John D. Scott, MD FASMBS
Chair

Teresa LaMasters, MD FASMBS
Co-Chair

C. Joe Northup, MD
Co-Chair

John Morton, MD FASMBS
Executive Council Liaison & Immediate Past Chair

Members

Jawad Ali, MD
Fernando Bonanni, MD FASMBS
Nicholas Brown, MD FASMBS
Allen Browne, MD
Arthur M. Carlin, MD FASMBS
Robert O. Carpenter, MD MPH FASMBS
David L. Chengelis, MD

Wayne English, MD FASMBS, Immediate Past Chair
Luke Funk, MD MPH FASMBS
Jeffrey Ganaw, MD FASMBS
Robert B. Lim, MD FASMBS
Linden Karas, MD
Tanyaradzwa Kajese, MD

Walter Lindstrom, Esq
Corrigan L. McBride, MD FASMBS
Rachel Moore, MD FASMBS
Fady Moustarah, MD MPH FRCSC 
Carl Pesta, DO FASMBS
Richard M. Peterson, MD MPH FASMBS
Kinga Powers, MD PhD

Regional Super STARS and STARS (State Access to Care Representatives)

Super STAR Northeast Region — Matthew Hutter, MD MPH FASMBS
NY — Ashutosh Kaul, MD FASMBS
NH — Maureen Quigley, APRN
ME — Jamie Loggins, MD
MA — Sheila Partridge, MD FASMBS
VT — Patrick Forgione, MD
CT — Darren Tishler, MD FASMBS
RI — Siva Vithiananthan, MD FASMBS

Super STAR Mid Atlantic Region —
Guilherme Campos, MD FASMBS
NC/SC — Ranjan Sudan, MD FASMBS
MD — David Von Rueden, MD
NJ — Alex Onopchenko, MD
PA — Ann M. Rogers, MD FASMBS
DE — Rahul Singh, MD
VA/WV — Troy Glembot, MD FASMBS

Super STAR Southeast Central Region — Brandon Williams, MD FASMBS
AL — Todd Foreman, MD FASMBS
FL — Joseph Chebli, MD FASMBS
GA — Titus Duncan, MD
OH — Joe Northup, MD
TN — Pamela Davis, BSN MBA RN CBN
KY — Joshua Steiner, MD

Super STAR Upper Midwest Region — Luke Funk, MD FASMBS
IN — Brenda Cacucci, MD FASMBS
MI — Matthew Weiner, MD
WI — Shanu Kothari, MD FASMBS & Kevin Wasco, MD FASMBS
MN — Daniel A.P. Smith, MD
IL — Jayaraj Salimath, DO BSN
MO — Christopher Eagon, MD FASMBS
IA — Matthew Christopherson, MD
NE — Gary Anthone, MD FASMBS
KS — Robert Aragon, MD

Super STAR Lower Midwest Region — Richard Peterson, MD MPH FASMBS
LA — William Richardson, MD FASMBS
MS — Jennifer O’Flarity, RN BSN
AR — John Baker, MD FASMBS
OK — Laure DeMattia, DO
TX — Robert Carpenter, MD MPH FASMBS
NM — Charles F. Bellows, MD
CO — Matthew Metz, MD

Super STAR Northwest Region — Valerie Halpin, MD FASMBS
MT — John Pender, MD
ND — Luis Garcia, MD FACS MBA
OR — Valerie Halpin, MD FASMBS
SD — Kristin Turek, CNP
WY — Kevin Helling, MD
ID — Allan Garay, MD
WA — Brian Sung, MD FASMBS
AK — Michael Todd, MD
Super STAR Southwest Region — Ajay Upadhyay, MD FACS FRCS
AZ — Robert Berger, MD
HI — Steven Fowler, MD FASMBS
CA — Ajay Upadhyay, MD FACS FRCS
NV — Shawn Tsuda, MD
UT — Eric Volckman, MD

Industry AD Hoc Appointed

Kay Sadik — Ethicon
Gary A. Richardson – Ethicon
Michael Oberg — Apollo Endosurgery Vincent Zeringue — Medtronic


Gina Baldo – Medtronic
Michael Morseon – Medtronic
Chris Gallagher — Potomac Currents
Joe Nadglowski — Obesity Action Coalition
W. Scott Butsch, MD MSc – The Obesity Society

ASMBS Staff Liaison

Leslie Vinson

Mission

The Access to Care Committee has the principal mission to assist patients affected by metabolic disease and obesity in obtaining appropriate, safe and effective medical care.

Objectives

  • Increase awareness of access issues and progress among the public and members.
  • Identify reasonable targets for progress in short, medium and long term.

Description

The Access to Care Committee has the principal mission to assist patients affected by metabolic disease and obesity in obtaining appropriate, safe and effective medical care. Committee activities include: developing the strategic vision and strategies to make improvement in access to care; advocating for legislative changes on the state and local level that will affect health care coverage; addressing the politics, policies and ethics of access issues on the local, state and national levels; and bringing together initiatives/partners to effectively address access issues.

Objectives

  • Increase awareness of access issues and progress among public and members
  • Identify reasonable targets for progress in short mid and long term

Committee Goals

Short-Term

  1. National campaign to abolish insurance mediated medical weight loss delays, i.e., weight loss holds and denials due to Pre-Op Weight Gain
    • Create Task Force in conjunction with Insurance and Communications Committees – Dr. Peterson (Lower Midwest Region Super STAR) Lead
  2. “Bundled Payment” Task Force and Tool Kit
    • Meetings already held in MS, WA, TN, FL and VA to develop bundled payment plans; anticipate other states to have similar meetings in the near future
    • Developing Toolkit and Coverage Map for monitoring trends for bundled payments decisions in each state – for industry and private insurers
  3. Revision Language HCSC – BCBS IL, TX, OK, NM, MT
    • Comments submitted regarding restrictive language on band revisions
    • Letter written by Dr. Ann Rogers sent to Aetna EVP and CMO on 10/12/16 – no reply
  4. Discrepancy Between BCBS Distinction Center and MBSAQIP Requirements
    • Insurance Companies’ “Quality” Centers and MBSAQIP Centers survey to determine how many MBSAQIP centers are not BC, AETNA, etc. quality centers
  5. Increase utilization of STARs and Super STARs
  6. Advocate in D.C. for patients
  7. Monitor future of Affordable Care Act
  8. Plans for reintroduction of Treat and Reduce Obesity Act
Specific Projects that Achieve Goals and Objectives:
  1. National campaign to abolish insurance mediated medical weight loss delays
    • Task Force in process of forming
    • Heat map of BC medically mandated weight loss requirements created
    • Collected denial examples from committee members, focusing on Aetna
    • Letter written by Dr. Ann Rogers with denial examples and ASMBS consensus statement sent to Aetna EVP and CMO on 10/12/16 – no reply
  2. “Bundled Payment” Task Force, First Meeting 5/4/16; Second Meeting 6/14/16 – Dr. C. Joe Northup Lead
    • Members: C. Joe Northup (Lead), John D. Scott Wayne English, Brandon Williams, Joseph Chebli (FL/BARINet), Dawn Gabriel (Ethicon), Mike Morseon (Medtronic), Joe Nadglowski (OAC), Chris Gallagher (Washington)
    • Draft “Bundled Payment Considerations ASMBS Toolkit Outline” presented at Obesity Week-End SPI
    • Goal is to have Tool Kit online by February 2017
  3. Monday, February 27th OCAN Hill Visit Day Register
    • Other dates in 2017: Friday, March 31st, Monday, April 24th, Monday, May 22nd, Friday June 23rd
  4. Monthly Access to Care Meetings

Mid-Term

  1. ObesityWeek 2017 Access to Care Symposium
    • Plan topics and speakers
  2. ASMBS ObesityPAC Receptions at ASMBS Week-End and ObesityWeek 2017
  3. VA Bariatric Surgery Task Force
    • Members: George Eid, Dan Eisenberg, Pradeep Pallati, Robert O’Rourke, Carl Pesta, Brian Smith, Kinga Powers, Chris Gallagher, Brandon Williams, Wayne English
    • Developing network of VA surgeons within each of the 23 VISNs to expand bariatric surgery access to all veterans
    • Patient education, legislative action website and social media campaign
    • Washington DC campaign
      -Director of VA
      -Veterans Affairs Committee
      -Each VISN surgeon champion will be asked to request a meeting with regional directors
      -Identify gaps (void VISN)
    • Collaborating with Military Committee to create overlaying map of VA and DoD Bariatric Centers
  4. Monitor weight loss holds and denials, bundle payment plans
Specific Projects that Achieve Goals and Objectives:
  1. Discuss symposium program materials and ObesityPAC at monthly Access to Care meetings
  2. VA Task Force Lead and Military Committee Chair met 9/15/16 and at ObesityWeek 2016

Long-Term

  1. Grow ASMBS ObesityPAC
  2. Continuing efforts with “Leave No States Behind” campaign
    • Affordable Care Act/Health Insurance Exchanges
    • Convert 27 “No” states to “Yes” states
    • Monitor filed complaint
  3. Medicaid Coverage in all 50 States: Only MONTANA remains
  4. State employee Coverage in all 50 States: PA, SC, MT, ID, WI
  5. Advocacy Efforts Tracking
Specific Projects that Achieve Goals and Objectives:
  1. Continue to collect ObesityPAC donations from ASMBS members and donate to federal and state political candidates who are champions for obesity
  2. Created an Advocacy Efforts document – updated monthly by STARs and Super STARs

2016 COMPLETED PROJECTS

  1. ObesityWeek 2016 Access to Care Symposium will be held November 2nd, 2016
  2. Creation of bundled payment task force
  3. Initiation of campaign to modify Aetna weight gain denials policy