Document Detail


Coverage of obesity treatment: a state-by-state analysis of Medicaid and state insurance laws.
MedLine Citation:
PMID:  20597460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We determined whether state Medicaid programs cover recommended treatments for adult and pediatric obesity and to what extent states regulate the treatment and coverage of obesity by private insurers.
METHODS: We conducted a state-by-state document review of Medicaid manuals and private insurance laws and regulations.
RESULTS: Eight state Medicaid programs appear to cover all recommended obesity treatment modalities for adults. Only 10 states appear to reimburse for obesity-related treatment in children. In the small-group insurance market, 35 states expressly allow obesity to be used for rate adjustments, while 10 states do so in the individual market. Two states expressly allow obesity to be used in eligibility decisions in the individual market. Five states provide for coverage of one or more treatments for obesity in both small-group and individual markets.
CONCLUSIONS: Very few states ensure coverage of recommended treatments for adult and pediatric obesity through Medicaid or private insurance. Most states allow obesity to be used to adjust rates in the small-group and individual markets and to deny coverage in the individual market.
Authors:
Jennifer S Lee; Jennifer L O Sheer; Nancy Lopez; Sara Rosenbaum
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Public health reports (Washington, D.C. : 1974)     Volume:  125     ISSN:  0033-3549     ISO Abbreviation:  Public Health Rep     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-08-31     Revised Date:  2011-07-04    
Medline Journal Info:
Nlm Unique ID:  9716844     Medline TA:  Public Health Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  596-604     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, The George Washington University, Washington, DC 20037, USA. jelee@gwu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Obesity Agents / therapeutic use
Bariatric Surgery / economics
Child
Counseling / economics
Evidence-Based Practice
Humans
Insurance Coverage / economics*,  legislation & jurisprudence
Insurance, Health / economics*
Medicaid / economics*,  legislation & jurisprudence
Nutrition Assessment
Obesity / economics*,  epidemiology,  therapy*
Practice Guidelines as Topic
Private Sector
State Government
United States / epidemiology
Chemical
Reg. No./Substance:
0/Anti-Obesity Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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