote of the board to discuss the item. Motions: Introducing a main motion 1) The chair may call on the person responsible for the next order of business. Or, when no one else has the floor, a board member may address the chair by proper title. After recognition by the chair, the board member may make a motion. 2) To make a motion, state, “I move that…,” and state your motion. For example, “I move that we discuss item #4 regarding updating our travel policy…” Regarding the above items of business, the person who introduced the item of business and who’s name appears on the item of business should introduce the motion. 3) Another member may second your motion. A second simply means that the motion should be discussed. If the motion is not seconded, it is not up for discussion. It is not lost, as there has been no vote. 4) Only if there is a second, the chair states “It has been moved and seconded that…” (state the motion). “Is there any discussion?” 5) Only one main motion may be on the floor at a time. Discussing a motion 1) All speaking points should be limited to 3 minutes. This will be enforced with a timer, and an OMA staff person will be designated to monitor the timer. A different time limit (or no time limit) may also be used if requested by a majority of the quorum, either for a single item of business, or for the entire meeting. 2) The member who made the motion is entitled to speak to it first. 3) Every member may speak to the motion. Only the motion at hand should be spoken either for or against. Each member should clearly state whether they are speaking for or against the motion. 4) A person may not speak against their own motion (however, they can vote against their own motion). 5) All discussion should be directed towards the motion. Avoid using a person’s name during the debate. 6) All questions should be directed to the chair. 7) Each member may only speak to the motion twice; however, asking a question or a brief suggestion does not count as that person’s debate.

Rules of Order Policy Board Approved September 2017

8) A person may only speak a third time with the chair’s permission. 9) Only the person who introduced the motion may speak again at the end (even if this is a third time). Voting on a motion 1) Before a vote is taken, the Chair puts the question to a vote by saying “Those in favor of the motion that… (repeat the motion) … say ‘Aye.’ Those opposed say ‘No.’” 2) Wait, then say “The motion is carried,” or “The motion is lost.” 3) If a member is in doubt about the result, he or she may call for “division.” A division is a demand for a standing vote count. This may be show of hands or ballot. 4) A majority is MORE than ½ of the votes cast by persons entitled to vote (a tie does NOT carry because it is not a majority). 5) A confidential written vote may be requested by any member of the board during in-person meetings. This would not require a second. Subsidiary Motions 1. Amending a motion a. Any main motion or resolution may be amended by: adding at the end, striking out or inserting words, substitution. b. To amend a motion, during discussion, a member may say “I move to amend the motion by…” Another member must second this amendment. c. The chair asks “Is there any discussion on the amendment? [repeat amendment].” At this point, only the amendment is discussed. d. When discussion ceases, the Chair says “Those in favor of the amendment [repeat amendment] say ‘Aye.’ Those opposed say ‘Nay.’ e. At this point, the motion carries or not. The main motion (amended or not) can now be voted on, discussion can continue, or the motion may be amended again (by another motion). f. Note, even if an amendment is passed, the main motion has still not been voted on – a separate vote is required. 2. Postpone definitely / indefinitely a. When the assembly does not want to take a position on the main question at all (indefinitely) b. When the assembly wants to delay to a certain time (definitely) 3. Motion to substitute a. When the assembly wishes to substitute a new motion for the original motion. 4. Refer a. Sends a pending motion to a committee, etc. 5. Limit debate / Extend debate 6. Lay the motion on the table (tabling the motion) a. This is used to lay the pending question aside and move on with other business. This may be appropriate when there is a more urgent question at hand, scheduling issue (people invited to speak to the board), etc. Privileged Motions 1. Call for order of the day – a member can interrupt a speaker to call for sticking with the agenda. 2. Recess – used to request an intermission (does not end the meeting)

Rules of Order Policy Board Approved September 2017

3. Adjourn – used to end the meeting. 4. Fix the time to Which to Adjourn – sets the time at which the meeting will adjourn; any unfinished business is moved to the next meeting. Incidental Motions 1. Point of order – used when member feels rules are being violated. Member may interrupt a speaker to raise a point of order. 2. Appeal – used to challenge the chair’s ruling. 3. Suspend the rules – example – suspend the time limit, allow other discussions, etc. 4. Withdraw – permits the maker of the motion to withdraw it. 5. Point of information – requests to the chair to provide information relevant to business at hand. A point of information must be in the form of a question. 6. Objection to consideration of a question – suppresses business that is irrelevant or inappropriate and undesirable to be discussed. Other Main Motions 1. Take from the table – resumes consideration of a motion laid on the table earlier. 2. Reconsider – reopens a motion to debate that has already been voted upon in the same session. 3. Rescind or amend – something previously adopted Other Rules of Conduct: 1. Be prepared – Carefully review the complete board manual before the board meeting. 2. Communicate prior to the meeting – Many items can be resolved before the meeting, saving valuable time. Or, big ticket items can be identified and proper time allocated. 3. Freedom of movement – Board members are welcome to stand, sit, or use the facilities as needed. 4. Freedom of opinion – Board members are free to express their opinions, without fear of stigmatization or personal attack by other board members. 5. Respect – Board members are expected to treat each other respectfully. 6. Attention – Board members are expected to pay attention. This requires turning off cell phones and other distracting electronic devices. Board members are expected not to be texting, emailing or making personal calls (barring emergency or urgent situations) during meetings. 7. Conflict of interest – If a real or perceived conflict exists, a board member must disclose this. Depending on the conflict, if the other board members feel the conflict is not germane to the item being discussed, the member may be allowed to discuss and vote. Other options – member may be allowed to discuss but not vote. Member may be not allowed to discuss or vote. Or, member may be asked to leave the board room for the discussion. The board should determine the level of conflict and appropriate level of involvement by the conflicted member on the issue at hand.

May 15, 2023

ATTN: Members of the Group Insurance Board

On behalf of the Wisconsin State Chapter of the American Society for Metabolic and Bariatric Surgery (ASMBS), Wisconsin Academy of NutriIon and DieteIcs (WAND, Obesity Medicine AssociaIon (OMA), The Obesity Society (TOS) and the NaIonal Consumers League (NCL), we urge the Employee Trust Funds (ETF) and the Group Insurance Board (GIB) to adopt state employee health plan coverage for pharmacotherapy and medical nutriIon therapy (aka nutriIon counseling) for the treatment of overweight or obesity. While our organizaIons truly appreciate the posiIve step that the GIB took to expand coverage of bariatric surgery and required precursor weight management and nutriIon services for members with BMI of 35 or greater in 2020, we believe it is criIcal that state employees have access to all evidence-based treatment tools for obesity. In line with this belief, our groups are pleased to endorse the April 27, 2023, comments of the Obesity AcIon CoaliIon and American Diabetes AssociaIon to the Group Insurance Board regarding coverage of obesity treatment services. We conInue to be frustrated by ETF staff recommendaIons that discourage the Board from providing coverage for Food & Drug AdministraIon (FDA) approved anI-obesity medicaIons (AOMs), robust intensive behavioral therapy or medical nutriIon therapy services for obesity. Failure to provide coverage for these criIcal services flies in the face of the large body of evidence demonstraIng how treaIng obesity improves health outcomes and quality of life for people living with obesity. As you know, obesity is a serious chronic disease that requires treatment and management just like diabetes, cancer, or high blood pressure. Obesity is not a ma[er of personal choice or moral deficiency. Obesity is o]en the root cause and driver of other health complicaIons. A recent report found that treaIng obesity can reduce diabetes (-8.9%), hypertension (-2.3%), heart disease (-2.6%), cancer (-1.3%), and disability (-4.7%) over 10 years in private insurance coverage and Medicare. In previous communicaIons with the Board, the obesity community has highlighted how since 2013, when the American Medical AssociaIon adopted formal policy declaring obesity as a complex and chronic disease and supporIng paIent access to the full conInuum of evidence based obesity care, numerous federal and state policy organizaIons have echoed the AMA’s posiIon. For example, the NaIonal Council of Insurance Legislators, NaIonal Lieutenant Governors AssociaIon, NaIonal Hispanic Caucus of State Legislators, the NaIonal Black Caucus of State Legislators, the Veterans Heath AdministraIon (VHA) and the Department of Defense (DOD) and the Federal Office of Personnel Management (OPM) have all recognized obesity as a chronic disease and echoed support for addressing this epidemic.

We urge the Board to be forward thinking – in the same fashion you were when you approved bariatric surgery coverage in 2020. As a naIon, we must move forward toward ensuring parity in treatment coverage for this complex and chronic disease – in the same fashion as we do for every other chronic disease state. Should you have any quesIons or need addiIonal informaIon, please feel free to contact Obesity Care ConInuum Policy Consultant Chris Gallagher at chris@potomaccurrents.com. Thank you.

Sincerely,

Wisconsin State Chapter of the American Society for Metabolic and Bariatric Surgery Wisconsin Academy of NutriIon and DieteIcs Obesity Medicine AssociaIon The Obesity Society NaIonal Consumers League

7173 S. Havana St #600-130 Centennial, CO 80112 P: 303.770.2526 | F: 303.779.4834 obesitymedicine.org

July 18, 2023

Anne/e Grant, RPh KS Medicaid Pharmacy Program Manager

Sarah FerAg KS Medicaid Director

Dear Anne/e and Sarah,

The Obesity Medicine AssociaAon (OMA) is an organizaAon of nearly 5,000 expert medical clinicians who treat the chronic and relapsing disease of obesity. One of the challenges our providers and their paAents face is the lack of coverage for the treatment of obesity, inclusive of effecAve FDA-approved anA-obesity medicaAons (AOMs) It has come to our a/enAon that Kansas Medicaid has been extremely forward thinking by providing coverage of AOMs since 2014 but now is planning to insAtute Criteria for Prior AuthorizaAon (PA) that will significantly restrict access paAents have to these powerful tools to treat their disease. The people in your Medicaid program with lower socioeconomic status are parAcularly vulnerable to obesity and have a higher disease risk than those with more means and educaAon. In your draX PA Criteria, you refer to AOMs as ‘Weight Loss Agents’ which implies treatment for a lifestyle problem to a degree rather than a treatment for a chronic disease. The American Medical AssociaAon (AMA) defined obesity as a chronic disease in 2013. Science has shown that obesity is not the liability of an individual’s lifestyle, but instead, obesity represents a complex and mulA-factorial disease. Obesity has geneAc origins with biological, environmental, and cultural influences which display differently in each paAent. Changing the nomenclature from “Weight Loss Agents” to Obesity Treatments or AnA-Obesity MedicaAons is a be/er representaAon of this class of drugs. Of the AOMs listed in your PA Criteria draX, it is unclear why generic, inexpensive medicaAons like phentermine or diethylpropion would require a PA at all. Phentermine/topiramate (Qsymia) and bupropion/naltrexone (Contrave) are also more reasonably priced and should be excluded from PA. Making providers renew PA every 3 months during treatment is excessive and will be costly. Michigan repealed their PA criteria when they weighed the Ame and money spent implemenAng the policy versus lecng doctors use their experAse when making decisions about medicaAon that is best for their paAents. It is the bias and sAgma surrounding the disease of obesity that has required a PA for a $10 generic medicaAon such as phentermine. By eliminaAng prior authorizaAon on lower cost medicaAons this will encourage prescribing of these drugs iniAally to reduce the use of costly newer medicaAons. We understand the need to have the more expensive GLP1 agonist type AOMs, semagluAde (Wegovy) and liragluAde (Saxenda) under a second Aer requiring PA. The draX criteria states that only those with ‘severe obesity’ with a BMI over 40 or adolescents with BMI > 140% of 95% will qualify for GLP1s. PaAents with a BMI 30-39 can have severe disease when they also have any of the 14 co-morbid condiAons listed in Table 2. It

7173 S. Havana St #600-130 Centennial, CO 80112 P: 303.770.2526 | F: 303.779.4834 obesitymedicine.org

doesn’t make sense to wait unAl someone has a BMI of 40 and in poorer health and costlier to the system, to allow them access to the most effecAve treatments. Requiring paAents to complete 3 months of lifestyle modificaAons to be candidates for GLP1s and to need to lose >3% of their body weight (or 2% BMI decrease for adolescents) is not evidenced based in predicAng someone’s degree of success with AOMs and is puniAve. Lifestyle changes are recommended for paAents with diabetes, hypertension, heart disease etc but none of these chronic condiAons require 3 months of a lifestyle modificaAon program to gain access to treatment. In truth, by the Ame paAents request help from a medical provider to treat their obesity, they have made mulAple a/empts at lifestyle change. Most of them have had success with weight loss but their story usually includes gradual weight recurrence due to the chronic and relapsing nature of obesity, not the paAents’ lack of diligence with diet and exercise. This is why AOM’s are recommended to be used long term for opAmal weight maintenance. Requiring renewal of the PA every 3 months is burdensome to provider, paAent, and your system for a long-term medicaAon. Again, this is not required for any other chronic disease. Your renewal criteria also require a paAent to lose 5% of their body weight (>4% reducAon in BMI% for adolescents) with the first 3 months of iniAaAng any AOM. This is oXen not long enough to decide a paAent is not responding to a parAcular treatment. Indeed, you propose a weight loss of 5% within 8 weeks of starAng the GLP-1 semagluAde ( Wegovy) when the dose is sAll being Atrated up and is unfair. Requiring a 10% body weight loss by 12 weeks to gain renewal on semagluAde means someone weighing 400 lbs will need to have lost 40 lbs. Most obesity specialists consider losing 1 lb a week as good, steady weight loss and 2 lbs a week as excellent. This would mean 12-24 lbs in 12 weeks is good to excellent weight loss. Therefore, for a 400 lb person, requiring 40 lbs is unrealisAc and puniAve. In the STEP Trials for Wegovy, they showed an average weight loss of 15% over 68 weeks. Your requirement of 15% loss at one year for renewal is cucng the Ame short. Metabolic co-morbid condiAons such as diabetes and hypertension have been shown to be improved aXer just 10% body weight loss. Using a 10% criteria for Wegovy, similar to that for Saxenda seems more in line with the ulAmate goal which is to improve overall health. Requiring paAents go up to the highest dose of semagluAde or be taken off medicaAon is also rooted in bias and sAgma around the disease of obesity. We do not do this with any other medicaAon. We as clinicians pracAce medicine by under an oath of “first do no harm.” To require paAents to increase their dose is again puniAve and medically inappropriate. Some paAents are high responders to this medicaAon and if it was not flat priced it would actually save money for you if they remain on the lower dose. Let’s advocate for pricing change with pharmaceuAcal companies such that staying on a lower dose adds value to care vs requiring a higher dose regardless of outcome and side effects. Requiring this higher dose is pracAcing medicine. Members of the OMA are powerful advocates for our paAents. We work Arelessly to improve access to obesity treatments throughout the country at both the local (state) as well as federal levels. To that end, the OMA respecnully requests the Kansas Medicaid reconsider the proposed PA criteria for limiAng your beneficiaries’ access to the prescribed obesity treatments they need in achieving opAmal health. Should you have any addiAonal quesAons or wish to speak with us directly, do not hesitate to contact us; our full contact informaAon is below. We are happy to provide more reasonable recommendaAons that can also be set forth to control cost.

7173 S. Havana St #600-130 Centennial, CO 80112 P: 303.770.2526 | F: 303.779.4834 obesitymedicine.org

Sincerely,

Angela Fitch, MD, FACP, FOMA, Dipl ABOM President Obesity Medicine AssociaAon Email: DrFitch@knownwell.health Cell: 952-237-5489

Rebecca Andrick, DO, FOMA, Dipl ABOM Chair OMA Advocacy Commi/ee drandrick@wtwdenver.com Cell: 303-868-9207

FOR REVIEW: Coalition Letter to CMS (CMS Health Equity Conference) Precision Strategies | Updated: 5.25.23 at 11 a.m. ET

***The deadline for signing the below letter is Thursday, June 1 by COB . We aim to send the final letter to CMS on Monday, June 5.

The Honorable Chiquita Brooks-LaSure, CMS Administrator Dr. LaShawn McIver, Director, CMS Office of Minority Health - - - - - - Dear Administrator Brooks-LaSure and Dr. McIver:

On behalf of the Health Equity Coalition for Chronic Disease — a coalition of prominent civil rights, racial equity, and health care leaders working to eliminate barriers to healthcare for communities of color — and allied organizations, we extend our deepest appreciation and gratitude to CMS leadership for your continued focus and emphasis on advancing health equity. We are excited by the inaugural CMS Health Equity Conference on June 7-8 and its focus on the future of equitable healthcare, which comes at an urgent moment. Millions of Black and Brown Americans are disproportionately impacted by the growing obesity epidemic. More than two-in-five American adults live with obesity, and almost 50% of Black and Latino adults. As obesity rates surge within communities of color — far outpacing obesity rates experienced by their white counterparts — Black and Brown Americans are disproportionately shouldering the burden of the obesity epidemic. But they don't have to: Obesity is a preventable and treatable disease. Given the interaction between social determinants of health and obesity, treatment of the disease requires more than lifestyle changes. Any approach for tackling this disease, must include a push to provide communities of color access to the full continuum of obesity care and treatment. We believe, as you do, that the need for health equity is urgent. Which is why we are urging CMS leaders to ensure that this week’s conference positions the obesity epidemic as a major focal point for discussion and future collaboration — including examining how CMS can expand access to the full continuum of obesity care and treatment for communities of color who are disproportionately impacted by the epidemic. The conference’s focus on “equitable healthcare” positions it to become the catalyst by which our nation’s obesity policy can begin moving forward — prioritizing and advancing more equitable policies that lead to better health outcomes for communities that have too often been overlooked and underserved by our nation’s health care system. We urge CMS leaders to take advantage of opportunities the conference presents to examine immediate actions that can begin to turn the tide for communities of color and other marginalized communities — such as ensuring coverage for breakthrough anti-obesity medications (AOMs) in Medicare. The current lack of access is the result of discriminatory rules rooted in outdated and dangerous stigmas. We believe opening up access to AOMs is within your authority and would represent a major step forward in addressing and dismantling existing health disparities and inequities. The reality is that the obesity epidemic has become a silent killer within marginalized communities. This is why the leaders of our coalition recently declared obesity a health emergency for communities of color, and urged the Biden administration to prioritize a series of urgent actions to turn the tide. Despite a landmark 2013 declaration by the American Medical Association (AMA) to recognize obesity as a disease — and recent comments by CMS to “close gaps in health care access, quality, and outcomes for underserved populations” — policies in our federal health programs remain woefully behind, furthering the stigma and other misconceptions around obesity. We believe the CMS Health Equity Conference can serve as an important springboard to chart a new path forward with respect to obesity care.