Medicare May Cover Weight Loss Surgery for Diabetes Patients

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Medicare May Cover Weight Loss Surgery for Diabetes Patients

Good news from the Centers for Medicare and Medicaid Services, which last week announced a clarification in its policy for Medicare coverage of bariatric surgery as a treatment for people with Type 2 Diabetes.

CMS will now consider Type 2 Diabetes as one of the co-morbidities used to determine whether bariatric surgery will be covered by the program – the stipulation being that the beneficiary must be morbidly obese, with a BMI of at least 35. Bariatric surgery will NOT be covered by Medicare when it is used to treat Type 2 Diabetes in a beneficiary with a BMI below 35.

This marks the first major policy change since 2006, when CMS expanded coverage of weight loss surgery for Medicare beneficiaries who exhibited a serious health condition in addition to morbid obesity, including high blood pressure, coronary artery disease, or osteoarthritis.

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