AGA praises Treat and Reduce Obesity Act reintroduction to expand obesity care in Medicare
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The AGA applauded the reintroduction of the Treat and Reduce Obesity Act into the 118th Congress as this bill would expand Medicare coverage for screening and treatment of obesity by health care providers specializing in obesity care.
The Treat and Reduce Obesity Act of 2023 (TROA; H.R. 4818/S. 2407), a bipartisan and bicameral bill seeks coverage under Medicare Part D for FDA-approved medications to treat obesity.
“Currently, many insurers do not cover anti-obesity medications, and others require cumbersome prior authorizations and appeals to obtain coverage,” Janese Laster, MD, the co-chair of AGA’s obesity advocacy efforts, told Healio. “This is often a deterrent from attempting to prescribe.”
She continued, “With these barriers removed, many gastroenterologists will take the time to counsel on nutrition changes and use these very helpful medications to aid in weight loss, which will help in the reversal of many obesity-related GI diseases such as GERD, fatty liver and gallstone disease to name a few and improve overall health.”
The reintroduction of TROA was led by Senator Tom Carper (D-DE) and Senator Bill Cassidy (R-LA) in the Senate and by members of the U.S. House of Representatives, including Rep. Ron Kind (D-WI), Rep. Tom Reed (R-NY), Rep. Raul Ruiz (D-CA) and Rep. Brad Wenstrup (R-OH-2).
“With obesity rates on the rise in our country, we must do more to combat this epidemic head on ,” Senator Carper said in a statement. “Too many of those in need are being denied care because of the high cost of medications or inaccessible treatment options. We cannot stand idly by while this disease continues to claim lives through related illnesses that are preventable and treatable. I’m proud of our bipartisan and bicameral legislation to open the door for Medicare to provide Americans with every available treatment and tool for reducing obesity’s physical, social and financial costs.”
The bill was first introduced into the 113th Congress in 2012 via the Senate, and proposed in every subsequent Congress with various versions over the following decade.
“The reintroduction and subsequent passing of TROA will greatly impact patient care by adding coverage of necessary nutrition and dietary follow-up, counseling, therapy and pharmacologic therapy for the millions of people in this country who suffer from excess weight,” Laster, who is also a founder of Gut Theory Total Digestive Care, told Healio. “This bill will also aid in awareness of obesity as a chronic disease that requires aggressive management for prevention of secondary disease processes and reversal of comorbidities as well.”
She continued, “Currently, due to lack of coverage, many obesity medicine physicians provide care at an out-of-pocket cost and, of the many patients who need these services, most do not have access. Subsequently, each year the prevalence of obesity continues to increase.”
The bill would also potentially cover intensive behavioral counseling, lifestyle counseling and support for specialists, psychologists and dietitians and other options for prevention and treatment of obesity.
According to Laster, the passing of TROA “will allow gastroenterologists who treat patients with obesity more time for counseling and will allow for the use of many of the new pharmacologic tools to be used in addition to diet and lifestyle changes.”
References:
- Obesity coverage advocacy toolkit. https://patient.gastro.org/obesity-coverage-advocacy-toolkit/. Accessed August 6, 2023.
- Reps. Wenstrup and Ruiz Reintroduce Bipartisan, Bicameral Bill to Cover Obesity Treatment in Medicare. https://wenstrup.house.gov/updates/documentsingle.aspx?DocumentID=407634. Published July 20, 2023. Accessed August 6, 2023.
- The Journey of TROA: Why the Treat & Reduce Obesity Act is still a Bill in Congress. https://www.obesityaction.org/how-troa-cycles-through-congress/. Accessed August 7, 2023.
- Treat and Reduce Obesity Act: TROA FAQ. https://www.obesityaction.org/troa/troa-faq/. Accessed August 6, 2023.
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