Here are five notes:
1. If approved, the new guidelines would follow the National of Institutes of Health criteria.
2. Under revised guidelines, a person with a BMI greater than 40 qualifies. Oregon would also cover patients with BMIs of 35 or higher with diabetes or with two of the following conditions: hypertension, coronary heart disease, mechanical arthropathy in a weight-bearing joint and sleep apnea.
3. Before the decision is finalized, the Oregon Health Authority will provide data on the number of bariatric surgeries Oregon has already covered. The state is concerned about the costliness of extending the Medicaid coverage guidelines.
4. The Oregon Health Plan has covered bariatric surgery for diabetes patients since 2008.
5. A subcommittee will review the proposal on Feb. 18, with the commission reviewing it by March 10 at the earliest.
More articles on coding, billing & collections:
Will Medicare reach 50% value-based payments by 2018? 5 key notes
Patients as payers: How to understand & thrive in healthcare’s consumer revolution
What payer consolidation means for ASCs — And how to conduct business moving forward
