Please note that the Access to Care Committee is not accepting new member applications at this time. Committee membership is currently by appointment only.
L. Renee Hilton-Rowe, MD FACS FASMBS
Chair
Philip Gachassin, MD MHCM FACS FASMBS
Co-Chair
Darren Tishler, MD FACS
Co-Chair
Joe Northup, MD FASMBS
Executive Council Liaison
ASMBS Staff Liaison
Leslie Vinson
Members
Amir Aryaie, MD FACS FASMBS
Nicholas Brown, MD FASMBS
David L. Chengelis, MD
Michael Cook, MD FACS FASMBS (Insurance Committee Chair)
Tuesday Cook, MD FACS DABOM (Diversity & Inclusion Committee Liaison)
Judy Chen, MD FRCSC FACS FASMBS (State Chapters Committee Chair)
Pamela Davis, RN BSN MBA CBN
Maher El Chaar, MD
Wayne English, MD FACS FASMBS, Senior Past Chair
Maria Iliakova, MD (Insurance Committee Co-Chair)
Linden Karas, MD
John Kelly, MD FACS
Colleen Kennedy, MD MBA FASMBS
Shanu Kothari, MD FASMBS
Teresa LaMasters, MD FACS FASMBS DABOM
Jamie Loggins, MD FACS
Saniea Majid, MD FACS ABOM FASMBS
John Morton, MD FASMBS, Senior Past Chair
Fady Moustarah, MD MPH FASMBS
Blake Movitz, MD
Joseph Northup, MD FASMBS, Senior Past Chair
Carl Pesta, DO FASMBS
Joshua Pfeiffer, MD FASMBS
John Primomo, MD
Nancy Puzziferri, MD MS FACS DABOM
John D. Scott, MD FACS DABOM FASMBS, Senior Past Chair
Michael Seger, MD FASMBS, Immediate Past Chair
Lloyd Stegemann, MD FASMBS
Don Selzer, MD (Insurance Committee Co-Chair)
Regional Super STARS and STARS (State Access to Care Representatives)
Super STAR Northeast Region — Matthew Hutter, MD MPH FASMBS
CT — Neil Floch, MD FACS
MA — Sheila Partridge, MD FACS FASMBS
ME — Open
NH — Robert Catania, MD FASMBS
NY — William O’Malley, MD
RI — Siva Vithiananthan, MD FASMBS
VT — Patrick Forgione, MD
All New New England — Melissa Page, MS RD CSOWM LDN (IH)
Super STAR Mid Atlantic Region — Guilherme Campos, MD FASMBS
DE — Rahul Singh, MD FACS FASMBS
MD — Joseph Greene, MD MBA
NJ — Michael Bilof, MD FASMBS
NC/SC — Keri Seymour, DO; Jaime Bull, PA-C
PA — Maria Altieri, MD MS; Cynthia Hipszer, RN MSN CNML CBN (IH)
VA/WV — Gregory Adams, MD FACS; Nathaniel Sann, MSN CRNP FNP-BC (IH)
Super STAR Southeast Central Region — Brandon Williams, MD FASMBS
AL — Todd Foreman, MD FASMBS
FL — Dennis Smith, MD FASMBS; Gwen Crispell, MSN RN CBN (IH)
GA — Aaron Bolduc, MD; Maria Immonen, MSN RN CNL CBN (IH)
KY — Joshua Steiner, MD
OH — John Zografakis, MD FASMBS
TN — Jessica Ardila-Gatas, MD
Super STAR Upper Midwest Region — Luke Funk, MD MPH FASMBS
IA — Matthew Christopherson, MD
IL — Juaquito Jorge, MD
IN — Ambar Banerjee, MD FASMBS; Sarah Muntel, RD (IH)
KS — Robert Aragon, MD
MI — Amy Somerset, MD & Michael Wood, MD; Colleen Buda, PA-C CSOWM (IH)
MN — Geoffrey Fasen, MD MS
MO — Christopher Eagon, MD FASMBS; Angela Britt, BC (IH)
NE — Gary Anthone, MD FASMBS
WI — Luke Funk, MD MPH FASMBS & Brandon Grover, DO FASMBS
Super STAR Lower Midwest Region — Robert O. Carpenter, MD MPH FASMBS
AR — Tripurari Mishra, MD; Shirley Bearden, RN CBN (IH)
CO — Matthew Metz, MD
LA — Shauna Levy, MD MS FACS; Laura Boyer, FNP C CBN (IH)
MS — Jennifer O’Flarity, RN BSN
NM — Fermin Fontan, MD
OK — Roy Greenway, Jr., MD; Carah Horn, MBA-HCA BSN RN
TX — Tanyaradzwa Kajese, MD FASMBS
Super STAR Northwest Region — Valerie Halpin, MD FASMBS
AK — Open
ID — Cory Richardson, MD FASMBS
MT — John Pender, MD
ND — Ellen Vogels, DO
OR — Derek Rogalsky, MD; Greg Showell, RN (IH)
SD — Kristin Turek, CNP
WA — Mohan Mallipeddi, MD
WY — Kevin Helling, MD
Super STAR Southwest Region — Ajay Upadhyay, MD FACS FRCS
AZ — Christine Lovato, MD FASMBS; Lauren Pellizzon, MS RD (IH)
CA — Ajay Upadhyay, MD FACS FRCS
HI — Steven Fowler, MD FASMBS
NV — Open
UT — Eric Volckmann, MD FASMBS
Industry AD Hoc Appointed
Ishita Doshi – Ethicon
Maria Thompson – Ethicon
Scott Wolven – Ethicon
Andrew Zebrak – Intuitive Surgical
Santosh Agarwal – Medtronic
Gina Baldo – Medtronic
Susan Hupp – Medtronic
Jamie Glonek – Novo Nordisk
Maggie Irwin – Novo Nordisk
Ginger Papesh – Novo Nordisk
Bridget Slusarek – Novo Nordisk
Joe Nadglowski – Obesity Action Coalition
W. Scott Butsch, MD MSc – The Obesity Society
Jennifer Deperry – Pfizer
Jeanine Sherman – ProCare Health
Chris Gallagher – Potomac Currents
Paul Hickey – ReShape Lifesciences
Walter Lindstrom, JD – ReShape Lifesciences
Nina Crowley – SECA
Mission
The Access to Care Committee has the principal mission to assist patients affected by metabolic disease and obesity in 1) obtaining appropriate, safe, and effective medical care, 2) to improve the care and treatment of people with obesity, and 3) to advocate for the health care policy that ensures patient access to high quality prevention and treatment of obesity.
Description
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
2023-2024 Committee Goals
- Utilize the surgeon and IH STAR and Super STAR Network effectively, involving State Chapter Presidents and IH State Leaders
- Support membership in utilizing the new 2022 ASMBS/IFSO Guidelines on MBS to increase access to care to treatment of obesity; Guidelines Toolkit; letters to insurers
- Monitor commercial insurance companies’ policy updates to their coverage of bariatric care and support our members in regard to requirements that impede their patients’ access to care with the assistance of our industry partners
- Utilization Subcommittee
- Outpatient/Same Day Surgery Subcommittee
- Continue to monitor Bundled Payments
- Access to Care Sessions at ASMBS Annual Meetings
- Help the OAC build their membership and support Obesity Care Week and OCAN’s Advocacy Hill Days
- Continual legislative efforts and support of the passage of the Treat and Reduce Obesity Act (TROA)
- Support the TREO Foundation’s annual Walk from Obesity
- Assist the ObesityPAC with State Chapter Advocacy Day Grants
- Continue efforts to improve State Health Exchange coverage (convert 27 “No” states to “Yes”), state employee coverage in all 50 states/monitoring any new pilot programs, and Medicaid coverage in all 50 States (only Montana remains)
- Continue advocacy presence and response to healthcare changes, and monitoring and responding to regulatory changes affecting ACA patient protections; track our advocacy efforts
- Encourage our members to become AMA members
Specific Projects that Achieve Goals and Objectives:
- Surgeon and IH STARs and Super STARs report on their states/regions during monthly meetings; OCC All STAR Program managed by D.C. Consultant
- Formed a Guidelines Subcommittee to create a Toolkit (in progress), authoring and signing on to letters to insurance carriers to affect change in their policies in line with the 2022 Guidelines
- Formed a Utilization Subcommittee for a targeted approach to reaching the “other 98%” of patients who have coverage but do not utilize it to increase use and awareness of their benefits
- Continue to monitor/respond to outpatient/same day surgery requirements; and possibly write a position statement
- Continue to monitor Bundled Payments
- Monthly updates in the “Advocacy & Access to Care” section in the Top 5 on the 5th and timely email dissemination of updated state/region-specific insurance policies to members and via State Chapters
- Planning/directing the Access to Care Session at ASMBS Annual Meeting 2023
- OAC Patient Advocacy, monthly Obesity Care Week reminders, TREO Foundation Walks from Obesity, and member participation in the Hill Visit Advocacy Days, which focused again on supporting passage of the Treat and Reduce Obesity Act
- Monthly Committee calls and Mid-month Committee leadership calls to discuss issues that arise in between monthly calls, updates from the OAC President and D.C. Consultant
- OAC Access to Care Postcards continue to be available on the ASMBS and OAC websites for download; members will continue to urge patients to join the OAC
- Continued use of the Facebook page (151 members) and DocMatter as a method to disseminate information to members
- Continue monitoring and responding to regulatory changes affecting ACA patient protections
- Monthly reminders of the ObesityPAC State Chapter Advocacy Day Grants; support of members in obtaining these grants
- Monthly reminders to join the AMA
2022-2023 Completed Projects
- Successfully implemented change using the 2022 ASMBS/IFSO Guidelines on MBS in the following insurance coverages: Blue Cross of Idaho, BCBS Michigan, Centene, Geisinger, HCA Employee WLS Plan, Horizon Blue Cross Blue Shield Of New Jersey, and Premera Blue Cross
- Increased coverage for SADI-S: Aetna (includes SIPS), Capital Blue Cross, Cigna, Geisinger, Kaiser Foundation Health Plan of Washington, Oregon Medicaid (and OAGB)
- Advocated for the FEHB determination that all federal plans should cover medical obesity treatment which was instated January 2023
- Kept members informed of updated insurance policies via the “Advocacy & Access to Care” section in the ASMBS Top 5 on the 5th monthly newsletter and frequent email communication to members and State Chapters
- Promoted the OAC’s Obesity Care Week and participated in OCAN’s 2023 Obesity Care Week Hill Visit Advocacy Days
- The committee continues to support advocacy efforts in all 50 states to improve state health exchange coverage, state employee coverage, Medicaid coverage in all 50 states and the passage of the Treat and Reduce Obesity Act