AMA & Medicare Approval for Gastric Bypass Surgery: What You Need to Know

Question
We have a patient that is being denied any bariatric surgery (gastric bypass) because of it being "experimental" and not having been "endorsed" (approved?) by the AMA. Do you know where I can get proof that this is not considered experimental any more and any proof of approval or endorsement by the AMA?

Answer
Hi Gail -

There has not been an approval of bariatric surgery by the AMA, but it was granted Medicare approval, which is sort of the Gold Standard.

If you go here: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1786
you can read more about this from Medicare.

There are also some good articles here: http://www.surgicalreview.org/articles.aspx

And here: http://www.asbs.org/

If you are having trouble working with your insurer, I would suggest that you contact the Obesity Action Coalition (www.obesityaction.org) - they have a free guide book called the OAC Insurance GUide that can help you to work on issues of coverage.

I hope this helps to point you in the right direction.

Please let me know if I can provide more information.

In Health,

Dr. Jacques