Published April 2026

The updated MVP Medical Policy for Weight Loss Medications is now effective as of April 1, 2026. The policy reinforces a holistic approach to obesity treatment, requiring lifestyle medicine engagement alongside the use of GLP 1 medications, while allowing flexibility in how Members meet participation requirements.

MVP does not require participation in a specific weight loss plan or program. Instead, coverage determinations are based on ongoing and consistent participation, defined as at least four visits within a six month period, scheduled on a regular and consistent cadence. Acceptable participation may include visits with a qualified nutritionist, sessions with a lifestyle coach or counselor, or one on one or group counseling. Exercise is also considered when clearly documented, including the type of activity, duration, intensity, and frequency.

To support coverage review, submitted records should clearly outline the Member’s individualized weight loss plan and demonstrate engagement in required components such as nutrition management, behavior modification, and/or counseling. Documentation must indicate visit frequency and include clinical notes confirming a minimum of four visits within the six month timeframe.

This policy underscores our commitment to lifestyle medicine and sustainable behavior change. By pairing medication therapy with nutrition counseling, regular physical activity, and goal setting, the approach supports long term health outcomes for Members while giving Providers flexibility in how care is delivered and documented. Providers are encouraged to review documentation carefully before submission to ensure it reflects both consistency and a comprehensive, member centered weight management strategy.