The Centers for Medicare & Medicaid Services (CMS) has announced a proposal to clarify its policies for Medicare coverage of bariatric (weight loss) surgery as a treatment for beneficiaries with type 2 diabetes.
CMS proposes to not cover bariatric surgery for patients who do not meet the definition of morbid obesity, but do have type 2 diabetes. While recent medical reports claimed that bariatric surgery may be helpful for these patients, CMS did not find convincing medical evidence that bariatric surgery improved health outcomes for non-morbidly obese individuals. CMS seeks comments from the public about this evidence and its implications for coverage, and about which groups of patients should be covered for this surgery.
The proposed decision notes that type 2 diabetes is one of the co-morbidities CMS would consider in determining whether bariatric surgery would be covered for a Medicare beneficiary who is morbidly obese. An individual with a body-mass index of at least 35 is considered morbidly obese.
Read the proposed decision memorandum.
