Endocrine Insider
February 5, 2009

Last week, The Endocrine Society and its partners, the American College of Surgeons (ACS), the Society for American Gastrointestinal and Endoscopic Surgery (SAGES), and the American Society for Metabolic and Bariatric Surgery (ASMBS), met with members of the Centers for Medicare and Medicaid Services (CMS) Coverage and Analysis Group on the agency's proposal to limit coverage for bariatric surgery to patients with type 2 diabetes and a BMI equal to or greater than 35. Patients with type 2 diabetes and a BMI of 30 to 34 would be ineligible for coverage of bariatric surgery under the Medicare program.

CMS acknowledged in its proposed policy that very little data exist on the subject of bariatric surgery in patients with type 2 diabetes and a BMI less than 35. The Society and its partners stressed in written comments and in their meeting with CMS that eliminating coverage for this population would almost ensure that these data would never be collected, as such an exclusion of coverage would likely impair the ability to recruit and retain volunteers for the randomized controlled studies that CMS recommends.

At the meeting, the Society, ACS, SAGES, and ASMBS recommended that CMS issue a coverage with evidence determination (CED) to allow for additional data to be gathered in the area of bariatric surgery in patients with type 2 diabetes and a BMI of 30 to 34. CMS plans to release its final rule on this subject in the coming weeks.

Stay tuned to Endocrine Insider for more information when the final rule is released.