Obesity Discussion Forums - View Single Post - Getting approved for obesity related surgeries w/ medicare/medicaid

Obesity Discussion · 04-02-06, 02:50 AM

It appears in the most recent release on the approvals for Medicaid that you have to have a BMI of 35 , and also have a medical condition.

"The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that open and laparoscopic Roux-en-Y gastric bypass (RYGBP), laparoscopic adjustable gastric banding (LAGB), and open and laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS), are reasonable and necessary for Medicare beneficiaries who have a body-mass index (BMI) > 35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity."

Here's a link:
http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=160

04-02-06, 02:50 AM	#1 (permalink)
Obesity Discussion Administrator Join Date: Jan 2005 Location: Phoenix, AZ Posts: 7,851 Weight Statistics 8/1/2006 Start Date: 185 lb Start Weight: 152 lb Current Weight: 155 lb Goal Weight: -33 lb Weight Loss: 5/1/2007 Goal Date:	Getting approved for obesity related surgeries w/ medicare/medicaid It appears in the most recent release on the approvals for Medicaid that you have to have a BMI of 35 , and also have a medical condition. "The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that open and laparoscopic Roux-en-Y gastric bypass (RYGBP), laparoscopic adjustable gastric banding (LAGB), and open and laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS), are reasonable and necessary for Medicare beneficiaries who have a body-mass index (BMI) > 35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity." Here's a link: http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=160 __________________