ATLANTA – State Representative Katie Dempsey (R-Rome) commented on Governor Nathan Deal signing into law House Bill 511 on Thursday, April 24, 2014. Sponsored by Rep. Dempsey, HB 511 creates a two-year pilot program to provide coverage for medically necessary bariatric procedures for the treatment and management of obesity and related conditions under the state health insurance plan. Participation in the pilot will be available to eligible state employees, public school teachers, and public school employees.
“After almost 4 years of work on this legislation, with the support of many across our state including the Department of Community Health, Obesity Action Coalition, Georgia Hospital Association, Georgia Society of the American College of Surgeons, Georgia Chapter of the American Society of Metabolic and Bariatric Surgeons, Medical Association of Georgia and Johnson & Johnson, I am pleased to say that Governor Deal has shown support for this measure and signed it into law,” said Rep. Dempsey. “With obesity, diabetes and hypertension on the rise, I think it is very important that we provide this necessary health benefit to Georgians. Not only will this program be beneficial to state health insurance plan members, physicians, and hospitals but the intent is for it to be a pathway to reinstating full bariatric benefits in our employee health coverage.”
Participation in the pilot program is limited to no more than 75 people per year. Eligible individuals must apply to participate in the program. Eligibility requires that the participant have a body mass index greater than either 40 or 35 and also suffer from co-morbidity such as diabetes, hypertension, or sleep apnea. Applicants who currently use tobacco will not be eligible for the program. Participants must also have been covered under a state health insurance plan for the past two years and plan to continue coverage for another two years. Bariatric procedures covered by the pilot program include the gastric band, Laparoscopic sleeve gastrectomy and Rouen-Y gastric bypass.
Under HB 511, a panel of medical and insurance professionals will be selected to review the pilot program every six months. The panel will determine the success of the procedure in reducing patients’ weight and comorbidities, as well as the costs associated with the procedures.