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HB 1451

County Government - As introduced, requires each county to create a county ethics commission. - Amends TCA Title 3, Chapter 6 and Title 5.

114th Regular Session (2025-2026) Introduced by G.A. Hardaway

ND HD: Requires Medicaid to cover comprehensive obesity treatment, including antiobesity meds, behavioral therapy, and bariatric surgery, with parity to other conditions.

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Bill Summary · HB 1451

Summary — HB 1451 (North Dakota)

A bill to create a new section in chapter 50‑24.1 of the North Dakota Century Code requiring medical assistance (Medicaid, including expansion coverage) to provide prescription drug benefits for antiobesity medication.

Main purpose

Require North Dakota’s medical assistance program to provide comprehensive coverage for the treatment of obesity, explicitly including FDA‑approved antiobesity medications, and to ensure such coverage is not subject to more restrictive criteria, limits, or cost‑sharing than coverage for other illnesses or conditions.

Key provisions

  • New statutory section (to NDCC chapter 50‑24.1) requires medical assistance coverage, including Medicaid expansion, to include comprehensive obesity treatment consisting of:
    • Intensive behavioral therapy;
    • Bariatric surgery; and
    • Antiobesity medication approved by the U.S. Food and Drug Administration (FDA).
  • Coverage criteria for antiobesity medications may not be more restrictive than the FDA‑approved indications for those medications.
  • Coverage for obesity treatment may not be treated differently from other conditions with respect to deductibles, lifetime dollar limits, benefit‑year maximums, copayments, or coinsurance.
  • The statute does not prohibit utilization management or medical‑necessity review, provided those determinations are done in the same manner used for other illnesses, conditions, or disorders covered by medical assistance.
  • Departmental notice requirement: the administering department must notify enrollees in writing, prominently in literature or correspondence, and provide the notice with annual enrollee materials or another mailing no later than December 31, 2025.

Who would be affected

  • Primary: North Dakota medical assistance (Medicaid) enrollees who are eligible for obesity treatment and FDA‑approved antiobesity medications.
  • Secondary: North Dakota Department of Human Services (or administering agency) for benefits administration and communications; health care providers prescribing obesity treatments; pharmacy benefit managers, insurers administering Medicaid benefits; and state Medicaid budget (potential increased pharmacy and treatment expenditures).

Potential impacts

  • Coverage expansion could increase Medicaid prescription drug and treatment spending in the near term; potential longer‑term savings may occur if obesity‑related morbidity is reduced. The bill text contains no explicit appropriation or fiscal estimate.
  • Administrative work required to update benefit policies, prior‑authorization/medical necessity protocols (to conform with the parity requirements and FDA indications), and enrollee notices.

Procedural status / timeline

  • Introduced: November 21, 2024 (creates a new section in NDCC ch. 50‑24.1).
  • The bill reached second reading and was considered, but failed to pass on second reading (vote: yeas 12, nays 81). As of that recorded action, the bill did not advance into law.

(Prepared from the bill text proposing the new NDCC section and the legislative status information provided.)

Compiled from official sources — confirm details with the bill’s official record.

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