Medicare Releases New Rules for Weight-Loss Surgery

To view CMS’ news release detailing their proposed changes, click here.

To view “Frequently asked questions about Medicare’s new rules regarding obesity surgery and why the rules are causing some cancellations,” click here.

The Centers for Medicare and Medicaid Services (CMS) announced it will expand its national coverage policy for obesity surgery. The new policy applies to all Medicare recipients including those more than 65 years old and Medicare disabled.

In May of 2005, the ASBS, along with other organizations, called on CMS to expand their coverage for obesity surgery. On November 23, 2005, CMS released their proposed rules for extending coverage of bariatric surgery. With the dedication of the ASBS and the many individuals affected by obesity, CMS has made significant decision for all obese and morbidly obese Medicare recipients.

In November 2005, CMS, the governing agency of Medicare, released proposed new rules under a National Coverage Decision (NCD) for weight-loss surgery. The OAC strongly encouraged all those affected by obesity and morbid obesity to raise their voices and respond to Medicare to advocate for safe and effective treatment.

Alert

Please note that the new rules regarding obesity surgery went into effect on February 21, 2006. Those scheduled to receive obesity surgery under Medicare in the next few days or weeks need to make sure their surgeon/hospital is a Center of Excellence (COE). If it is not a COE and surgery is performed, Medicare may not pay for it.

Click here to view the OAC’s news release applauding Medicare and calling on private insurers to follow suit.

Click here to view the OAC’s Comments on the NCD Proposed Rules for Bariatric Surgery.



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