Last month Blue Cross Blue Shield of Alabama announced and published their new Medical Policy on Surgical Weight Loss Management. Following the announcement, a local news station in Birmingham accurately reported that Blue Cross Blue Shield of Alabama does not cover certain types of weight loss surgery. Unfortunately, many were left with the impression that Blue Cross Blue Shield is no longer covering Roux-En-Y Gastric Bypass Surgery.

Blue Cross Blue Shield of Alabama does continue to cover Laparoscopic and Open Roux-En-Y Gastric Bypass Surgery. Blue Cross Blue Shield of Alabama has specific guidelines and criteria that must be met prior to approval for Gastric Bypass Surgery.

• The patient must enroll in and complete a physician supervised weight loss program for a duration of six months in the immediate six months prior to request for approval. (Only 3%-5% of patients maintain non-surgical weight loss.)
• The patient's body mass index (BMI) must be at least 35 with significant co-morbidities or at least 40 without significant co-morbidities.
• The patient must have suffered from morbid obesity for at least three years prior to request for approval.
• The patient must not have smoked within eight weeks prior to surgery.
• Patients must also be at least 18 years of age.

While these changes will delay treatment for the morbidly obese patient, we and our team are prepared to assist these patients in meeting the demands of these new changes.