On March 22, 2012, Centers for Medicare & Medicaid Services (CMS) issued a proposed National Coverage Decision (NCD) surrounding bariatric surgery – specifically suggesting that Medicare should add sleeve gastrectomy (sometimes referred to as the gastric sleeve or sleeve) to the list of other bariatric surgical procedures that the program currently covers.

While this is good news, the OAC and the obesity community are extremely troubled that CMS is proposing that Medicare cover sleeve gastrectomy only when such procedures are performed as part of a randomized controlled trial. This approach is referred to as coverage with evidence development (CED), and not full coverage as the OAC hoped.

Call to Action!

The OAC does not agree with CMS’ suggestion that currently there is not enough scientific evidence to justify full coverage of gastric sleeve. Therefore, we are asking OAC members to contact CMS and urge the agency to drop its proposed CED requirement in favor of full coverage for gastric sleeve.

Download the OAC’s guide, titled A Patient’s Guide to Advocating for Improved Access to Metabolic and Bariatric Surgery under Medicareby clicking here and start advocating today! CMS will be accepting comments on the National Coverage Decision until April 28, 2012.

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