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Published: May 21, 2026

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PMHNP Scope of Practice for Weight Loss/GLP-1 in Florida

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Written by Klarity Editorial Team

Published: May 21, 2026

PMHNP Scope of Practice for Weight Loss/GLP-1 in Florida
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You’re a psychiatrist treating patients for depression and ADHD. Increasingly, those same patients are asking about Ozempic, Wegovy, or phentermine for weight loss — often because they’ve gained weight on antipsychotics or mood stabilizers. Maybe you’re considering adding weight management to your telehealth practice to better serve your panel. Or you’re a PMHNP wondering if you can legally prescribe GLP-1 medications without stepping outside your scope of practice.

Here’s the reality: Yes, psychiatrists (MDs/DOs) can legally prescribe weight-loss medications — including GLP-1 agonists like semaglutide and older controlled-substance appetite suppressants like phentermine. But there’s a catch: the rules around telehealth prescribing (especially for controlled substances), state-by-state licensing, and scope-of-practice expectations are complex and rapidly changing. And if you’re a psychiatric nurse practitioner, the scope question gets trickier fast.

This guide breaks down what you need to know: the current DEA rules for prescribing controlled substances via telehealth (extended through 2026, but not permanent), which states allow telehealth weight-loss prescribing and which require in-person visits, what the rules are for PMHNPs vs. psychiatrists, and the practical compliance steps — PDMP checks, informed consent, follow-up schedules — you need to avoid regulatory headaches.

Let’s get into it.


The Big Picture: Federal DEA Rules for Telehealth Prescribing (2025-2026)

The Ryan Haight Act — the 2008 federal law that governs online prescribing of controlled substances — normally requires at least one in-person medical evaluation before a provider can prescribe any Schedule II-V controlled drug to a new patient via telemedicine. Pre-pandemic, this was the law of the land: no Adderall, no Xanax, no phentermine via telehealth without first meeting the patient face-to-face.

Then COVID happened. The DEA waived that requirement during the Public Health Emergency, allowing providers to prescribe controlled substances via telehealth to new patients they’d never seen in person. That flexibility was supposed to expire multiple times, but the DEA and HHS have extended it repeatedly to avoid a ‘telehealth cliff.’

As of January 2026, the DEA announced a fourth extension through December 31, 2026. This means you can continue prescribing controlled substances (including Schedule IV phentermine for weight loss or Schedule II stimulants for ADHD) via telehealth nationwide without an initial in-person exam — but only through the end of 2026.

Here’s what matters for weight-loss prescribing:

  • GLP-1 agonists (semaglutide, tirzepatide) are NOT controlled substances. You can prescribe Wegovy or Ozempic via telehealth with no DEA restrictions. The only requirements are standard prescribing guidelines: appropriate evaluation, documentation of BMI and comorbidities, patient consent, and follow-up.

  • Phentermine (Schedule IV) and other appetite suppressants ARE controlled substances. Under the current DEA extension, you can prescribe phentermine to a new patient via telehealth federally — but state laws may impose stricter requirements (more on that below). You’ll need a DEA registration and must check your state’s Prescription Drug Monitoring Program (PDMP) database.

What’s coming next? The DEA has proposed permanent rules that would likely require a special telemedicine registration for providers who want to prescribe Schedule III-V controlled substances via telehealth, and potentially limit Schedule II prescribing to certain specialists or impose caps (like initial 30-day supplies only). These rules are still in draft — public comment periods were open in early 2025 — but the direction is clear: telehealth prescribing of controlled substances will continue in some form, but with more guardrails than the current free-for-all.

Bottom line for psychiatrists: You can prescribe phentermine via telehealth right now under federal law (through 2026), but you must stay current on state rules and prepare for changes when DEA’s permanent regulations drop. For GLP-1s, there are no federal controlled-substance barriers — just standard medical practice expectations.


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Can Psychiatrists Legally Prescribe Weight-Loss Medications? (Scope of Practice)

Short answer: Yes. A fully licensed psychiatrist (MD or DO) has broad prescribing authority. There’s no separate ‘obesity medicine license’ — any physician can treat obesity as long as they’re competent to do so and follow the standard of care.

But here’s the nuance: Medical boards expect you to practice within your competence. If you’re prescribing GLP-1 medications or phentermine, you’re expected to know how to:

  • Evaluate for contraindications (e.g., history of thyroid cancer for GLP-1s, uncontrolled hypertension for phentermine)
  • Document appropriate indications (BMI ≥30, or ≥27 with comorbidities like type 2 diabetes or hypertension)
  • Provide or coordinate comprehensive weight management (diet, exercise, behavioral counseling)
  • Monitor for adverse effects and adjust therapy accordingly

Many psychiatrists already do this incidentally — for example, prescribing metformin or a GLP-1 to offset antipsychotic-induced weight gain, or managing stimulant-induced appetite suppression in ADHD patients. Expanding to dedicated weight-loss treatment is legally permissible, but it shifts you into a different clinical domain.

State-specific requirements matter. For example:

  • Florida requires any physician prescribing weight-loss drugs to document the patient’s BMI, obtain written informed consent about risks/benefits, and re-evaluate the patient at least every 3 months. These rules apply to all prescribers — psychiatrists included.

  • New Jersey mandates a comprehensive evaluation before prescribing weight-loss medications: history and physical exam, ruling out endocrine causes of obesity, psychiatric evaluation, and documented counseling on diet and exercise.

  • Virginia requires a physical exam, lab work, and follow-up within 30 days of starting therapy.

If you’re a psychiatrist in one of these states and you decide to prescribe for weight loss, you’re held to the same standards as a family medicine doc or endocrinologist. Document thoroughly. Follow up regularly. Don’t wing it.

What About PMHNPs and Psychiatric NPs?

This is where it gets complicated. A Psychiatric-Mental Health Nurse Practitioner (PMHNP) is trained and certified to treat mental health conditions. Prescribing purely for obesity — a metabolic/endocrine condition — may be viewed by state nursing boards as outside your scope of practice.

Here’s the state-by-state reality:

  • States with independent practice (California, New York after 3,600 hours, Illinois with FPA): Even if you have independent practice authority, your scope is defined by your training and certification. A PMHNP prescribing for weight loss without additional training or physician collaboration could be flagged by the board for practicing outside their specialty.

  • States requiring physician collaboration (Texas, Florida, Pennsylvania): You’ll need a collaborating physician who’s comfortable overseeing weight-loss treatment. Ideally, that’s a family practice doc or someone with bariatric medicine experience — not another psychiatrist. Your collaborative agreement should explicitly include weight-loss medications if you plan to prescribe them.

  • Practical workaround: Some PMHNPs obtain additional certification in obesity medicine (e.g., through the American Board of Obesity Medicine) or work under protocols developed by a physician with that expertise. Others limit their weight-loss prescribing to patients with a primary psychiatric diagnosis (e.g., binge-eating disorder, depression contributing to weight gain) where the obesity treatment is adjunctive to mental health care — that’s safer ground for a psych NP.

The safer play for PMHNPs: If you want to do dedicated weight-loss treatment, team up with a physician who specializes in it or operate under explicit protocols. Don’t try to solo-prescribe GLP-1s or phentermine unless you’ve got the training and your state’s nursing board would support it.


State-by-State Telehealth Prescribing Rules: Where You Can (and Can’t) Prescribe Weight-Loss Meds Online

Federal DEA rules are one thing. State laws are another. Some states have gone back to requiring in-person exams for controlled substances — even while the federal waiver is active. Others are fully permissive. Here’s what you need to know for priority states:

New York: In-Person Required for Controlled Substances

New York currently requires at least one in-person medical evaluation before prescribing any controlled substance to a patient. This is a state Department of Health regulation (10 NYCRR §80.63), updated in May 2025.

What this means for weight-loss prescribing:

  • GLP-1s (semaglutide, tirzepatide): No problem. You can prescribe via telehealth — they’re not controlled substances. Do a proper video evaluation, document weight/BMI, obtain consent, and you’re good.

  • Phentermine (Schedule IV): You cannot start a new patient on phentermine via pure telehealth in New York unless you meet one of the narrow exceptions (e.g., another NY provider saw the patient in person within the past 12 months and referred them to you, or you’re covering for a colleague who saw the patient in person).

Exceptions: Emergency situations (5-day supply max if you have an existing patient relationship), or if a consulting provider did the in-person exam and shared records.

Bottom line: If you’re running a telehealth weight-loss practice in NY and want to prescribe phentermine, you’ll need a hybrid model — either see patients in person for the initial visit or partner with a local clinic that can do the face-to-face exam.

Florida: Telehealth-Friendly, But Strict Documentation Rules

Florida allows telehealth for weight-loss treatment with no in-person requirement — but imposes detailed prescribing standards.

Key rules (Florida Admin Code 64B8-9.012):

  • Patient must have BMI ≥30 (or ≥27 with comorbidities)
  • Initial evaluation (can be via telehealth): history, physical exam, necessary tests
  • Written informed consent required — must outline risks/benefits of weight-loss medications
  • Re-evaluation at least every 3 months while on medication
  • Providers must give patients a ‘Weight-Loss Consumer Bill of Rights’ (Florida’s consumer protection law)

Controlled substances: Florida prohibits prescribing Schedule II drugs via telehealth — except for psychiatric treatment, inpatient/hospice care, or nursing home patients. Since phentermine is Schedule IV (not II), it’s allowed via telehealth in Florida.

PDMP: You must check Florida’s E-FORCSE database before prescribing any controlled substance (including phentermine) for patients 16 and older.

For PMHNPs: Florida requires physician collaboration for prescribing. If you’re a psych NP, you’ll need a supervising physician — ideally someone with bariatric or primary care expertise — and explicit protocols for weight-loss treatment.

Bottom line: Florida is one of the better states for telehealth weight-loss prescribing, but you need tight documentation and compliance with the quarterly follow-up rule.

California: Telehealth-Friendly, Corporate Practice Rules Apply

California allows telehealth evaluations to meet the ‘appropriate prior examination’ requirement for prescribing (Business & Professions Code §2242). No in-person exam needed if the standard of care is met via video.

Key requirements:

  • Telehealth consent: Must obtain and document patient consent for telehealth services (B&P §2290.5)
  • PDMP (CURES): Must check before first Schedule II-IV prescription (e.g., phentermine) and at least every 4 months for ongoing therapy
  • E-prescribing: Mandatory for all prescriptions (including controlled substances)

NP scope: California allows experienced NPs to practice independently under AB 890 (phased in 2023-2026). However, a PMHNP prescribing for obesity may still be outside their certified scope — consult your collaborating physician or obtain additional training.

Corporate practice of medicine: Non-physicians cannot own or control medical practices in California. If you’re building a telehealth weight-loss service, it must be physician-owned or structured through a compliant MSO model.

Bottom line: CA is telehealth-friendly, but be mindful of CPOM rules and ensure PMHNPs aren’t overstepping their scope.

Texas: Telehealth Allowed, Delegation Required for NPs

Texas allows telehealth prescribing of weight-loss medications (including phentermine) with no in-person requirement, as long as you establish a valid patient relationship via live video or store-and-forward technology combined with audio.

Key rules:

  • Standard of care: Evaluation must be sufficient for diagnosis — online questionnaires alone don’t cut it
  • NP/PA scope: Must have a Prescriptive Authority Agreement with a Texas physician. Protocols must explicitly include weight-loss drugs if NPs will prescribe them.
  • PDMP: Check the Tx PMP before prescribing phentermine (best practice, even if not strictly mandated by statute for Schedule IV)
  • Follow-up: Texas law requires telehealth providers to give follow-up instructions and (with patient consent) send a report to the patient’s PCP within 72 hours

Bottom line: Texas is permissive for telehealth, but NPs can’t practice independently — you’ll need tight physician collaboration.

Pennsylvania: No Specific Telehealth Law, Standard-of-Care Applies

Pennsylvania has no comprehensive telehealth statute (as of 2025), so providers follow general medical board guidance: the standard of care via telehealth must equal in-person care.

Key points:

  • Controlled substances: No state-level in-person requirement (currently defers to federal DEA extension). You can prescribe phentermine via telehealth.
  • PDMP: Must check PA PDMP before first opioid or benzodiazepine prescription, and each time for ongoing opioid/benzo therapy. For other controlled substances (stimulants, phentermine), check before first prescription and as clinical judgment dictates.
  • NP scope: CRNPs require a collaborative agreement with a physician. No independent practice in PA yet.

Bottom line: PA is telehealth-friendly by default, but practice conservatively — document thoroughly and follow standard medical practice.

Illinois: Telehealth-Friendly, Full Practice Authority for NPs

Illinois explicitly allows telehealth for patient evaluations and prescribing. No in-person exam required as long as the telehealth encounter meets the standard of care.

Key points:

  • Full Practice Authority (FPA): Experienced APRNs (4,000+ hours) can practice and prescribe independently, including controlled substances.
  • PDMP: Must check PMPnow for Schedule II narcotics (opioids). Not mandated for stimulants/phentermine by law, but best practice is to check.
  • E-prescribing: Required for all controlled substances (as of Jan 2023)

Bottom line: Illinois is one of the most permissive states for telehealth weight-loss prescribing. NPs with FPA can run independent practices, though PMHNPs should still be cautious about scope.


The Economics of Telehealth Weight-Loss Prescribing: Why Platforms Beat DIY Marketing

Here’s the hard truth about patient acquisition: acquiring a qualified psychiatric or weight-loss patient through DIY marketing typically costs $200-500+ when you factor in all costs — agency fees, ad spend, staff time to qualify leads, no-show rates, months of SEO investment, and failed campaigns.

Let’s break it down:

  • SEO: Building organic traffic takes 6-12 months of consistent investment (content, backlinks, technical optimization) before you see meaningful patient flow. Most solo providers don’t have the expertise or budget.

  • Google Ads: Mental health and weight-loss keywords cost $15-40+ per click. Most clicks don’t convert to booked patients. A realistic cost per booked patient through PPC is $200-400+ after you account for testing, optimization, and wasted spend.

  • Directory listings (Psychology Today, Zocdoc): Monthly subscription fees plus per-booking charges (Zocdoc charges $35-100+ per booking). You’re competing with hundreds of other providers on the same page.

The alternative: pay-per-appointment platforms like Klarity Health. Instead of spending $3,000-5,000/month on marketing with uncertain results, you pay a standard listing fee per new patient lead — only when a qualified patient books with you.

Why this matters for weight-loss prescribing:

  • Pre-qualified patients: Klarity matches patients to your specialty and availability. No wasted time on leads who aren’t a fit.
  • No upfront marketing spend: Zero ad spend, zero monthly subscriptions. You control your schedule and only pay when you see patients.
  • Built-in telehealth infrastructure: No separate platform costs — everything’s included (video, EHR, e-prescribing).
  • Both insurance and cash-pay flow: Diversify your revenue without building two separate marketing funnels.

This is guaranteed ROI vs. gambling on marketing channels. DIY marketing can eventually be cost-effective if you have the budget, expertise, and patience — but for most providers (especially those scaling or starting out), a platform that handles patient acquisition removes the risk entirely.


Compliance Checklist: How to Prescribe Weight-Loss Medications Via Telehealth Without Getting Flagged

Here’s your step-by-step to stay compliant:

1. Verify Patient Location and Licensure

You must be licensed in the state where the patient is located at the time of the telehealth visit. Verify location at each visit (patients travel). If you’re not licensed in their state, you can’t treat them.

2. Obtain Telehealth Consent

Many states (California, Illinois, Florida indirectly) require documented patient consent for telehealth. Include this in your intake process — a simple checkbox and signature works.

3. Conduct a Thorough Evaluation

State medical boards review telehealth cases to ensure the evaluation was adequate. Your documentation should include:

  • History: Weight history, previous weight-loss attempts, dietary habits, exercise level, relevant medical history (thyroid, diabetes, cardiovascular)
  • Mental health screening: Especially important for psychiatrists — document any eating disorders, depression, or body dysmorphia
  • Physical exam (via video): Weight/BMI (patient self-reported or measured at home), blood pressure if available, visual assessment of overall health
  • Labs (if applicable): Thyroid function, A1C, lipid panel — either recent labs from PCP or order through a telehealth lab service

For controlled substances (phentermine): Document the same level of detail you’d expect for an in-person visit. State boards will scrutinize telehealth controlled-substance prescriptions.

4. Check the PDMP

Before prescribing any controlled substance (phentermine, stimulants, etc.), check your state’s Prescription Drug Monitoring Program database:

  • California: CURES — before first fill and every 4 months
  • Florida: E-FORCSE — before every controlled-substance prescription
  • New York: PMP — within 24 hours before prescribing Schedule II-IV
  • Texas: Tx PMP — before prescribing (best practice for phentermine)
  • Pennsylvania: PA PDMP — before first opioid/benzo, each time thereafter; recommended for other controlled substances

Document the PDMP check in your note.

5. Obtain Informed Consent for Weight-Loss Medications

Florida explicitly requires written informed consent outlining risks and benefits. Even if your state doesn’t mandate it, best practice is to document:

  • Potential side effects (GI issues for GLP-1s, cardiovascular effects for phentermine)
  • Expected weight-loss outcomes (realistic expectations)
  • Alternative treatments (diet, exercise, lifestyle modification)
  • Risks of not treating obesity (diabetes, cardiovascular disease)

6. Schedule Follow-Ups

Most states and standard-of-care guidelines expect regular follow-ups:

  • Florida: At least every 3 months while on medication
  • Virginia: Within 30 days of starting therapy
  • General best practice: Monthly for the first 3 months, then quarterly

Use follow-ups to assess efficacy, adjust dosing, monitor for side effects, and reinforce lifestyle changes.

7. Coordinate with Primary Care

Many states (Texas, New Jersey) recommend or require sending a report to the patient’s PCP. Even if not required, it’s good practice — especially for psychiatrists prescribing outside their usual specialty. Coordinate care and ensure someone’s monitoring cardiovascular risk factors, labs, etc.

8. Use E-Prescribing and EPCS

Most states now mandate electronic prescribing for controlled substances (EPCS). Make sure your telehealth platform supports it (Klarity does).


FAQ: Weight-Loss and GLP-1 Prescribing for Psychiatrists

Q: Can I prescribe Ozempic or Wegovy via telehealth if I’ve never seen the patient in person?

A: Yes, in most states — GLP-1 agonists are not controlled substances, so the DEA’s in-person exam requirement doesn’t apply. As long as you conduct a proper telehealth evaluation (video visit, documented history/exam) and meet your state’s standard of care, you can prescribe semaglutide or tirzepatide via telehealth. States like Florida, California, Texas, and Illinois explicitly allow this. New York allows it too (no in-person requirement for non-controlled meds).

Q: Can I prescribe phentermine via telehealth?

A: Depends on your state. Phentermine is a Schedule IV controlled substance. Under current federal rules (DEA extension through Dec 2026), you can prescribe phentermine via telehealth to new patients in most states. Exceptions:

  • New York: Requires at least one in-person visit before prescribing any controlled substance (with narrow exceptions)
  • Other states (California, Texas, Florida, Illinois, Pennsylvania): Allow telehealth prescribing of phentermine under current DEA rules, as long as you meet standard-of-care requirements (proper evaluation, PDMP check, documentation)

Q: As a PMHNP, can I prescribe GLP-1 medications for weight loss?

A: Legally, it depends on your state’s scope-of-practice laws and your collaborative agreement (if required). Practically, prescribing purely for obesity may be outside a PMHNP’s scope since your training is in mental health, not metabolic/endocrine conditions.

Safer approaches:

  • Work under a physician-developed protocol specifically for weight-loss treatment
  • Obtain additional certification in obesity medicine
  • Limit weight-loss prescribing to patients with a primary psychiatric diagnosis where obesity treatment is adjunctive (e.g., binge-eating disorder, SSRI-induced weight gain)

In states requiring physician collaboration (Texas, Florida, Pennsylvania), your supervising physician should ideally have bariatric or primary care expertise.

Q: What documentation do I need for telehealth weight-loss prescribing?

A: At minimum:

  • Patient demographics and location (for licensure verification)
  • Comprehensive history (weight, diet, exercise, medical history, medications)
  • Documented exam findings (weight/BMI, vital signs if available)
  • Informed consent for telehealth and for weight-loss medication
  • Treatment plan (medication, dosing, lifestyle modifications)
  • PDMP check (if prescribing controlled substances)
  • Follow-up plan

State-specific additions:

  • Florida: Written informed consent + ‘Weight-Loss Consumer Bill of Rights’
  • New Jersey: Documentation of psychiatric evaluation and counseling on diet/exercise
  • California: Telehealth consent per B&P §2290.5

Q: How often do I need to see weight-loss patients?

A: Best practice is monthly for the first 3 months, then quarterly for ongoing treatment. Florida mandates at least quarterly re-evaluations. Virginia requires follow-up within 30 days. Even if your state doesn’t specify, frequent follow-ups are expected for safety and efficacy monitoring.

Q: Do I need special training or certification to prescribe weight-loss medications?

A: Not legally (for physicians), but it helps. The American Board of Obesity Medicine (ABOM) offers certification for physicians (and some NPs/PAs). It’s not required, but it demonstrates competence and can help if you’re ever questioned about practicing outside your specialty.

For PMHNPs, additional training or certification is strongly recommended if you want to do dedicated weight-loss treatment.

Q: What are the risks of prescribing GLP-1s or phentermine via telehealth?

A: Clinical risks:

  • GLP-1s: GI side effects (nausea, vomiting, diarrhea), pancreatitis, thyroid cancer risk (though rare)
  • Phentermine: Cardiovascular effects (elevated heart rate, blood pressure), insomnia, anxiety, potential for abuse

Regulatory risks:

  • Prescribing controlled substances without proper evaluation or PDMP checks can trigger medical board investigations
  • Practicing ‘outside your scope’ (especially for PMHNPs) can result in license discipline
  • Inadequate documentation or follow-up can lead to malpractice claims

Mitigation: Follow state rules, document thoroughly, coordinate with primary care, and schedule regular follow-ups.


The Bottom Line: You Can Prescribe Weight-Loss Meds Via Telehealth — But Do It Right

Psychiatrists have full legal authority to prescribe weight-loss medications, including GLP-1 agonists and controlled-substance appetite suppressants like phentermine. The current federal DEA extension (through December 2026) allows telehealth prescribing of controlled substances without an in-person exam — but state laws vary widely, and you must stay compliant with PDMP checks, documentation standards, and follow-up schedules.

For PMHNPs, the scope question is trickier. Unless you have additional training or physician oversight, prescribing purely for obesity may be risky. Stick to cases where obesity treatment is adjunctive to mental health care, or team up with a physician who specializes in weight management.

The economics favor platforms over DIY marketing. Instead of spending thousands per month on Google Ads, SEO, and directory listings with uncertain ROI, a pay-per-appointment model lets you acquire qualified patients with zero upfront risk.

Ready to expand your telehealth practice into weight-loss treatment? Join Klarity Health’s provider network to access pre-qualified patients, built-in compliance tools (PDMP integration, e-prescribing), and a platform that handles patient acquisition so you can focus on clinical care.


Sources and References

  1. U.S. Department of Health & Human Services – Press Release: ‘HHS & DEA Extend Telemedicine Flexibilities for Prescribing Controlled Medications Through 2026’ (Jan 2, 2026) – Official DEA/HHS policy statement. https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html

  2. Florida Statutes § 456.47 – Use of Telehealth to Provide Services (Florida Telehealth Act, 2019) – Text of law governing telehealth in FL. http://www.leg.state.fl.us/statutes/

  3. Florida Admin. Code 64B8-9.012 – ‘Standards for the Prescription of Drugs to Treat Obesity’ (Effective Aug 8, 2022) – Official rule outlining obesity prescribing requirements. https://regulations.justia.com/states/florida/64/64b8/chapter-64b8-9/section-64b8-9-012/

  4. Goodwin Law – Client Alert: ‘A Changing Regulatory and Reimbursement Landscape for Weight-Loss Drugs’ (Mar 30, 2024) – Detailed overview of state rules (FL, NJ, VA). https://www.goodwinlaw.com/en/insights/publications/2024/03/alerts-lifesciences-hltc-changing-regulatory-reimbursement-weight-loss-drugs

  5. California Medical Association – News: ‘GLP-1 medications for weight loss will no longer be covered by Medi-Cal’ (Dec 2, 2025) – Official CA Dept. of Health Care Services policy. https://www.cmadocs.org/newsroom/news/view/ArticleId/51074/GLP-1-medications-for-weight-loss-will-no-longer-be-covered-by-Medi-Cal

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All professional services are provided by independent private practices via the Klarity technology platform. Klarity Health, Inc. does not provide medical services.
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