Medicare to Cover Surgery to Treat Obesity

Medicare has announced that it will pay for three forms of obesity surgery as long as the procedures are done in “high-volume centers that achieve low mortality rates.”

Under the new rules, Medicare will pay for surgery for obese patients who have unsuccessfully tried other treatments, have a body mass index of more than 35 and suffer from other weight-related problems such as diabetes, heart disease or sleep apnea as long they have the operations at centers certified as well qualified by the American College of Surgeons or the American Society of Bariatric Surgery.

The coverage will be limited to three of the most commonly performed procedures for restricting the size of the stomach — Roux-en-Y gastric bypass, gastric banding and biliopancreatic diversion with a duodenal switch. The number of people undergoing the procedures, which cost $25,000 to $40,000, has increased rapidly over the last decade, jumping from about 16,000 operations in 1992 to an estimated 170,000 in 2005.

The decision is important because private insurers often follow Medicare’s lead.