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CMS removes language that said obesity is not an illness

Physician Practice Advisor, July 21, 2004

The United States Department of Health & Human Services (HHS) removed language in the Medicare Coverage Issues Manual that stated that obesity was not an illness. Though this isn't a green light for Medicare to cover obesity-related treatment, it is a step in that direction.

"With the new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese and its many associated medical conditions," said HHS Secretary Tommy G. Thompson. 

Legally, Medicare can only cover medically necessary services for illness and injury. If obesity wasn't an illness, Medicare couldn't cover obesity treatment. Now the public can request that Medicare review medical evidence to determine which obesity treatments will be covered.

"This change in Medicare's coverage policy puts the focus on public health," said CMS Administrator Mark McClellan, M.D., Ph.D. "The medical science will now determine whether we provide coverage for the treatments that reduce complications and improve quality of life for the millions of Medicare beneficiaries who are obese."

For more information, click here.

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