HELP FIGHT MEDICARE'S RULING

Hi, everyone. Thanks for your responses. I'd like to clarify a couple of things: First, I was mistaken in thinking that this ruling just popped out of somebody's head. There *was* a comment period on the proposed ruling and so forth; apparently the hospitals knew this might be coming. So if you were in-process for WLS when this ruling came out, I urge you to contact your hospital and your surgeon and tell them that waivers are available. Ask them if they've applied for a waiver. Urge them to do it if they haven't and stay on them until they do. Second, I believe the new rules are *good*, not bad. My objection is only that the ruling didn't give facilities time to get certified, thus leaving so many of us hanging. I received a response from one of you saying that the comment period ended in December of 2005 and that the ruling went into effect in February of 2006. That's not NEARLY enough time for all the WLS facilities to get certified. Who knows how long it takes to get from application to approval? We're talking bureaucracy here, people. Nothing moves quickly. Third, here's concrete proof that this ruling didn't allow enough time to get certified: in the whole USA there are now only 117 facilities certified to perform WLS. Whole areas of the country don't have a certified facility. See which hospitals *are* certified here: http://www.cms.hhs.gov/MedicareApprovedFacilitie/BSF/list.asp#TopOfPage (thanks for the link, those who posted it) One of you pointed out that Medicare recipients should have been notified of the proposed rule; I agree wholeheartedly. Another response pointed out that the hospitals were hoping the rule wouldn't pass, which is why they didn't apply for certification. I disagree. There are just too many hospitals that aren't on the certified list - there can't be that many with their heads in the sand. Someone else suggested that hospitals didn't apply for the certification because it costs them money to get certified. THAT, I believe. I still urge you to contact your lawmakers. I paid to have this issue listed in the Soapbox at congress.org; I'm now asking everyone to PLEASE visit and voice your opinion: http://www.congress.org/congressorg/issues/alert/?alertid=8541136&content_dir=ua_congressorg Thanks, everyone. Lisa Owens

I'm so glad to hear someone talking about this subject. I was in the process of looking for a surgeon when thi**** the fan. Since I had not started the paper work yet I wouldn't be eligible for a waiver. I am in a part of the country where there are very few Centers of Excellence. I have found one in Little Rock but their doctors don't qualify and one in St. Louis but they don't accept Medicare. I wonder what criteria they used to certify the doctors & hospitals? I live in north central Arkansas and I am 63 yrs. old. I'm afraid that by the time a hospital and doctor near me gets certified I'll be too old. Thanks for letting me vent. Marilyn A

I live in Missouri where this is a center of excellence and you're right, they don't accept Medicare as far as I could find out. When I found out about the Medicare policy, I started researching, I wanted to know what it took for a hospital to become a center of excellence and how long it would take. This is what I found at the Surgical Review Corporation website: "For a center to receive an ASBS/SRC Center of Excellence designation the hospital or institution must perform at least 125 bariatric surgeries per year collectively and the surgeon must have performed at least 125 bariatric surgeries him or herself and perform at least 50 per year. The Center must also report long-term patient outcomes and have an on-site inspection to verify all data. In addition, the Center must have a dedicated multi-disciplinary bariatric team that includes surgeons, nurses, medical consultants, nutritionists, psychologists and exercise physiologists." Also, these are the fees to be paid to become a Center of Excellence: Application Fees: Surgeons Provisional Status: $500 Full Approval: $1,000 Hospitals Provisional Status: $5,000 Full Approval: $10,000 Surgical Groups Provisional Status: No Fee Full Approval: No Fee Renewal Fees: Surgeons: $500 Hospitals: $5,000 Surgical Groups: No Fee For more information on the process that they have to go through, go to this link: http://www.surgicalreview.org/centers.html I wish you all the best of luck on your journey, Lia