| |
|
|
Centers of Excellence for Bariatric Surgery (Article 5) |
|
Bariatric surgery continues to be a common treatment option for patients with morbid obesity and related chronic diseases. To provide TRICARE beneficiaries with the highest quality of appropriate medical, nutritional and psychological care, we encourage referring beneficiaries to the centers of excellence for bariatric surgery.
|
|
The centers of excellence for bariatric surgery are nationally recognized as being able to provide the best quality care. These facilities are certified by the American College of Surgeons as Level 1 Bariatric Surgery Centers, or certified by the American Society for Bariatric Surgery as Bariatric Surgery Centers of Excellence. These facilities are listed at www.cms.hhs.gov/MedicareApprovedFacilitie/.
|
|
Facilities certified as a center of excellence are evaluated based on the following criteria: |
|
-
Surgical experience (number of procedures performed)
-
Hospital facilities
-
Multidisciplinary care available
-
Complications and mortality rates
-
Long-term and follow-up programs
|
|
Humana Military has worked diligently to bring these centers into the TRICARE South network. Additionally, Humana Military is working to identify those beneficiaries who have requested an evaluation and have met the criteria for bariatric surgery. This is in effort to refer and have these beneficiaries schedule their pre- and post-operative care with a center of excellence on the TRICARE network provider list.
|
|
By helping beneficiaries obtain the appropriate referrals, the risk of postoperative complications and early death after surgery may be reduced. Surgeons and facilities with higher volumes of bariatric surgery have lower rates of complications and patients spend less time in recovery, which contribute to better post-operative results for your patient.
|
|
In May 2006, the Centers for Medicare and Medicaid Services (CMS) implemented a Medicare National Coverage Decision that allows coverage for bariatric surgery only in approved facilities. This has been a common decision among several commercial health care plans that cover bariatric surgery.
|
|
Please carefully consider referring candidates for bariatric surgery to TRICARE-authorized facilities. For TRICARE beneficiaries in the South Region, bariatric surgery requires prior authorization by Humana Military.
|
|
Back to Top
|
|
|
|
Contacts (Article 6) |
|
|
| |
Back to Top
|
|
Created: June 14, 2007
|
| |
|
| |
|
