Medicare Advisory Committee Appears To Support Coverage for Bariatric Surgeries

Members of a Medicare advisory committee that met last week to consider whether CMS should approve coverage for bariatric surgeries agreed that "there's good scientific data showing" the procedures can provide "important health benefits," USA Today reports (Weise, USA Today, 11/9).

In July, HHS Secretary Tommy Thompson announced plans to remove language from the Medicare coverage manual that states obesity is not an illness. However, Medicare will not classify obesity as a disease, Thompson said. Medicare currently covers obesity treatments only when beneficiaries also have related conditions such as type 2 diabetes. The advisory committee last week began to consider evidence on the effectiveness of bariatric surgeries in the treatment of morbid obesity (California Healthline, 11/3).

The committee last week said evidence indicates that stomach-reduction surgery can increase long-term survival rates and reduce short-term mortality rates compared with nonsurgical medical management of obesity. In addition, the committee said that "doing the surgeries laparoscopically, via instruments inserted through tiny slits rather than by opening up the abdomen, was almost equally safe," USA Today reports.

Several groups in the next two months plan to make a formal request for Medicare to cover bariatric surgeries, and CMS would make a decision on such a request, in part based on recommendations from the advisory committee, after a nine to 12-month review period. Approval of Medicare coverage for bariatric surgeries likely would have "broad implications for what treatments are available to patients nationwide" because private health insurers often follow Medicare in coverage decisions (USA Today, 11/9).