CMS covers obesity screening, counseling

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Obesity will now join the portfolio of preventive services covered by Medicare under the Patient Protection and Affordable Care Act (PPACA), according to the Centers for Medicare & Medicaid Services (CMS).

CMS said that the new initiative aligns with the Million Hearts initiative led by both CMS and the Centers for Disease Control and Prevention and multiple other Health and Human Services agencies. The goal of the initiative aims to prevent one million heart attacks and strokes in the next five years.

According to CMS, nearly 30 percent of the Medicare population is classified as obese, which can lead to many chronic diseases such as cardiovascular disease and diabetes. “Obesity is a challenge faced by Americans of all ages, and prevention is crucial for the management and elimination of obesity in our country,” said CMS Administrator Donald M. Berwick, MD, in a statement.  

The screening and counseling for obesity for eligible beneficiaries will be offered by primary care providers in physicians’ offices.

The intensive behavioral therapy for obesity will consist of the following:

  • Screening for obesity in adults using measurement of body mass index (BMI) calculated by dividing weight in kilograms by the square of height in meters (expressed in kg/m 2);
  • Dietary (nutritional) assessment; and
  • Intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise.

If a patient screens positive for obesity with a BMI of 30 kg/m 2 or greater, they would then get face-to-face counseling each week for a month and one face-to-face counseling visit every other week for an additional five months.

If a patient achieves a weight reduction of at least 6.6 pounds during the first six months of counseling, he/she will receive a counseling visit every month for an additional six months (a total of 12 months of counseling).