Medicare Coverage of Obesity Treatments on Horizon while Reimbursement for Sleep Therapy Shrinks

Just as Medicare and CMS are cutting reimbursement as much as 75% on Durable Medical Equipment Services and Products U.S. Rep. Bill Cassidy filed legislation to make some weight-loss prescription drugs and treatments available to residents through the federal Medicare program for seniors.

The “Treat and Reduce Obesity Act” comes on the heels of the American Medical Association deciding to officially recognize obesity as a disease.

In the past, many weight-loss drugs and treatments were considered too risky or having too many side effects, Cassidy said, so Medicare disallowed the inclusion of obesity treatments. But medicine and technology have advanced enough over the years that now is the time to legally allow such treatments through Medicare, he argued.

“The only way we improve health care outcomes is by preventing those (unhealthy) drivers,” Cassidy said.

Ironically a Nation Sleep Foundation study finds “Sometimes the best way to treat obesity can be to treat an underlying sleep problem. Successful treatment of sleep apnea, usually with nasal continuous positive airway pressure (CPAP), may reduce sleepiness and then motivate patients to effectively lose weight, which will in turn help the obesity and the sleep apnea,”

Although no cost is attached to the bill yet, the legislation could bring federal cost hikes with the goal of preventative care.

“As a physician, I have personally seen the impact of obesity on people’s health and spiraling health care costs,” Cassidy said in his prepared statement. “The medical consequences of obesity are clear, but less often discussed is the fiscal consequence of America’s growing waistline.”

He contended that obesity is responsible for $61.8 billion in Medicare and Medicaid spending. In 2010, the Congressional Budget Office said that nearly 20 percent of the increase in health care spending was caused by obesity.

Conversley a Harvard Study found as of 2011 the total annual costs of Obstructive Sleep Apnea (OSA) and related conditions to be $115 billion. Much like Obesity multiple health conditions stem from untreated OSA. Cardiovascular Disease, Hypertension, Diabetes, Sleep related Vehicle Accidents, Depression as well as Obesity.

Cassidy’s bill is cosponsored by U.S. Rep. Ron Kind, D-Wis., and in the Senate with U.S. Sens. Lisa Murkowski, R-Alaska, and Tom Carper, D-Del.

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