Policy
Medicare to Pay for Obesity Screening & Counseling
In 2012, Medicare will start paying for “preventive services” related
to obesity.
Noting that an estimated 30 percent of men and women who
are Medicare beneficiaries are obese, the Centers for Medicare& Medicaid Services (CMS) announced Dec. 2 that it would begin
covering screening and counseling services.
CMS Administrator Donald M. Berwick, M.D., in one of his final
announcements before stepping down, noted, “Obesity is a challenge
faced by Americans of all ages, and prevention is crucial for the
management and elimination of obesity in our country. It’s important
for Medicare patients to enjoy access to appropriate screening and
preventive services.”
The CMS announcement of the new obesity coverage policy linked
the condition to “many chronic diseases, including those that disproportionately
affect racial and ethnic minorities, such as cardiovascular
disease and diabetes. Addressing the prevention of obesity-related
disparities has the potential to reduce obesity prevalence while also
closing the gap on health disparities among Medicare beneficiaries.”
Screening and counseling services by primary-care providers will
be covered. Beneficiaries who are found to be obese — defined by
a body mass index equal to or greater than 30 kg/m2 — would be
offered a face-to-face counseling visit each week for the first month,
then face-to-face visits every other week for five more months.
Patients who lose at least 6.6 lbs. (3 kg) of weight during their first
six months of counseling would then be offered face-to-face counseling
visits once a month for an additional six months in hopes of
keeping the trend going.
Counseling would include dietary assessment and “intensive
behavioral counseling and behavioral therapy to promote
sustained weight loss through high-intensity interventions on diet
and exercise.”
This article originally appeared in the January 2012 issue of Mobility Management.