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Medicare to Cover Obesity Prevention Services

Published: 1/31/12
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In late November, the Centers for Medicare and Medicaid Services (the federal agency that administers the two public insurance programs) announced that Medicare would begin covering obesity prevention services. Under the new benefit, Medicare beneficiaries are eligible to receive free obesity screenings, and individuals identified as obese (a Body Mass Index of 30 kg/m2 or greater) are also eligible for free obesity counseling in primary care settings. The counseling consists of weekly face-to-face sessions with a primary care provider for the first month and bi-monthly face-to-face sessions for the next five months. Individuals who lose at least six-and-a-half pounds of weight over this period will also qualify for an additional six months of counseling. The counseling services covered under the benefit include diet assessments, behavioral counseling, and behavioral therapy. However, weight-loss medications will not be reimbursed. The benefit is part of a collection of preventive services now covered by Medicare under the new healthcare reform bill (Affordable Care Act). Although the benefit has some limitations (e.g., counseling by dieticians and behavioral psychologists will not be reimbursed; counseling is limited to one year), with approximately 30% of Medicare enrollees now obese, it represents an important step in our nation’s efforts to address the growing obesity epidemic. In the coming years, we look forward to tracking the success of this program within the Medicare population, and we hope to see Medicare’s actions spur other large insurers to adopt similar obesity prevention policies. –BK

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