Health Insurance Daily

Medicare Clarifies Policy On Bariatric Surgery

The Centers for Medicare and Medicaid Services recently announced that Medicare will cover bariatric surgery for beneficiaries that are morbidly obese with type 2 diabetes.

Under the new policy, CMS will consider covering bariatric surgery for individuals with a body-mass index of at least 35 that have type 2 diabetes, as long as the surgery is performed at a CMS-approved facility. Previously, overweight diabetics could qualify for coverage of the surgery, even if their BMI was slightly less than 35. A normal BMI falls in the range of 18.5 to 25.
"Limiting coverage of bariatric surgery in type 2 diabetic patients who are not considered clinically obese is part of Medicare's ongoing commitment to ensure access to the most effective treatment alternatives with good evidence of benefit, while limiting coverage where the current evidence suggests the risks outweigh the benefits," says Dr. Barry Straube, director of the agency's office of clinical standards and quality.

Article provided by Employee BenefitNews 02/19/09

posted by Mike @ 5:03 AM