CMS Will Cover Bariatric Surgery for Morbidly Obese Medicare Beneficiaries Who Have Type 2 Diabetes
CMS on Thursday announced that it will cover bariatric surgery for Medicare beneficiaries who are morbidly obese and have type 2 diabetes, CQ HealthBeat reports. Individuals with a body mass index of at least 35 are considered morbidly obese. A BMI of between 18.5 and 25 is considered normal. The agency in 2006 expanded coverage of four types of bariatric surgery to Medicare beneficiaries with a BMI of 35 or higher and at least one co-morbidity related to obesity. Thursday's announcement specified type 2 diabetes as a co-morbidity.In a statement, CMS Acting Administrator Charlene Frizzera said, "Medicare beneficiaries who are morbidly obese may face tremendous health complications," adding, "Today's coverage decision assures that beneficiaries who are morbidly obese can access safe, effective weight loss options to help prevent these complications."
Beneficiaries will be required to receive the surgery at facilities certified by the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery. CMS also said that the surgery will not be covered for beneficiaries with BMIs lower than 35 because current evidence has not proven that bariatric surgery will lead to improved health outcomes in those people (Attias, CQ HealthBeat, 2/13). This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
