The Centers for Medicare and Medicaid (CMS) has reconsidered its stance on Medicare coverage for bariatric surgery. As of February 21, 2006, the list of nationally-covered procedures includes open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and open and laparoscopic biliopancreatic diversion with duodenal switch. Coverage was even extended to those over the age of 65 years, a segment of the population previously excluded by last year's preliminary proposal. With new data and analyses demonstrating that surgeons with more experience have similar outcomes for patients of all ages, the CMS decided to include this segment of the population with the stipulation that the procedures be performed in facilities most likely to achieve better outcomes.
All other surgical bariatric procedures remain non-covered. In order to qualify for coverage, patients must have additional health problems, such as hypertension, type 2 diabetes, and heart disease.
According to the National Institutes of Health, approximately 34 percent of Americans are overweight and 27 percent are obese. With the average cost for a bariatric surgical procedure being about 25 thousand dollars, this is a much needed relief to patients who cannot possibly afford this life saving surgery.
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