Access to Care Committee

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

Tanyaradzwa, MD 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 (Georgia)
Nicholas Brown, MD FASMBS (Kansas)
Judy Chen, MD FACS ABOM FASMBS (State Chapters Committee Chair, Washington)
David L. Chengelis, MD (Michigan)
Michael Cook, MD FACS FASMBS (Insurance Committee Chair, Louisiana)
Tuesday Cook, MD FACS DABOM (Diversity & Inclusion Committee Liaison, Maryland)
Pamela Davis, RN BSN MBA CBN (Illinois)
Wayne English, MD FACS FASMBS, Senior Past Chair (Tennessee)
Neil Floch, MD FACS (Connecticut)

Maria Iliakova, MD (Insurance Committee Co-Chair, Iowa)
Linden Karas, MD FACS (Ohio)
John Kelly, MD FACS FASMBS (Massachusetts)
Colleen Kennedy, MD MBA FASMBS (Texas)
Shanu Kothari, MD FASMBS (South Carolina)
Teresa LaMasters, MD FACS FASMBS DABOM (Iowa)
Shauna Levy, MD MS FACS (Louisiana)
Jamie Loggins, MD FACS (North Carolina)
Saniea Majid, MD FACS ABOM FASMBS (New Jersey)
John Morton, MD MPH MHA FASMBS, Senior Past Chair (Connecticut)
Fady Moustarah, MD MPH FASMBS (Michigan)
Blake Movitz, MD FACS (Michigan)

Joseph Northup, MD FASMBS, Senior Past Chair (Illinois)
Carl Pesta, DO FASMBS (Michigan)
Joshua Pfeiffer, MD FACS FASMBS (Wisconsin)
Sarah Pergande, DO (Wisconsin)
John Primomo, MD (Texas)
Nancy Puzziferri, MD MS FACS DABOM (Oregon)
Shireesh Saraubh, MD FACS FASMBS (Washington)
John D. Scott, MD FACS DABOM FASMBS, Senior Past Chair (South Carolina)
Michael Seger, MD FASMBS, Immediate Past Chair (Texas)
Lloyd Stegemann, MD FASMBS (Texas)
Don Selzer, MD (Insurance Committee Co-Chair, Indiana)

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

Super STAR Northeast Region — Matthew Hutter, MD MPH FASMBS
STARs
CT — Danielle Friedman, MD FACS; Gabrielle Berthiaume, DNP-C (IH)
MA — Sheila Partridge, MD FACS FASMBS
ME — Kirk Sahagian, DO FACS
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
STARs
DE — Rahul Singh, MD FACS FASMBS
MD — Curtis Frederick, MD
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 — Joseph Greene, MD MBA FACS FASMBS (Virginia)

Super STAR Southeast Central Region — Brandon Williams, MD FASMBS
STARs
AL — Danuel Laan, MD FASMBS
FL — Joey Jarrard, MD; Carah Horn, MBA-HCA BSN RN FASMBS-IH CBN (IH)
GA — Aaron Bolduc, MD; Maia Routly, DNP MA RN CPN EBP-C (IH)
KY — Joshua Steiner, MD
KY/OH — Amy Laktash, MSN APRN NP-C (IH)
OH — John Zografakis, MD FASMBS
TN — Jessica Ardila-Gatas, MD

Super STAR Upper Midwest Region — Luke Funk, MD MPH FASMBS
STARs
IA — Matthew Christopherson, MD
IL — Juaquito Jorge, MD; Betsy Felde, MBA RDN LDN (IH)
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 — James McGreevy, MD
MO — Christopher Eagon, MD FASMBS; Angela Britt, BC (IH)
NE — Ivy Haskins, MD FASMBS
WI — Luke Funk, MD MPH FASMBS & Brandon Grover, DO FASMBS

Super STAR Lower Midwest Region — Robert O. Carpenter, MD MPH FASMBS
STARs
AR — Tripurari Mishra, MD; Shirley Bearden, RN CBN (IH)
CO — Matthew Metz, MD
LA — Vance Albaugh; Laura Boyer, FNP C CBN (IH)
MS — Jennifer O’Flarity, RN BSN
NM — Fermin Fontan, MD
OK — Roy Greenway, Jr., MD
TX — Tanyaradzwa Kajese, MD FASMBS

Super STAR Northwest Region — Valerie Halpin, MD FASMBS
STARs
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
STARs
AZ — Christine Lovato, MD FASMBS; Lauren Pellizzon, MS RD (IH)
CA — Ajay Upadhyay, MD FACS FRCS
HI — Steven Fowler, MD FASMBS
NV — Morgan Pomeranz, MD FACS FASMBS
UT — Eric Volckmann, MD FASMBS

Industry AD Hoc Appointed

Geri Cramer – Boston Scientific
Ann Roy – Boston Scientific
Kate Thomas – Eli Lilly
Ishita Doshi – Ethicon
Maria Thompson – Ethicon
Scott Wolven – Ethicon
Andrew Zebrak – Intuitive Surgical
Suzanne Baeke – Leavitt Risk
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
Chrystal Jones – Obesity Action Coalition Advocacy Manager
Joe Nadglowski – Obesity Action Coalition President
W. Scott Butsch, MD MSc – The Obesity Society
Jennifer Deperry – Pfizer
Chris Gallagher – Potomac Currents, Washington D.C. Advisor
Jeanine Sherman – ProCare Health
Paul Hickey – ReShape Lifesciences
Walter Lindstrom, JD – ReShape Lifesciences
Nina Crowley, PhD RD LD – 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

  1. Utilize the surgeon and IH STAR and Super STAR Network effectively, involving State Chapter Presidents and IH State Leaders
  2. 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
  3. 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
  4. Utilization Subcommittee
  5. Outpatient/Same Day Surgery Subcommittee
  6. Continue to monitor Bundled Payments
  7. Access to Care Sessions at ASMBS Annual Meetings
  8. Help the OAC build their membership and support Obesity Care Week and OCAN’s Advocacy Hill Days
  9. Continual legislative efforts and support of the passage of the Treat and Reduce Obesity Act (TROA)
  10. Support the TREO Foundation’s annual Walk from Obesity
  11. Assist the ObesityPAC with State Chapter Advocacy Day Grants
  12. 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)
  13. Continue advocacy presence and response to healthcare changes, and monitoring and responding to regulatory changes affecting ACA patient protections; track our advocacy efforts
  14. Encourage our members to become AMA members
Specific Projects that Achieve Goals and Objectives:
  1. Surgeon and IH STARs and Super STARs report on their states/regions during monthly meetings; OCC All STAR Program managed by D.C. Consultant
  2. 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
  3. 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
  4. Continue to monitor/respond to outpatient/same day surgery requirements; and possibly write a position statement
  5. Continue to monitor Bundled Payments
  6. 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
  7. Planning/directing the Access to Care Session at ASMBS Annual Meeting 2023
  8. 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
  9. 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
  10. 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
  11. Continued use of the Facebook page (151 members) and DocMatter as a method to disseminate information to members
  12. Continue monitoring and responding to regulatory changes affecting ACA patient protections
  13. Monthly reminders of the ObesityPAC State Chapter Advocacy Day Grants; support of members in obtaining these grants
  14. Monthly reminders to join the AMA

2022-2023 Completed Projects

  1. 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
  2. Increased coverage for SADI-S: Aetna (includes SIPS), Capital Blue Cross, Cigna, Geisinger, Kaiser Foundation Health Plan of Washington, Oregon Medicaid (and OAGB)
  3. Advocated for the FEHB determination that all federal plans should cover medical obesity treatment which was instated January 2023
  4. 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
  5. Promoted the OAC’s Obesity Care Week and participated in OCAN’s 2023 Obesity Care Week Hill Visit Advocacy Days
  6. 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

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