Payback eyed for obesity surgery

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The federal government is expected to make a final decision in the next several weeks on whether it will cover surgeries for obese Medicare patients.

The Centers for Medicare and Medicaid Services (CMS) in November urged coverage for obese Medicare patients for gastric bypass or banding surgeries, even if they do not have any chronic illnesses such as hypertension, diabetes, osteoarthritis or heart disease.

"The bariatric issue is coming close to a decision," said Don McLeod, spokesman for the health agency that handles public health insurance programs for the poor and elderly.

Mr. McLeod said the 90-day period in which the agency is required to make a ruling is running out and a ruling is expected to come in the next week or two.

In its initial proposal, CMS also requested to stop coverage of bariatric surgeries for patients who are 65 or older, citing scientific evidence that these surgeries carry greater health risks.

Currently, Medicare covers bariatric surgeries for patients with existing obesity-related illnesses, regardless of their age, Mr. McLeod said. Coverage has been available for at least the past decade.

The proposed policy changes follow a decision by CMS in July 2004 to eliminate language from Medicare's coverage manual that said obesity was not a disease.

That move, which stopped short of classifying obesity as an illness, allowed Medicare participants to ask for reimbursement for treating excessive weight.

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