FIGHT MEDICARE'S RULING ABOUT HOSPITALS!!

According to the news and the PA at the surgeon's office where I *had* an appointment for next week, on February 21st the announcement was made that "Medicare would cover some procedures only at hospitals considered "centers for excellence" by the American College of Surgeons and the American Society for Bariatric Surgery." Hospitals were given no time to apply for certification from either organization. We ALL need to contact our federal congressmen and senators about this. The more he11 we raise, the more likely it is the rule will be reversed or revised. Here are some things to point out in your communication (preferably by phone): 1. There was no notice given for this ruling. Hospitals should have had time to apply for certification. 2. Obesity is a life-threatening disease and this ruling has dramatically reduced the facilities available to perform bariatric surgery for months to come. 3. Waivers ARE available and you should urge your politicians to push for a waiver for your particular hospital. Here's the list of US Senators. Just find yours and slam them with emails & phone calls: http://www.senate.gov/general/contact_information/senators_cfm.cfm Here's the list of Congressmen. Ditto above: http://www.congress.org/congressorg/issuesaction/alertlist/?issue=30

Thank you, Lisa, for this important information as this as impacted my situation. I was all set on Friday to hear from my surgeon's office about scheduling a date for surgery and, to my dismay, they called and said that because they are not a "center of excellence" they cannot perform my surgery. Although I am not really under Medicare, my insurance is Tricare Prime (the government insurance program for military personnel, both retired and active duty) which I'm almost certain uses the same criteria as Medicare. I have been unable as yet to get any straight answers from Tricare--surprise, surprise. In researching "centers of excellence" I have only found one in the Phoenix area which means they are going to be really busy. I am definitely going to be contacting my congressmen. Thanks again, Lisa.

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