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Talking Points for CMS Decision on Intensive Behavioral Therapy for Obesity

  • The Centers for Medicare and Medicaid Services (CMS) recently released a decision memorandum regarding Intensive Behavioral Therapy for Obesity (CAG-00423N)
  • In the decision, CMS determined that this potentially lifesaving preventive service could only be furnished by primary care providers in the primary care setting.
  • 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 patients.
  • The decision prevents this group from directly billing for services and from providing services outside of primary care, and limits access for older patients to qualified professionals that would help manage chronic disease.
  • Under CMS' decision, primary care providers with significantly less training on obesity counseling are being asked to produce quality outcomes in the treatment of this costly and disabling condition.
  • A recent survey of primary-care physicians in which 78 percent said they had no prior training on weight-related issues. Of those, 72 percent said no one in their office had weight-loss training.
  • Registered Dietitians are cost-effective physician extenders who provide services collaboratively and demonstrate a return on investment that results in cost savings in the delivery of our nation's health care.



As a constituent, I am asking you to take the following action:

  1. Contact your CMS liaison and indicate your opposition to this decision.
  2. Support efforts to expand coverage and reimbursement of nutrition services by Registered Dietitians as a component of quality health care delivery.

In addition, I will be asking you to sign on to a forthcoming letter from fellow members of Congress to CMS that asks the agency to reinterpret statutes used in determining this coverage and to reconsider its rule. I will follow up with you when the letter is ready for signature.