Bill Summary for SB0786/HB0090

FYI: Bill Summary for SB0786/HB0090 "This bill would require health insurance agreements to offer coverage for bariatric surgery to treat morbid obesity, effective January 1, 2006. The covered procedures would include any gastrointestinal surgeries identified by the National Institutes of Health (NIH) as effective for treating morbid obesity. This bill would require health insurance providers to use the same reimbursement formula for bariatric surgery that they use for other procedures. Also, health insurance providers would be required to follow NIH guidelines when developing standards and barriers to access for bariatric surgery. Providers would be authorized to require documentation that the insured was unable to overcome morbid obesity via a physician assisted weight loss program whether or not the insurance provider covers physician assisted weight loss programs. This bill would not apply to the following types of health insurance policies: government health plans such as Medicare or TennCare, short term travel, accident-only, limited or specific disease, or short term nonrenewables of up to six months." Tammy

Okay so does this mean that the company my hubby works for would have to remove the exclusion they have??

Yes, I believe that if they pass this bill into law, all private/group health insurance policies will be required to cover WLS as long as they follow the NIH guidelines. Tammy

Sorry, I thought you lived in TN. I didn't realize you were in Alabama and that your husband's insurance was BCBS of Alabama. This is a State of TN bill/law, that is why I posted it on the State of TN message board. Sorry for any confusion. I did find this info by searching our state's legislature's webpage so you might want to try doing that for your state, maybe your state has one too. Good Luck. Tammy

My hubby works for a company out of TN and therefore has BCBS of TN not BCBS of AL. I have BCBS of AL and they consider the DS 'experimental'. I do know that BCBS of TN does not consider the DS 'experimental' that is why I am excited to see if this law will pass. That way I can have the surgery and have my hubby's insurance cover it--if the company will be required to remove the exclusion for WLS due to the new law.

My hubby works for a company out of TN and therefore has BCBS of TN not BCBS of AL. I have BCBS of AL and they consider the DS 'experimental'. I do know that BCBS of TN does not consider the DS 'experimental' that is why I am excited to see if this law will pass. That way I can have the surgery and have my hubby's insurance cover it--if the company will be required to remove the exclusion for WLS due to the new law.