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
Revision on 10/29/12
My surgeons office told us about this and that they should be considered a center for excellence soon (NWH). I actually agree with this requirement. Medicare deals with the frailest members of our country the elderly and disabled and they should be managed by hospitals with a great deal of experience and not just whoever is convenient. I think anything meant ot protect the patient is a great thing. Other insurance companies may follow suit in the future and this would in effect force all bariatric surgeons to have comprehensive programs and to focus on this field rather than doing a few a year. Surgeons shouldn't be allowed to practice in this field if they ar enot interested in being the best and offering psych, nutrition, and very (importantly) support groups...if a practice doesn't ahve these they shouldn't be doing surgery.
Lisa
I think you are getting a little carried away here. Hospitals have more than 2 years to apply as a center of excellence. I used it as one of my criteria picking hospitals before my surgery in 2003.
Recent studies have shown the the mortality rate at these hospitals is much better than average.
Your crusade would be better spent going after the small hospitals that are getting into wls without the needed experience, equipment and support.
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