By Jennifer Corbett Dooren
Of DOW JONES NEWSWIRES
WASHINGTON (Dow Jones)--Medicare could start routinely covering bariatric surgery and other treatments to help people lose weight under new coverage guidelines announced Thursday.
Health and Human Services Secretary Tommy Thompson announced the change Thursday at a Senate Appropriations subcommittee hearing.
Until now, Medicare didn't recognize obesity as an illness. In fact, in its official coverage manual it was stated that obesity wasn't an illness. That language has now been removed, further opening the door for Medicare to cover treatments such as bariatric surgery which includes various procedures that make the stomach smaller.
Such treatments are currently covered if they are used to treat another disease such as diabetes.
"Obesity is a critical public health concern," Thompson said noting that it causes other health problems and premature death. "Treating obesity-related illnesses and complications adds billions of dollars to the nation's health care costs."
Medicare is prohibited from covering treatments unless they were caused by an illness or injury. Changing the obesity rules allows treatment to be covered solely for treating obesity rather than another co-existing illness.
A spokesperson for the Centers for Medicare & Medicaid Services said the agency would review individual treatment requests for coverage. Those requests typically come from manufacturers of a drug or device and health-care organizations. Those requesting a treatment decision must show evidence that the treatment works. For example, such evidence might show that bariatric surgery reduces a person's risk for developing diabetes.
Sean Tunis, the CMS chief medical officer, said Medicare will convene its coverage advisory committee this fall to evaluate evidence that obesity-related surgical procedures such as bariatric surgery may reduce the risk of heart disease and other illnesses.
-By Jennifer Corbett Dooren, Dow Jones Newswires; 202-862-9294; [email protected].