Posts Tagged ‘CMS’

Opening Medicare to Semaglutide for Obesity and Heart Disease

March 22, 2024 — This is a striking change. Until now, the steadfast refusal of CMS to allow coverage of any obesity medicine by Medicare has been unwavering. Then two weeks ago, FDA granted a new indication for semaglutide for persons with both heart disease and obesity to prevent heart attacks, strokes, and deaths. Now CMS says it’s A-OK […]

Botox, Knee Replacements, and Obesity Meds

October 3, 2022 — Health insurers, including Medicare, are regarding obesity meds like Botox Cosmetic, when they should be thinking of them more like a knee replacement. This observation, from a report by Jamy Lee in MarketWatch, sums up the challenge for people seeking obesity care in a health system that pays for the complications of untreated obesity, but […]

House Appropriations Calls for Obesity Meds in Medicare

June 30, 2022 — Okay, this is hardly a final victory, but it sure does feel good. The U.S. House Appropriations Committee released its legislative report on funding for Health and Human Services. It’s a beastly 623 page document that goes over all the spending priorities for the department. However, if you dig deep into it, there’s a paragraph […]

Telehealth Works in Obesity Care, but What’s Next?

January 19, 2022 — A new study in Obesity tells us that telehealth can work just fine in obesity care. But what will the future hold? Payers and patients will likely have their their say. Already, telehealth businesses have had quite a bumpy ride. A prime example would be Teledoc, which saw its stock soar from $83 per share […]

Does Medicare Care About Preventing Diabetes?

October 23, 2019 — We have an effective treatment for preventing diabetes. It cuts the risk by 60 percent in people with prediabetes. For every person on Medicare, it saves $2,650. In just 15 months. But Medicare can’t figure out how to make it available to the people who need it. This is the sad story of implementing the […]

The Vague Paternalism of Medicare Obesity Coverage

August 31, 2017 — “At the end of the day, what we’d like to see is fewer obese people in the Medicare population about which we have to have these conversations.” Those striking words came Aloysius Cuyjet, MD, MPH. They came after he chaired more than five hours of evidence review at Medicare’s advisory committee on evidence and coverage […]

Obesity Treatment Prevention Is Working Very Well

August 5, 2016 — Obesity treatment prevention is probably the one and only obesity-related policy that is working with 99% effectiveness. A new study in Obesity gives us hard numbers for this overwhelming success. John Batsis and Julie Bynum analyzed Medicare claims from 2012 and 2013 for more than 27 million beneficiaries. They were looking for people who received intensive […]

CMS Ditches Obesity Surgery Quality Standards

September 26, 2013 — Seven years after imposing obesity surgery quality standards for Medicare, CMS (the Centers for Medicare and Medicaid Services) has decided to drop them entirely. Folks with their own (competing) standards had lobbied CMS to decide that the current standards weren’t working well enough and that they reduced access to care for some patients. To the […]

Obesity Surgery Standards at Risk

August 12, 2013 — The proposal to eliminate obesity surgery standards by the Centers for Medicare and Medicaid Services (CMS) will put the safety of vulnerable patients at risk, according to a coalition of the major professional and patient groups advocating for people with obesity. At present, only facilities certified as centers of excellence can be paid for obesity […]

CMS Questions Value for Bariatric Centers of Excellence

June 29, 2013 — In a proposed decision memo, the U.S. Centers for Medicare and  Medicaid (CMS) services concludes that certification requirements for bariatric centers of excellence “do not improve health outcomes for Medicare beneficiaries.” And thus, CMS is proposing to remove the requirement for bariatric centers of excellence to receive reimbursement for Medicare patients. This proposed decision was […]