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Medicare News

Medicare Adds Obesity Screening, Counseling to Free Preventive Services

Benefit includes face-to-face counseling visit each week for a month, one visit every other week for an additional five months

Nov. 29, 2011 - Senior citizens struggling with obesity received welcomed news from Medicare today – the addition of obesity screening and counseling to the list of free preventive services that are now available without cost sharing under the Affordable Care Act.

Over 30% of both men and women in the Medicare population are estimated to be obese, according to the Centers for Medicare & Medicaid Services (CMS).

Obesity is directly or indirectly associated with many chronic diseases, including those that disproportionately affect racial and ethnic minorities, such as cardiovascular disease and diabetes.

 

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Addressing the prevention of obesity related disparities has the potential to reduce obesity prevalence while also closing the gap on health disparities among Medicare beneficiaries.

Screening for obesity and counseling for eligible beneficiaries by primary care providers in settings such as physicians’ offices are covered under this new benefit.

For a beneficiary who screens positive for obesity with a body mass index (BMI) of 30 or higher, the benefit would include one face-to-face counseling visit each week for one month and one face-to-face counseling visit every other week for an additional five months.

The beneficiary may receive one face-to-face counseling visit every month for an additional six months (for a total of 12 months of counseling) if he or she has achieved a weight reduction of at least 6.6 pounds (or 3 kilograms) during the first six months of counseling.

“This decision is an important step in aligning Medicare’s portfolio of preventive services with evidence and addressing risk factors for disease,” said Patrick Conway, MD, MSc, CMS Chief Medical Officer and Director of the Agency’s Office of Clinical Standards and Quality.

“We at CMS are carefully and systematically reviewing the best available medical evidence to identify those preventive services that can keep Medicare beneficiaries as healthy as possible for as long as possible.”

CMS says this action complements the Million Hearts initiative led jointly by CMS and the Centers for Disease Control and Prevention. Other partners in this program include other HHS agencies, communities, health systems, nonprofit organizations, and private sector partners across the country. The goal is to prevent one million heart attacks and strokes in the next 5 years.

“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. “It’s important for Medicare patients to enjoy access to appropriate screening and preventive services.”

Through the end of October, 22.6 million people with Original Medicare have received one or more of the free covered preventive services this year.

To read the final decision on the new national coverage determination, click here.

For more information about Million Hearts, please visit millionhearts.hhs.gov.

>> Check your BMI with this easy table

>> Calculate your BMI – National Heart Lung and Blood Institute

 

 

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