CMS, which first floated the obesity coverage plan last September, said it expects more than 30% of the Medicare population to qualify for the new benefit. Beneficiaries with body mass index values of 30 or more can receive weekly in-person intensive behavioral therapy visits for one month, followed by visits every two weeks for an additional five months, fully paid by Medicare ---- with no copayment.
Additional monthly sessions will be covered for up to six months afterward if the beneficiary has lost at least 6.6 pounds (3 kg) during the first six months. Medicare patients who fail to lose the 6.6 pounds in six months may be reevaluated at the one-year mark after the initial screening. Those showing "readiness to change" and a BMI value still at 30 or more may receive another round of counseling paid by Medicare.
A former president of the American Heart Association was also not 100% pleased with the new coverage. Robert Eckel, MD, of the University of Colorado's medical school in Aurora, Colorado said in a recent phone interview that he was skeptical that the counseling to be provided would achieve major, lasting improvements in patients' health. "The question is sustaining the benefit" of successful weight loss beyond the first year, he said. He said his initial reaction was that the coverage is "more money [paid out by Medicare] without proven benefit."
To qualify under the new benefit, counseling must be consistent with the "five A's" listed in a U.S. Preventive Services Task Force recommendation, according to CMS's decision memo:
- Assess: Ask about/assess behavioral health risk(s) and factors affecting choice of behavior change goals/methods.
- Advise: Give clear, specific, and personalized behavior change advice, including information about personal health harms and benefits.
- Agree: Collaboratively select appropriate treatment goals and methods based on the patient's interest in and willingness to change the behavior.
- Assist: Using behavior change techniques (self-help and/or counseling), aid the patient in achieving agreed-upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change, supplemented with adjunctive medical treatments when appropriate.
- Arrange: Schedule follow-up contacts (in person or by telephone) to provide ongoing assistance/support and to adjust the treatment plan as needed, including referral to more intensive or specialized treatment.
DR SCHIERLING'S COMMENTS ON THIS REPORT:
Hey, there is no one out there that understands more than I do what excess weight is doing to this country. In fact, I believe that it is such a critical issue that I have website categories for both OBESITY and WEIGHT LOSS. Medicare's guidelines are a joke. You get the first 6 months on the taxpayer's dime. And if you can manage to loose 1.1 lbs a month for those six months, you get an additional 6 months. For those who can't loose 6 lbs in 6 months ---- but "show a readiness to change" you can also get an extra 6 months.
Will this work? Not a chance! How do I know this? Most of the medical community is still practicing about 40 years behind the current research in this particular area (HERE). They are still promoting diet pills (anyone remember Fen Phen?), and "FAT FREE" eating; all while destroying the ENDOCRINE & IMMUNE SYSTEMS with round after round of antibiotics and other harmful drugs. Tax payer funded obesity counseling is nothing more than the medical community's attempt to grab hold of an even bigger slice of the pie (no pun intended) that is the extremely lucrative weight loss industry --- especially when medical science has shown us that RAPID WEIGHT LOSS is more effective than slow weight loss!
And the comments by Dr. Wilensky about this program being evaluated for 5 years and either continued or dropped.... How many government programs are ever dropped? Once a program is begun, it takes on a life of its own. Why do you think our government is so bloated and out of control?
By the way, compare these maps below. It is a well known fact that many prescription drugs are associated with weight gain. In fact, interestingly enough, states with the highest prescription rates also tend to be the states with the highest rates of obesity. Medicare already plies American seniors (already the single most over-medicated group of people on the planet) with an unlimited supply of drugs. Now they are going to get them while they are coming and going by providing "counseling". Is anyone going to help them get off their 15-20 medications? Of course not! If the doctors and politicians who run Medicare have their way (you know; that group of people with their hands deep in the pockets of Big Pharma), it will be a craddle-to-grave drug-fest.