WV medicaid

melody S.
on 3/10/15 12:47 am - Morgantown, WV

Does anyone know when the new requirements for bariatric surgery go into effect for WV medicaid? My surgeon said that medicaid is not approving any new bariatric surgeries until it does, and they seem to have no idea when it will be. My pre-op testing is only good for six months, and I only have three months of that time left. I'm getting concerned that they won't approve my surgery in time.

There are seven days in a week and "some day" is not one of them.

    

KittysarusRex
on 5/14/15 4:19 pm

I went for a consult in Feb and I was basically told it wasn't approved, but when it is and changes go into effect I could try again.  They said it may be sometime within a year, and they may have stricter guidelines like PEIA insurance.

melody S.
on 5/14/15 4:57 pm - Morgantown, WV

I got tired of waiting for my surgeon's office to get back to me about it, since the new guidelines went into effect on the first of April. Here is a link to the PDF they sent me. It has the requirements. 

 

http://www.dhhr.wv.gov/bms/Documents/Chapter%20519.4%20-%20Bariatric%20Services.pdf

There are seven days in a week and "some day" is not one of them.

    

KittysarusRex
on 5/14/15 5:16 pm

Oh!  Thank you so much!  This gives me some hope, as I was looking through cash pay options and getting depressed.

melody S.
on 5/14/15 5:19 pm - Morgantown, WV

Good luck to you! It looks like I will have to put my surgery off until January. Again. But this time it just might happen. 

There are seven days in a week and "some day" is not one of them.

    

KittysarusRex
on 5/14/15 5:33 pm

I've been morbidly obese for most of my adult life with high BP for 10 years now, and had struggles to control it, but, I want to know what "aggressive treatment" is because I'm worried.  My doctor said it would drop with weight loss, and he thinks I'm a good candidate, but I guess it depends on what Medicare thinks. :\

melody S.
on 5/14/15 6:38 pm - Morgantown, WV

May I ask which county you are in? I'm in Monongalia. My surgeon is Dr. Akkary. Good luck!

There are seven days in a week and "some day" is not one of them.

    

KittysarusRex
on 5/14/15 6:40 pm

Cabell, Looking at CAMC or Cabell Huntington hospital, but I already went to a seminar at CAMC.

KittysarusRex
on 5/19/15 12:00 pm

How are you doing your exercise?  The way insurance worded it is "a physician supervised nutrition and exercise program, over a consecutive 12 month period, including evaluation and management with a licensed dietician, and increase in physical activity, and behavioral modification."

 

I thought it meant doctor supervised exercise program but the bottom part makes me think exercise in general.  

melody S.
on 5/19/15 12:26 pm - Morgantown, WV

I use the form my surgeon's office gave me when I went for my seminar. It has boxes for my original weight, latest weight, exercise(s) and duration of exercises. My PCP fills it out every month when I see her. Your surgeon should give you something similar.

There are seven days in a week and "some day" is not one of them.

    

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