The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule to reinterpret their long-standing statutory exclusion to mandate Medicare and Medicaid coverage of anti-obesity medications (AOMs) when used to treat obesity. The basis for this reinterpretation is “increases in the prevalence of obesity in the United States and changes in prevailing medical consensus towards recognizing obesity as a disease.” Given that medical guidelines have evolved since CMS established the original statutory interpretation, to now consider obesity a disease, CMS argues that any medication for the treatment of obesity should be coverable, even when used for weight loss or chronic weight management for individuals diagnosed as obese.
The Academy will be submitting formal comments to CMS and is seeking member feedback on the proposed rule. Please complete the Medicare Advantage and Part D summary and feedback form by Friday, January 3, 2025.
Submit feedback here: https://forms.office.com/r/CVdkkNMNgy
Post expires at 5:00pm on Friday January 3rd, 2025