has medicare changed thier policy?

I have seen a few folks talking about medicare changing what they expect you to do before you can have surgery. Does anyone have a site or a list I can look at.?? Tina

Hi Tina. I haven't seen you around latley. How is everything going? How are you coming along with getting approved for surgery. Are you still working on it. Hope everything is going good with you. 

Misty, Well things are not good here... My dad is in the hospital. He had to have emergency surgery and is not doing too well.  I haven't been able to get to the doctor to start my process and I am so worried that by the time I do get to the doctor the insurance will have changed thier process. I hope to get here more often and things just go from bad to worse. I miss you guys a BUNCH!!! But my daddy comes first.....  Sending my love to you all. Tina

I am sorry to hear about your Dad. I hope and pray he makes a full recovery. I do not know anything about medicare and their policies so I can't help. But don't forget to also take care of yourself and I hope everything works out for you. Talk to you soon.

Hi Tina,  hope this helps  Good Luck, Belinda... Medicare criteria effective February, 2007

·        BMI of 35 or greater with one of the following life-threatening or disabling co-morbid conditions: poorly controlled type II diabetes, poorly controlled hypertension, poorly controlled dyslipidemia, severe cardiopulmonary disease (e.g. coronary disease, CHF, asthma, COPD, pulmonary hypertension), obstructive sleep apnea, severe arthropathy of weight bearing joints or pseudotumor cerebri

 

·        Surgery is medically appropriate for the patient

 

·        There is documented evidence of repeated failure of multiple attempts (usually 3) to lose weight on a supervised non-surgical management weight loss program (e.g., diet, exercise or drugs).  It would be expected that a weight loss program would consist of compliance with a physician directed program for at least a consecutive 6 month period without significant gaps.  Monthly documentation of the beneficiary’s compliance should include: **vital signs to include weight, current dietary program, physical activity/exercise program, behavioral interventions, consideration of or use of pharmacotherapy with FDA- approved medication, if appropriate       

 

·        Psychological evaluation (and counseling)

 

·        Treatable metabolic causes for obesity (e.g., adrenal, pituitary or thyroid disorders) have been ruled out or if present have been maximally clinically treated if present

 

·        Surgery performed at ASBS Center of Excellence

 

 

 

**All documentation must be written in the medical record monthly (diet, exercise and behavioral interventions)

 

 

 

 

 

 

 

 

 

 

 

Belinda, Thank you so very much. I just worry that if I get started with the six month diet that it wont be suffice for them to accept my having the surgery. I have been big all my life... I just want this to end.... and I am getting ready to get rid of it one way or another. I hope you have a great day and thank you ever-so-much for your information! Tina

You're welcome Tina,  glad that I could help. Take care, Belinda...