Good news for Medicare patients wanting VSG.

Tenacious88
on 3/31/12 9:37 am - Fort Lauderdale, FL

VSG on 02/05/14

Hi: This is good news for those with Medicare who want VSG surgery, it's a long statement but worth reading.

CMS Considers Medicare Coverage for Gastric Sleeve

Gastric sleeve surgery soon may be covered by Medicare, following a review of public comments demonstrating evidence of the procedure’s effectiveness for the treatment of obesity.

CMS Considers Medicare Coverage for Gastric Sleeve The Centers for Medicare and Medicaid Services (CMS) soon will begin its review of public comments on a proposal to cover gastric sleeve surgery for Medicare patients suffering from morbid obesity.

CMS received an informal request on August 22, 2011, for consideration of sleeve gastrectomy as a covered procedure. Today is the last day of the one-month period during which CMS solicited comments as to “whether there is adequate evidence, including clinical trials, for evaluating health outcomes of laparoscopic sleeve gastrectomy (LSG) for the indications listed in the current Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Determination."

Gastric sleeve surgery involves removing approximately 75-80 percent of the stomach to restrict the amount of food that a patient can comfortably eat, thereby limiting caloric intake and promoting weight loss. Unlike with gastric bypass surgery, gastric sleeve surgery does not involve rerouting or bypassing any portion of the small intestine. Rather, the remaining stomach pouch, which is shaped like a tube or sleeve, remains connected to the natural stomach outlet (pyloric valve). As a result, gastric sleeve patients have a lower risk of malnutrition and dumping syndrome.

Research indicates that morbidity and effectiveness rates for gastric sleeve surgery fall between those of Lap-Band and laparoscopic Roux-en-Y bypass procedures; however, long-term studies are limited.

Currently, Medicare covers open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding (commonly known as the Lap-Band procedure), and open and laparoscopic biliopancreatic diversion with duodenal switch. Patients must have a body mass index (BMI) of 35 or higher and have at least one obesity-related comorbidity, such as type 2 diabetes or heart disease. Other physician-supervised treatments for the management of obesity must be shown to have been ineffectual, and the procedure must be performed at a surgical facility that meets specific standards specified by CMS.

The agency plans to issue a proposed decision on coverage of laparoscopic sleeve gastrectomy by March 30, 2012, and to make a final decision by June 30.

"We as Losers need to have Bull Dog Tenacity to win the war against obesity"

califsleevin
on 3/31/12 10:01 am - CA

VSG on 05/09/11

It is good news (when it officially happens,) not just for those covered by medicare, but for all of those whose insurance doesn't yet cover the sleeve as once medicare covers a procedure, the insurance companies have a hard time saying that such a procedure is "investigational" or "experimental". The same thing happened when the DS was finally vetted by medicare, and all of the insurance companies finally caved in and started covering it. So, good luck to all of those who are still fighting for coverage.