IQ Testing
I was doing my homework and ran across this article..........
Modern Healthcare; 1/29/2007, Vol. 37 Issue 5, p36-36, 1p, 1c
Patient advocates are crying foul over a first-of-its-kind coverage policy instituted by Blue Cross and Blue Shield of Tennessee-one that requires seriously obese members to undergo intelligence testing before being approved for bariatric surgery.
The Obesity Action Coalition has called for the Tennessee Blues to immediately scrap the test, part of a rigorous medical and psychological screening process prior to the procedure. The coalition claims that the policy, implemented by the Chattanooga-based company in April 2006, is discriminatory and sets a dangerous precedent of denying access to care based on a patient's intellect.
"They're perpetuating the ugliest of stereotypes associated with obesity today--that the obese are somehow of lower intelligence than the general public," says coalition spokesman James Zervios. "It's just another hurdle for the obese patient to overcome in trying to access life-saving treatment."
By its own account, the Tennessee Blues is the first known insurer to require IQ testing to access any medical procedure, bariatric or otherwise. But the 4.6 million-member company insists it has never denied coverage based on a patient's IQ score; rather, the test results are used to ensure that patients are "mentally equipped" to undergo a major procedure that will require them to make lifelong changes in diet and exercise.
"There is nothing in our policy that indicates you cannot have the procedure if you score below a certain level," says Tennessee Blues spokesman Mary Thompson. "But based on what a person's score is, we know how much follow-up they will need or how intensive the case management should be. If a person's IQ is deemed low ... it could have a bearing on the level or method of (preoperative education) and follow-up they require."
The new policy comes as health insurers, deluged by bariatric-surgery claims, have been moving to restrict coverage of the $25,000 procedure. Some insurers have stopped paying for the surgery altogether, while a growing number of others now require patients to either lose 10% of their body weight or prove they failed a medically supervised diet program.
Zervios fears that the Tennessee Blues' new policy could create a snowball effect among insurers desperate to cut costs. "This is something that needs to be stopped before it catches on anywhere else," he says. "Otherwise, what's next? Denying cancer patients chemotherapy if their IQ scores come back too low?"
Modern Healthcare; 1/29/2007, Vol. 37 Issue 5, p36-36, 1p, 1c
Patient advocates are crying foul over a first-of-its-kind coverage policy instituted by Blue Cross and Blue Shield of Tennessee-one that requires seriously obese members to undergo intelligence testing before being approved for bariatric surgery.
The Obesity Action Coalition has called for the Tennessee Blues to immediately scrap the test, part of a rigorous medical and psychological screening process prior to the procedure. The coalition claims that the policy, implemented by the Chattanooga-based company in April 2006, is discriminatory and sets a dangerous precedent of denying access to care based on a patient's intellect.
"They're perpetuating the ugliest of stereotypes associated with obesity today--that the obese are somehow of lower intelligence than the general public," says coalition spokesman James Zervios. "It's just another hurdle for the obese patient to overcome in trying to access life-saving treatment."
By its own account, the Tennessee Blues is the first known insurer to require IQ testing to access any medical procedure, bariatric or otherwise. But the 4.6 million-member company insists it has never denied coverage based on a patient's IQ score; rather, the test results are used to ensure that patients are "mentally equipped" to undergo a major procedure that will require them to make lifelong changes in diet and exercise.
"There is nothing in our policy that indicates you cannot have the procedure if you score below a certain level," says Tennessee Blues spokesman Mary Thompson. "But based on what a person's score is, we know how much follow-up they will need or how intensive the case management should be. If a person's IQ is deemed low ... it could have a bearing on the level or method of (preoperative education) and follow-up they require."
The new policy comes as health insurers, deluged by bariatric-surgery claims, have been moving to restrict coverage of the $25,000 procedure. Some insurers have stopped paying for the surgery altogether, while a growing number of others now require patients to either lose 10% of their body weight or prove they failed a medically supervised diet program.
Zervios fears that the Tennessee Blues' new policy could create a snowball effect among insurers desperate to cut costs. "This is something that needs to be stopped before it catches on anywhere else," he says. "Otherwise, what's next? Denying cancer patients chemotherapy if their IQ scores come back too low?" 
OK I am waiting for the flaims now. I can kinda understand where they are coming from on this. I mean would someone who is mentally disabled really understand what is going on and understand what they need to do after surgery? (I am not talking mildly disabled. I am talking moderatly or severly disabled or those that are not even aware of what is going on) But to say that you have to have a 100 or higher that would not be right. At the same time this is a call the doctors should be making. If the doctor doesn't think the person would be able to follow the aftercare plan then they shouldn't be submitting the info to the person's insureance. I guess the bottonline is this: This is something that should be taken care of in the pre-op stages of the tests, as in will they follow the diet after and understand what is going on. Not something for the insurance companies to determine.
Hi Kathy,
The required sessions with the program psychologist shows him/her if a person is capable of the proper mind set and if they'd be able to do follow up care and do the plan accordingly...without an IQ test.
I think with the IQ test, itself, would not show if a patient would be able to do this. It's just a test, a number...and even some of the highest of intelligent people wouldn't be able to follow the plan! It's all how dedicated someone is to this venture, also.
Now, if someone is severely mentally disabled (ie: downs syndrome, psychotic, etc) would take a lot of evaluation by the pros to see if they'd actually understand what is truly involved with the surgery. I don't think that they'd do surgery on them. But, the term "mentally disabled" is a very broad term with a lot of different levels in between.
I guess there's a lot of avenues to it that have to be thought about.
Paula
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