Medicare Changes Policy on Obesity
Some Treatments May Be Covered
By Rob Stein and Ceci Connolly
Washington Post Staff Writers
Friday, July 16, 2004; Page A01
The federal Medicare program yesterday abandoned a long-standing policy that obesity is not a disease, removing what has been a major roadblock for many people trying to get treatment for the burgeoning health problem.
After years of review, the Centers for Medicare & Medicaid Services, which runs the health program for the elderly and disabled, announced it is dropping language that had led the agency to routinely deny coverage for weight-loss therapies.
The decision does not automatically mean any specific treatment will be covered, but it opens the door to what is expected to be a flood of applications from individuals, doctors and companies for Medicare to begin paying for therapies. These include stomach surgery, diet programs, and behavioral and psychological counseling. (Note: weight-loss drugs are not covered.)
"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and die prematurely," Health and Human Services Secretary Tommy G. Thompson said in announcing the long-awaited decision. "With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese."....
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Because private insurance companies often pattern their coverage after Medicare, the decision is expected to put strong pressure on them to expand coverage for weight-loss treatments. Representatives from the insurance industry, which recently began scaling back on payments for stomach surgery, welcomed the decision and signaled that companies will take their cues from Mediicare....In addition to the practical implications of getting insurance to pay for more treatment, many experts said the move would help counter the stigma that is often associated with people who are overweight and obese....
http://www.washingtonpost.com/wp-dyn/articles/A52835-2004Jul15.html