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Call to Action!

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.

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.

One Comment for this Post
  • Gladys Strain
    April 23, 2012 at 4:11 pm

    As director of laparoscopic and bariatric surgery at Weill Cornell School of Medicine, I protest the restriction of the laparoscopic sleeve gastrectomy to RCT trials. One can not assign the type of bariatric surgery a patient receives on a random basis. Different surgeries meet different patient needs and the decision as to the appropriate surgery one is to receive is best made between the patient and his or her surgeon. I have just published two papers in Surgery for Obesity and Related Diseases regarding outcomes for the sleeve gastrectomy [Strain GW¹, Saif T¹, Gagner M², Rossidis M¹, Dakin G¹, Pomp A¹ A cross sectional review of the effects of laparoscopic sleeve gastrectomy (LSG) at 1, 3, and 5 years Surgery for Obes and Related Diseases 2011, 7:714-719.
    Saif T, Strain GW, Dakin G, Gagner M, Costa R, Pomp A. An Evaluation of nutrieint status after laparoscopic sleeve gastretomy (LSG)1, 3, and 5 years after surgery. SOARD (in press)
    If the committee had reviewed thee and other recent reports they would have little question that the sleeve gastrectomy deserves insurance acknowledgement.

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