BALTIMORE--A new proposal would cover bariatric surgery for obese Medicare beneficiaries under age 65, but would end coverage of the procedure for seniors.

CMS currently covers bariatric surgery, including gastric bypass, for beneficiaries of all ages as a treatment for a co-morbidity--including hypertension, type 2 diabetes, stroke and sleep apnea--but not obesity alone.

The agency said it proposes not covering bariatric surgery for those 65 and older, except for patients in clinical trials, because recent studies indicate significant surgical risks in the elderly population. According to a recent study by David R. Flum, Early Mortality Among Medicare Beneficiaries, seniors had two-fold to three-fold higher death rates after bariatric surgery compared with other individuals. About 13 percent of men and 6 percent of women 65 to 74 died within a year of the surgery. In patients 75 and older, half of the men and 40 percent of women died within the year.

For the younger population, there is evidence that the surgery produces benefits for those who have at least one obesity-related health problem and have been unsuccessful with previous medical treatment, according to CMS.

"While the best proven 'treatment' is a nutritious diet and regular exercise, and medical treatments are also available, some beneficiaries may significantly reduce their health risks through surgery," said CMS Administrator Dr. Mark McClellan.

To submit comments on the proposal, visit www.cms.hhs.gov/coverage.

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