Bariatric Surgery on Hold?

Check out the response I got from ACHA (Agency for Health Care Administration ). I emailed them right after that post came out and just got a response this morning. Dear Ms. Long: Thank you for your email to the Agency for Health Care Administration regarding the Florida Medicaid program and coverage policy for bariatric/gastric bypass surgery. Your inquiry was sent to the Bureau of Medicaid Services for response. Florida Medicaid provides reimbursement for a variety of surgical procedures. Of these procedures, bariatric/gastric bypass surgery is covered for reimbursement when medically necessary, and must be performed by a Medicaid enrolled provider. Reimbursement for this procedure has not changed. This procedure requires prior authorization before being performed. Your primary care physician must initiate the prior authorization process. Since this procedure is performed in the hospital, your physician must coordinate this authorization process with KePro South, the Medicaid peer review organization (PRO). They will work directly with your primary care physician to obtain medical information necessary for this review. Your physician may already have this information, however, if he is not aware of this process he may locate this information on the KePro South website at www.keprosouth.com, or by calling 1-866-889-6510 and request to speak to the provider services representative for your area. I hope this information is helpful. If you have further questions regarding the prior authorization process you may contact your local Area Medicaid Office at 904-353-2100. Sincerely, Madeleine Nobles Registered Nurse Consultant Bureau of Medicaid Services

Michelle, Thanks for the info and the update! Erika L.