NPR : News

Filed Under:

Medicare Offers Expanded Coverage To Battle Expanding Waistlines

Keeping off the pounds is tough at any age. Now seniors are getting a helping hand from the Centers for Medicare and Medicaid Services, which has announced that it will cover screening and counseling for obesity as a free preventive service for Medicare beneficiaries.

Coverage is effective immediately.

Advocates hope that CMS's decision may encourage private insurers and Medicaid to begin covering obesity screening and counseling as well.

"I think it's fantastic," says Dr. Marijane Hynes, a primary care physician at George Washington Medical Faculty Associates Weight Loss Clinic.

"We've been dealing with diabetes and hypertension and working backwards," she says. Now physicians can address obesity on its own, hopefully before related medical problems arise.

Under the new rules, beneficiaries whose body mass index is 30 or higher would be eligible for counseling services. The covered benefits include one face-to-face counseling session every week for a month, then counseling every other week for an additional five months. Beneficiaries who have lost at least 6.6 pounds at the end of six months would be eligible for six more monthly counseling sessions.

The coverage is in line with current recommendations from the U.S. Preventive Services Task Force, which recommends intensive counseling and behavioral interventions for obese adults.

More than a third of Medicare beneficiaries have BMIs over 30, the cutoff for obesity, according to CMS.

Until now, doctors didn't get paid for counseling patients about their weight. "Lack of reimbursement is one of those obstacles to getting physicians and their patients into a dialogue about weight management," says Morgan Downey, publisher of the Downey Obesity Report and former executive director of the American Obesity Association.

Now, at least for Medicare beneficiaries, that barrier is removed.

Many private plans currently cover bariatric surgery for people who are morbidly obese, but don't cover less drastic treatments like counseling before people reach that stage.

"For the earlier stages of obesity, coverage is much more spotty, and that's a problem that most employers and health plans are trying to work through," says Ted Kyle, a pharmacist and chairman of the Obesity Society's advocacy committee.

Medicare covers bariatric surgery in certain instances.

So are most primary care physicians ready to hit the ground running now and begin counseling their Medicare patients about how to change their diets and habits and lose weight? No, says Hynes.

But now that doctors will get paid for taking the time to do so, they can offer a handful of suggestions straight off, like encouraging people to get out and walk more or stop drinking sugary juices, she says.

Patients who've been struggling to drop pounds for years may in fact be more clued in about weight loss strategies than their doctors, at least initially, says Downey. "But hopefully it will be a minority of cases, and [the new coverage] will encourage physicians to seek out information in this area," he says.

Copyright 2011 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

NPR

Black Leadership In The Age Of Obama: A Look Back

PBS NewsHour co-anchor Gwen Ifill joins All Things Considered from the Democratic National Convention in Philadelphia, to discuss her 2009 book The Breakthrough. Ifill is re-examining the book's conclusions about black political leadership as President Obama prepares to leave office.
NPR

QUIZ: How Much Do You Know About Presidents And Food?

It's week two of the party conventions, and all these speeches are making us hungry. So we made a quiz to test your savvy about presidents and our favorite topic, food.
NPR

LIVE BLOG: President Obama To Headline Third Night Of DNC

As the third day opened, Bernie Sanders supporters demanded a roll call to nominate Tim Kaine as the Democratic vice presidential candidate. Kaine was eventually nominated by acclamation.
NPR

Police Use Fingertip Replicas To Unlock A Murder Victim's Phone

Michigan State University engineers tried 3-D-printed fingertips and special conductive replicas of the victim's fingerprints to crack the biometric lock on his Samsung Galaxy phone.

Leave a Comment

Help keep the conversation civil. Please refer to our Terms of Use and Code of Conduct before posting your comments.