BC/BS of IL ...NO MO medically supervised diet
HCSC Removes Mandatory Pre-Operative Weight Loss Requirement
Health Care Services Corporation (HCSC), the parent company of BlueCross BlueShield (BCBS) of Illinois, Texas, Oklahoma, and New Mexico has eliminated the mandatory six month weight loss requirement prior to bariatric surgery. Multiple meetings and correspondence between ASMBS members and Medical Policy representatives of HCSC resulted in this improved access to care for patients suffering from obesity.
Access to care became more onerous when HCSC increased the preoperative requirement from three to six months on March 15, 2011. That led to a meeting between the officers of the Illinois State Chapter of ASMBS, Drs. Christopher Joyce and Rami Lutfi, and BCBS of IL at which time clinical data was provided and reviewed. The Chairman of the Insurance Committee, Dr. Jaime Ponce, the Chairman of the Access to Care Committee, Dr. John Morton, and the Chairman of the State Chapters Committee, Dr. Lloyd Stegemann provided valuable assistance and guidance. In addition, the draft of the ASMBS Position Statement on Preoperative Supervised Weight Loss Requirement was instrumental in preparation for the meeting. Through Dr. Stegemann, similar efforts were applied in Texas between its State Chapter and BCBS of Texas.
After months of correspondence between the state chapters’ leadership and BCBS, followed by an objective internal review of the medical evidence by the medical policy makers, HCSC came to the conclusion that the pre-operative weight loss requirement should be removed. That was revealed at a meeting in Chicago between the President of ASMBS, Dr. Robin Blackstone, the President of the Illinois Chapter of ASMBS, Dr. Joyce, and the Director of Medical Management of BCBS of IL, Dr. Rose Ann Madarang, on September 21, 2011.
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