In a recent decision memorandum by
The Center for Medicare and Medicaid Services (CMS) regarding Intensive
Behavioral Therapy for Obesity (CAG-00423N), CMS determined that potentially
lifesaving and risk reducing preventive services for Obesity could only be
furnished by primary care providers in the primary care setting (i.e. MDs,
Clinical Nurse Specialists, Nurse Practitioners, and Physicians’ Assistants).
Interesting that all these practitioners are also part of the care team for
surgical /obesity patients or patients treated with pharmaceuticals. None of them qualify as nutrition
care professionals in the primary care setting but have (next to) no training
in food and nutrition counseling, life-style changes for long-term success, have
no robust ‘outcome data’ showing their own professions have established benefits
for long-term weight reduction, have no additional time in their already
over-scheduled days in the clinics. In addition, all of these providers bill
for professional time at
substantially higher rates than do Registered Dietitians (RDs).
As a result, CMS has eliminated the most
qualified providers, notably Registered Dietitians (RDs), along with clinical
psychologists and other specialists who have been able to produce the best results for weight reduction for obese patients and made a
ruling that uses professionals at a higher cost than RDs. The decision prevents
RDs from directly billing for obesity treatment services and from providing
services outside of primary care setting, and thus limits access for older
patients to qualified professionals that would help reduce a very high
risk for many types of cancer such as esophagus, pancreas, kidney, colorectal,
endometrial, and post-menopausal breast cancer.
Please consider signing ADA’s petition
to President Obama to urge CMS to include RDs in obesity treatment.
We need 25,000 signatures by January 7, 2012 for the White House to review this
petition. (Note: I have heard that this website is often ‘slow’ and frustrating
due to the high traffic it receives. It went quickly for me, but if it is slow
for you, please hang in there)
Quick, easy steps:
1) go to
2) click on “issues” – at the 4th link on top
of home page.
3) in this link – click on “we the people” at far right.
4) click “open petitions”
5) go to the
petition that starts with “urge CMS to reconsider…..”
In addition, if you are so inclined,
please share this announcement on your Facebook and other social networking
accounts plus with clients, friends, and colleagues.
We all know and acknowledge there is
no single or simple answer to treating obesity (or preventing it), but by not
including RDs as providers for an obesity diagnosis and treatment, CMS has
shifted the care to health care professionals who are already over-worked, have
no training in nutrition and weight loss counseling, cost more to the health
care system, plus what is most worrisome to me, are likely to give up too
soon and recommend drugs or bariatric surgery for these patients, both of which
are more invasive, more expensive, increase risk of more complications
(increasing cost and decreasing quality of life), and are not the highest
quality medical care available.
I hope you will agree and sign this petition.
Note: Anyone can sign – you do not need to be an RD or a health care
Thank You !