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New Type of Therapy to be Covered by Medicare


The Centers for Medicare & Medicaid Services (CMS) recently announced that Medicare will now cover the costs of behavioral therapy for Americans suffering from obesity.

“The announcement by the Centers for Medicare & Medicaid Services that Medicare will now cover intensive behavioral therapy for obesity will help our nation take on one of its most significant health problems,” said American Heart Association CEO Nancy Brown. “It will also move us one step closer to achieving our shared goal of preventing one million heart attacks and strokes.”

On November 29th, the CMS announced the addition of more preventive services to the lineup that is already available at no cost to Americans. These services include obesity screenings and counseling aimed at reversing the trend of steadily increasing obesity rates in the United States.

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

The screening and counseling services are, under the Affordable Care Act, available at no cost to qualified Americans. But determining the qualification of each of those wishing to participate comes through a very specific set of criteria.

According to the CMS, those who screen positive for obesity with a BMI of 30 or greater are eligible for one face-to-face counseling visit every week for a month, and then one visit every other week for an additional five months.

What’s more, if the beneficiary experiences adequate documented reductions in weight (at least 6.6 pounds, or 3 kilograms) during the first six months, then they will be eligible for six additional months of monthly counseling sessions.

“This decision is an important step in aligning Medicare’s portfolio of preventive services with evidence and addressing risk factors for disease,” says Dr. Patrick Conway of CMS.

With more than 72 million Americans (34 percent of all American adults) suffering from obesity, the passing of this measure will provide the opportunity for many to make changes in their daily lives.

“We can begin to change this dire forecast with prevention and treatment,” Brown adds. “This new Medicare benefit will go a long way to help stamp out obesity, one of the nation’s greatest health challenges.”

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