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Obese elderly or disabled patients are now eligible for a variety of surgical weight-loss procedures under the U.S. Medicare health insurance plan, U.S. government officials said on Tuesday.
Patients must have tried and failed other weight loss options, have at least one weight-related medical problem and have a high body mass index, the Centers for Medicare and Medicaid Services said.
Previously, Medicare patients could only receive gastric bypass surgery, in which the lower part of the stomach is either closed off or removed and its contents detoured around the large intestine directly to the small intestine.
But Tuesday’s final ruling opens the door to laparoscopic adjustable gastric banding that squeezes the stomach smaller with a small band.
Companies that make stomach bands and other devices for weight-loss procedures, including Inamed Corp., Tyco International Ltd.‘s US Surgical, and Johnson & Johnson unit Ethicon Endo-Surgery Inc., had asked Medicare to consider coverage.
Privately held Transneuronix Corp. as well as the American Society for Bariatric Surgery and the American Obesity Association also made the request.
The decision may help set coverage standards for insurance companies, which eye agency decisions before setting their own policies.
Medicare officials previously proposed coverage only for disabled patients, citing possible risks for the elderly. Under the final decision, older patients can only undergo the procedure at medical centers that treat large numbers of patients and have low death rates.