10.25.2023 OMA Board Book

approved medication indications, we do appreciate that coverage policy does exist for anti-obesity medications. We agree that step therapy is better than stopping therapy for patients needing treatment for their obesity.” In connecting with the Kansas Medicaid program, OMA expressed appreciation to the state for making positive changes to their PA criteria such as removing PA restrictions on lower cost medications and updating their nomenclature to reflect anti-obesity medications as opposed to weight loss drugs. However, OMA continued to express concern over the program’s unrealistic cost and utilization numbers and discriminatory lifestyle modification requirements. Obesity Advocates Continue to Make Slow Progress in Wisconsin On May 17th, the Wisconsin Employee Trust Funds’ (ETF) Group Insurance Board (GIB) held a public hearing where obesity advocates urged the GIB to adopt state employee health plan coverage for pharmacotherapy and intensive behavioral therapy (IBT) for the treatment of overweight or obesity. While ETF staff continue to recommend that the Board NOT provide AOM coverage, many on the GIB asked for additional debate on the issue. Unfortunately, during that special hearing on June 30th, the GIB voted against providing state employee coverage for anti-obesity medications (AOMs) for 2023. However, the Board does plan to devote a significant portion of its November 16th meeting to the issue as it begins its evaluation process for benefit year 2024. Obesity Care Continuum (OCC) member groups have been advocating before the ETF and the GIB for the past three years for the state employee plan to provide coverage for AOMs and robust medical nutrition therapy (MNT). OCC members will be coordinating advocacy efforts in the coming months to present a strong case for coverage at the November 16th meeting.

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