QuestionWe 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?
AnswerHi 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
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