Prohibited standards and permitted factors for coverage of feeding or eating disorder treatments. (Effective January 1, 2027)

eating disorder treatments. (Effective January 1, 2027) An insurer that offers or provides coverage for the treatment of a diagnosed feeding or eating disorder under a health plan: (1) Shall not utilize any of the following standards as the sole reason for denying, limiting, or restricting the coverage: (a) Body mass index; (b) Ideal body weight; or (c) Any other standard requiring an achieved weight; and (2) May consider the following factors when determining the medical necessity of a treatment, or the appropriate level of care, for an individual with a diagnosed feeding or eating disorder: (a) Eating behaviors; (b) The need for supervised meals and support interventions; (c) Laboratory results of heart rate, renal or cardiovascular activity, and blood pressure; (d) Recovery environment; and (e) Co-occurring disorders.