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.

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