Accredited Bariatric Centers and Access for Medicare Patients

Dear Bariatric Times Editor:
In the debut installment of the column , “Ask the Leadership with Raul J. Rosenthal, MD, FACS, FASMBS, ” which was published in the March 2013 issue of Bariatric Times, Dr. Nguyen refuted the argument that the accreditation requirement limited access by stating that there were over 750 accredited centers nationwide. I would like to point out that the fact that those centers are accredited does not necessarily mean that they accept Medicare patients. I just took care of a Medicare bariatric surgery patient. I have also had Medicare patients with problems from bariatric surgeries done elsewhere (some were done long ago) present to me. I then have to shop them around for an accredited center that will take them. In my experience I have found that some accredited centers have high fees for accepting someone else’s patient, will not take Medicare patients that did not have their surgery at that institution, and so on. To my knowledge, there is no requirement that an accredited center take Medicare patients or any other group of patients, so I do not think we can say that a large number of accredited centers takes care of the access problem simply.

Once the new accreditation process is finalized, this will not be a problem for me locally; however, I am concerned that these issues will continue for patients elsewhere. I appreciate the accreditation process and support it in a lot of ways, but it does have some significant shortcomings that need to be dealt with. I believe access is one of them.

I enjoyed the article but just wanted to give you my “street-level” view on this specific topic. I appreciate the work that both of you (Drs. Rosenthal and Nguyen) and the rest of the leadership of the American Society for Metabolic and Bariatric Surgery (ASMBS) and American College of Surgeons (ACS) are doing to help with these issues. I hope the debate will only make us better.

Respectfully,
Chris Sanborn, MD, FACS
Medical Director of Bariatric Surgery, Erlanger Metabolic & Bariatric Surgery Center, Chattanooga, Tennessee

References
1.    Nguyen N. Complications and Reoperation Before Versus After the Centers for Medicare and Medicaid Services Policy of Restricting Coverage to Bariatric Centers of Excellence: Comments on the Michigan Study. Bariatric Times. 2013; 10(3): 12–14.

Category: Letters to the Editor, Past Articles