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October 2, 2013

Medicare Policy on Bariatric Surgery: Decision Making in the Face of Uncertainty

Author Affiliations
  • 1Center for Medical Technology Policy, Baltimore, Maryland
JAMA. 2013;310(13):1339-1340. doi:10.1001/jama.2013.278849

Since 2006, Medicare has paid for bariatric surgery for certain obese patients with the requirement that the institutions providing this service be certified as level 1 bariatric surgery centers by the American College of Surgeons or as bariatric surgery centers of excellence by the American Society of Metabolic and Bariatric Surgery.1 Responding to a request to reconsider its policy, the Medicare program conducted a detailed review of available evidence and issued a draft decision memo in June 2013 proposing to eliminate the requirement for certification as a condition of reimbursement.2 This proposed policy change has triggered substantial controversy, with dueling claims and counterclaims about the quality of the scientific evidence and triggering forceful statements from the bariatric surgical community in support of continuing the requirement.