Weight loss surgical procedures have been proven to be the only viable option for sustained weight loss when compared to all other modalities, including diet, exercise, behaviors modifications, appetite suppressant, and other less scientific approaches. Different weight loss procedures have had varying degree of success as measured with resolution of the co-morbidities and long term weight loss.
One such specific modification in policy involves primary and revision weight loss surgery.
These policy changes have significant practical implications for those seeking surgical treatment for morbid obesity and associated co-morbidities.
First of all, they create a road block for those patients who are not able to provide documentation for the “…6 continuous months, in the 2 years prior to surgery, to enable both behavioral changes and adequate assessment of anticipated postoperative dietary maintenance.” It also places the responsibility on the surgeon by requiring that compliance with these requiremens are “…. fully appraised and documented by the physician requesting authorization for surgery.”
For all those who are not in California, please note that a lot of policies do start here and propagate to the rest of the country. I would propose that everyone take time to contact their state health insurance providers regulatory agency and voice their opposition to the proposed changes.
The state regulatory agencies are located here. (https://www.dsfacts.com/image-files-new/agencies-by-state.pdf)
- Weight loss Medications compared to surgery February 20, 2024
- SIPS-SADI and ASMBS December 31, 2023
- Survey December 16, 2023
- Long Term Outcome Survey December 1, 2023
- Weight Loss Injection May 10, 2023
Wow, thanks for the info, Dr K. I'm so glad I'm in Australia! If the specialist says it's medically necessary then it's accepted here.