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Posted 1/4/2021

Prepared by Christopher Gallagher, OCC Washington Representative

TROA Report Language Lands in Omnibus Spending Package

On December 21st, Congress passed a sweeping year-end bill to provide longdelayed coronavirus relief and fund the government through September 2021. The $2.3 trillion package, which includes $1.4 trillion to fund the government and $900 billion in coronavirus relief, also contains appropriations report language specific to the policy provisions of the Treat and Reduce Obesity Act (TROA).

Through the hard work of the Academy of Nutrition and Dietetics and the Obesity Care Advocacy Network (OCAN), Congress inserted the following language regarding CMS Program Management into the Labor-HHS section of the spending bill:

“Addressing Obesity and Related Comorbidities:

The agreement encourages CMS to work to ensure beneficiary access to the full continuum of care for obesity, including access to FDA-approved antiobesity medications under Medicare Part D, if determined as clinically appropriate by the patient’s physician, consistent with CMS’ s approach to pharmacotherapy agents used for weight gain to treat AIDS wasting and cachexia. The agreement also encourages CMS to reexamine its Medicare Part B national coverage determination for intensive behavioral therapy for obesity considering current United States Preventive Services Task Force recommendations.”

OCAN Leaders Meet with Biden Transition Team

On December 17th, OCAN leaders met with key members of the Biden transition team to educate them regarding OCAN’s policy priorities. The meeting, which included transition team members with strong backgrounds in the Centers for Medicare & Medicaid Services (CMS) and the Food & Drug Administration (FDA), focused on the devastating impact that COVID-19 is having on individuals affected by obesity — especially people of color.

Given these facts, OCAN urged the new Administration to take immediate steps to administratively implement policies — such as TROA — that could quickly expand coverage options for the more than 42 percent of Americans that are affected by obesity. OCAN is hopeful that this will be the beginning of a continuing dialogue with the Biden Administration in the coming four years.

ASMBS Calls on Insurance Regulators and Health Plans to Extend Patient Deductibles for Bariatric Surgery

During December, Both ASMBS and its State Chapters reached out to insurance commissioners and health plans across the country to urge health plans to extend the time frame for patients’ deductibles to the end of the first quarter of 2021. In making this request, ASMBS highlighted the tremendous concern that has been raised by patients awaiting bariatric surgery as the year comes to an end.

In its December 22nd letter to the National Association of Insurance Commissioners (NAIC), ASMBS discussed “how for most patients, their out of pocket deductible will reset at the end of the calendar year. Frequently, the out of pocket expense is prohibitive for a patient to seek medical care. These costs are now often many thousands of dollars, and during this difficult time, the impact to a family is even greater for those seeking medical care. Therefore, a delay in receiving care at this time for many will translate into the inability to receive care for many years until they can recover financially or even the possibility of never receiving the life-saving treatment they need.”

Becerra Nominated for HHS/Murthy for Surgeon General

On December 7th, President-Elect Biden announced a number of his key picks to head up his healthcare policy team in his new Administration. For Secretary of Health and Human Services (HHS), Biden has chosen current California Attorney General Xavier Becerra. Reprising his role as Surgeon General during the Obama Administration will be Dr. Vivek Murthy.

OCAN, OAC and TOS/ASMBS Comment on Vaccine Allocation

During September and December, the OAC, OCAN and ASMBS/TOS submitted comments to the scientific community surrounding principles for allocation priority of new COVID-19 vaccines. In general, the obesity community applauded the National Academy of Sciences and the CDC’s Advisory Committee on Immunization Practices for their agreement that individuals with underlying conditions, such as obesity, that would place them at significant risk for severe outcomes should they contract COVID-19 be among the top priority group for receiving the vaccine. Additionally, appreciation was offered to the scientific community for highlighting the need for transparency and allocation guidelines that do not unfairly discriminate against any one group.

State Advocacy Update

Obesity Advocates Make Progress on Prescribing Rules in Ohio

On December 9th, obesity advocates in Ohio were pleased to witness a positive discussion surrounding prescribing rules for weight loss drugs during the State Medical Board of Ohio’s (SMBO) monthly meeting. During November, OCC groups joined with leadership from the Ohio State Medical Association (OSMA) in an hour-long meeting with SMBO Policy Committee Chair Dr. Amol Soin that focused on the need for the Board to eliminate its dated prescribing rules for anti-obesity medications (AOMs).

Dr. Soin briefed SMBO members during the December 9th call — highlighting both the volume of comments from the obesity community as well as their passion for their patients. Given the tremendous amount of feedback, Dr. Soin was able to secure the approval of the Board to have an in-depth discussion regarding the prescribing rules during the SMBO’s January meeting.

According to OSMA Director of Regulatory Affairs Jennifer Hayhurst, this is great news and a strong sign that the Board could undertake a serious review of the issue. Special thanks are in order for OSMA and their catalytic efforts to secure the November meeting with SMBO Policy Committee Chair Soin!


Start at 19:30 into video:

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