May Capitol Update

May Capitol Update


OCC May 5 Advocacy Day


OCC Leaders Participate in GWU Roundtable on Primary Care Decision Aid


Obama Administration Issues Guidance on Tobacco Cessation Services

May 5 OCC Advocacy Day

On May 5, 2014, leaders from the Obesity Care Continuum (OCC) participated in the OCC monthly advocacy day -- targeting key legislators in the Indiana, Massachusetts, and Texas congressional delegations. The focus of these meetings was to secure a champion to initiate a sign-on letter to the Department of Health and Human Services (HHS) -- urging the Department to issue guidance similar to what the Office of Personnel Management announced in March regarding coverage of obesity treatment services in the Federal Employees Health Benefit (FEHB) Program

In a March 20, 2014 letter to all FEHB Program Carriers regarding coverage of FDA-approved obesity drugs and bariatric surgery, OPM stated that:

"It has come to our attention that many FEHB carriers exclude coverage of weight loss medications. Accordingly, we want to clarify that excluding weight loss drugs from FEHB coverage on the basis that obesity is a "lifestyle" condition and not a medical one or that obesity treatment is "cosmetic"- is not permissible. In addition, there is no prohibition for carriers to extend coverage to this class of prescription drugs, provided that appropriate safeguards are implemented concurrently to ensure safe and effective use."

March 20, 2014 OPM Letter:

OCC Leaders Participate in Roundtable Discussions on Primary Care/Patient Engagement

On April 30, 2014, OCC leaders took part in a roundtable discussion organized by the George Washington (GW) Obesity Research Team to evaluate a GW-developed primary care decision aid tool that is designed to help primary care physicians and their care teams work more effectively with patients around weight loss and weight management. The tool includes four components: team training; an algorithm that identifies potential treatments; a physician summary report; and clinical guidance. The GW Obesity Decision Aid will be tested in a small pilot involving a multi site primary care practice starting this spring.
The goal of the roundtable was to gather perspectives and feedback on the usefulness and adaptability of the obesity decision aid in various primary care settings. The information received from the roundtable will be used to further refine the tool as well as the implementation process so that a broader dissemination plan can be developed.

On May 1, 2014, OCC leaders also participated in a second roundtable hosted by the STOP Obesity Alliance to gather information and insight in order to develop a dialogue tool that will provide health care professionals with the information necessary to have productive conversations with their patients about weight and health. Given that providers often feel unequipped to handle these conversations, the tool will be a timely resource for providers looking for more information on how to facilitate conversations that empower and support patients. The final discussion tool will be released later in the year.

Obama Administration Issues Guidance on Tobacco Cessation Treatment Services

On May 5, 2014, the Obama Administration issued a Fact Sheet on health policy issues that included guidance regarding health plan responsibilities surrounding tobacco cessation treatment services. Under this new guidance, health plans will be "considered in compliance" with a requirement to cover smoking cessation if they offer support for at least two attempts to quit a year. The services must be provided at no cost to consumers and should include four tobacco counseling sessions of at least 10 minutes each. These can be done by phone or individual or groups sessions. Insurers also should cover both prescription and over-the-counter medicines for a 90-day treatment regimen.

Anti-tobacco advocates praised the decision stating that "the new guidance from the Obama administration establishes a minimum standard for what insurers must cover, said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. Myers continued, saying that "it is critical that the Department of Health and Human Services and other federal departments effectively enforce this standard and ensure that insurers provide the necessary coverage, especially given the evidence that many so far have failed to do so."

This recent action by the Administration gives obesity advocates hope that HHS may be willing to issue similar minimum standards surrounding obesity screening and treatment services that are mandated covered services under the Affordable Care Act provisions governing preventive services.