Help for those needing answers to OHP questions

I came across this information on the OHP website and thought it might be helpful to those asking questions about the state program. This info is from the state medicaid manual, pub 6 covered issues manual, medical procedures. 35-26 Treatmeant of obesity- "services in connection with the treatment of obesity are covered services when such services are an integral and necessary part of a course of treatment for one of these illnesses." Meaning-hypothyroidism, Cushings disease, hypothalamic lesions, diabetes, hypertension, cardiac and respiratory diseases. 35-40 Gastric Bypass Surgery for Obesity- Gastric bypass surgery, which is a variation of the astrojejunostomy, is performed for patients with extreme obesity. Gastric bypass surgery for extreme obesity is covered under the program if (1) it is medically appropriate for the individual to have such surgery; and (2) the surgery is to correct an illness which caused the obesity or was aggravated by the obesity. The website is www.omap.hr.state.or.us/stateplan/ then go to www.hcfa.gov/medicaid this is the department of health and human services health care financing admin. my physician says yes the OHP does pay for this surgery. however i think it must be for the types of conditions that are listed on this website. good luck email me if have questions or just want to talk. [email protected]

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