Medicare to Cover Obesity Screening, Counseling

By Steve Gigliotti
Steve Gigliotti
Steve Gigliotti
December 1, 2011 Updated: December 1, 2011
First Lady Michelle Obama (R)
First Lady Michelle Obama (R) speaks alongside Health and Human Services (HHS) Secretary Kathleen Sebelius (L) on childhood obesity, and steps that families, schools and communities can take to fight it. This week The Centers for Medicare and Medicaid Services (CMS) announced that Medicare is adding coverage for preventative services to reduce obesity. (Saul Lobe/AFP/Getty Images)

The Centers for Medicare and Medicaid Services (CMS) announced this week that Medicare is adding coverage for preventative services to reduce obesity. These services are now offered under the Affordable Care Act. The goal of the program is to prevent 1 million heart attacks and strokes over the next five years.

“Obesity is a challenge faced by Americans of all ages, and prevention is crucial for the management and elimination of obesity in our country,” said CMS Administrator Donald M. Berwick, MD. “It’s important for Medicare patients to enjoy access to appropriate screening and preventive services.”

Obesity is defined as patients that have a Body Mass Index (BMI) of 30 or greater. According to the Centers for Disease Control and Prevention (CDC), there has been a dramatic increase of obesity in the United States over the past 20 years.

According to CMS, in 2010 there was no state in the country with an obesity rate of under 20 percent, with 12 states having obesity rates of over 30 percent. On average, one-third of all adult Americans are obese.

Last year first lady Michelle Obama, along with Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and U.S. Surgeon General Regina Benjamin, announced their plans to combat obesity. “The surge in obesity in this country is nothing short of a public health crisis that is threatening our children, our families, and our future,” said first lady Michelle Obama. “In fact, the health consequences are so severe that medical experts have warned that our children could be on track to live shorter lives than their parents.”

Beneficiaries of Medicare who are diagnosed with obesity would qualify for the care. The care will include face-to-face counseling to reduce the patient’s weight. Under the program, the patient will receive counseling every week for a month, then every other week for an additional five months. Following this, the patient may receive counseling for an additional six months, provided they have a weight reduction of at least 6.6 pounds.

Obesity related deaths are estimated to be at 400,000 each year in the United States. In 2008, the medical costs to combat obesity totaled about 147 billion dollars, according to the CDC.

“This decision is an important step in aligning Medicare’s portfolio of preventive services with evidence, and addressing risk factors for disease,” said Patrick Conway, M.D., MSc, CMS chief medical officer and director of the agency’s Office of Clinical Standards and Quality. “We at CMS are carefully and systematically reviewing the best available medical evidence to identify those preventive services that can keep Medicare beneficiaries as healthy as possible, for as long as possible.”

Steve Gigliotti
Steve Gigliotti