Obesity Medications Report Provides Important Information for Coverage Policy

After more than a decade of advocacy, the Congressional Budget Office (CBO) released a report on the anticipated cost impact of Medicare coverage of obesity medications. While the report does not score the Treat and Reduce Obesity Act (TROA), which would also expand Part B services including intensive behavioral therapy (IBT), it contains important information that will help shape future policy. The Academy applauds the efforts of CBO and lawmakers to explore the cost of obesity medications and calls on both to continue to explore the financial impact of IBT.

The Treat and Reduce Obesity Act would provide coverage for obesity medications under Part D Medicare and would give those living with obesity access to IBT counseling services both as frontline therapy or in conjunction with other treatments. The bipartisan bill has gained interest as new medications show promise in addressing obesity as a chronic disease.

“While obesity medications are promising, they are most effective when accompanied by lifestyle interventions. For some, lifestyle intervention may be the only safe treatment option and those individuals deserve access to resources such as registered dietitian nutritionist (RDN) services that can help manage their obesity,” said Jeanne Blankenship, MS, RDN, vice president of Policy Initiatives and Advocacy for the Academy of Nutrition and Dietetics. “It’s disappointing that IBT services were not addressed by the CBO report. The Academy remains committed to ensuring access to comprehensive treatment for individuals living with obesity and will continue to work collaboratively to achieve that goal.”

Policymakers and advocates have contemplated how to increase access to obesity medications for eligible Medicare beneficiaries while ensuring cost containment. The Academy encourages more attention to the Part B section of TROA which authorizes IBT, a necessary and practical component to quality health care and to on-label use of obesity medications provided by RDNs and other health care providers.

Earlier this year, the U.S. House Ways and Means Committee passed a reduced version of the bill that would allow those who age into Medicare and have been prescribed obesity medications for a year to continue to have access. This would remove a decades-long statutory prohibition on Medicare coverage of weight loss medications. The reduced version would mandate a national coverage determination review of the Part B benefit, but otherwise does not increase access to the service. The narrowed bill, which was supported by the Academy as a first step, has yet to be considered by the full House.

The U.S. Senate has not yet addressed TROA in the current congress and it is unclear if efforts will be made to narrow the bill like the House following the release of the report. The Academy is advocating for the original TROA language in the Senate and for Part B services to remain in place.

Academy members are encouraged to join the monthly MNT Access Advocacy Affinity Group to stay informed and to participate in efforts to move TROA before the current congress ends.