Posted 3/10/2015

Prepared by Christopher Gallagher, ASMBS Washington Representative

March 2nd OCC Advocacy Day

ASMBS Washington Representative Chris Gallagher joined with other leaders of the Obesity Care Continuum (OCC) for the OCC’s monthly Advocacy Day on Capitol Hill, which took place on March 2nd. Mr. Gallagher was joined by American Society of Bariatric Physicians (ASBP) Advocacy Committee Chair Dr. Carolynn Francavilla, The Obesity Society’s (TOS) Executive Director Francesca Dea and the Obesity Action Coalition’s (OAC) President Joe Nadglowski and Board Chair Ted Kyle in visiting with a number of key legislators in the Colorado congressional delegation — educating these offices regarding plans for the reintroduction of the Treat and Reduce Obesity Act (TROA).

In addition to sitting down with staff in Senator Michael Bennet’s (DCO) office, OCC leaders also visited with the offices of Representatives Ed Perlmutter (D-CO), Diana DeGette (D-CO), Jared Polis (D-CO) and Mike Coffman (R-CO). The next monthly

OCC Advocacy Day will take place on Monday, April 27th.

OCC State Efforts on Essential Health Benefits Going into March, ASMBS State Chapters continued their fast and furious pace toward reaching out to key state policymakers, such as Insurance Commissioners, Governors and Healthcare Committee Chairs in state legislatures in an effort to secure coverage for obesity treatment services as an essential health benefit under state health exchange plans across the country. Activities over the last month included face-to-face meetings with key policymakers in Connecticut, Florida, Georgia, Indiana, Oregon, Tennessee and Washington.

OCC Submits Comments on Proposed SBC Regulations

On March 2, 2015, the OCC submitted comments in response to HHS proposed regulations designed to update the current Summary of Benefits and Coverage (SBC) document, which qualified health plans (QHPs) must provide to consumers to explain each plans’ covered services. Specifically, the OCC expressed concern over the Departments’ inclusion of “Bariatric Surgery” and “Weight Loss Programs” on the SBC form as optional services that QHPs may opt to either exclude or cover within their plan offerings.

HHS “Responds” to Johnson/Blumenauer Letter

In early 2014, the Office of Personnel Management (OPM) issued specific guidance to both Multi-State Health Plans and Federal Employee Health Benefit Program carriers regarding obesity treatment services – stating that the agency will no longer tolerate plans excluding obesity treatment coverage on the basis that obesity is a “lifestyle” condition or that treatment is “cosmetic.” On September 15, 2014, 49 House Members signed onto a congressional letter authored by Representative Eddie Bernice Johnson (D-TX) and Representative Earl Blumenauer to HHS Secretary Sylvia Burwell – urging the Department to follow OPM’s lead and issue similar guidance on obesity treatment coverage to state health exchanges.

In late February, HHS finally “responded” to the Johnson/Blumenauer letter stating that consumers in the marketplace should have access to a range of evidence-based obesity treatment. However, HHS Secretary Burwell continued that the Department does not identify coverage of specific services — highlighting HHS guidance that leaves these coverage decisions up to the states.