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U.S. Reviews Weight-Loss Coverage

November 26, 2005|From Associated Press

WASHINGTON — The government is proposing to expand Medicare coverage of weight-loss surgery for the disabled, but eliminate coverage of such surgery for the elderly.

The Centers for Medicare and Medicaid Services said that gastric bypass and other weight-loss surgeries might help people with extreme obesity. That is why the agency is proposing to make it easier for the disabled to get the surgery.

Medicare now covers the cost if the surgery is recommended to treat other health problems. The proposed expansion would allow for the treatment of obesity before associated health problems set in.

"While the best proven treatment is a nutritious diet and regular exercise ... some beneficiaries may significantly reduce their health risks through surgery," said Mark McClellan, the agency's administrator.

Recent medical studies have shown that weight-loss surgery poses greater risks for the elderly, the agency said in explaining its proposal that Medicare not cover such operations for those beneficiaries.

About 8,000 Medicare beneficiaries had weight-loss surgery covered through the program in 2004. About three-quarters of those procedures were for the disabled and one-quarter were for the elderly. The government paid about $13,000 per procedure, agency officials said.

Last month, a study in the Journal of the American Medical Assn. showed that death rates after weight-loss surgery for patients age 65 and older were two to three times higher than they were for younger people.

The proposal is not final. The agency is seeking public comment on how much to expand coverage for the disabled and how much to curtail it for the elderly.

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