News from the Access to Care Committee and State Chapters:
Progress in Florida and Louisiana for Patient Access

Published in September/October Issue             

Florida Makes Progress in Obtaining Unfettered Access to Metabolic and Bariatric Surgery for Patients with Type 2 Diabetes Mellitus (T2DM)

Florida spends almost $19 billion a year, second only to California, on T2DM treatment costs in the United States. The state of Florida is now paving the way to improve access to metabolic and bariatric surgery for patients with T2DM.

Dr. Joseph Chebli became a delegate of the Sarasota County Medical Society earlier this year, at the behest of Florida State Representative, Dr. Julio Gonzalez, and was subsequently asked to serve on a state-run Diabetes Advisory Panel. This provided an opportunity for Dr. Chebli to write a late resolution allowing the Florida Medical Association (FMA) to work with the state legislature in an effort to make access to bariatric surgery a high priority for patients with obesity and T2DM, which he presented to the FMA during a meeting on July 30th.

The ASMBS Florida State Chapter reports that the resolution received the FMA’s support. The Annual Meeting, held in Orlando, on Sunday, July 31st concluded with Resolution 16-110 deemed to be:

"RESOLVED, That the Florida Medical Association supports legislation to promote access to Metabolic Bariatric Surgery among severely obese (BMI≥35) patients with type 2 diabetes."

The ASMBS would like to thank Dr. Chebli for his advocacy efforts, and making the state of Florida one of the leaders in improving access to care for obese patient with T2DM.

Ochsner Improves Bariatric Coverage for Employees in Louisiana

Ochsner, under an internally funded Humana plan, has reportedly improved bariatric surgery coverage for their employees by removing the required copay for bariatric surgery services. This means a lot for the employees who could not afford the copay, which was a major concern and obstacle to necessary and life prolonging surgery. Since Ochsner is such a large employer in Louisiana, the benefits should be seen over the next few years. Appropriately, the NIH criteria have been adopted as indications for surgery. Patients will still be required to pay their deductibles according to the level of their insurance plan.

According to the Louisiana ASMBS State Chapter, insurance coverage for bariatric surgery in the state is very poor and for most people, bariatric surgery is not a covered benefit. This is not unique to Louisiana, but surgeons and integrated health personnel of the Louisiana ASMBS State Chapter have been working tirelessly with policy makers and other stakeholders to advocate for patients who deserve more fair and comprehensive obesity treatment coverage.