4.19.2023 Board Book

7173 S. Havana St #600-130 Centennial, CO 80112 P: 303.770.2526 | F: 303.779.4834 obesitymedicine.org

January 24, 2023

Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-9898-NC P.O. Box 8016, Baltimore, MD 21244-8016.

Dear Administrator Brooks-LaSure:

The Obesity Medicine Association (OMA) appreciates the opportunity to provide comments in response to the Department of Health and Human Services and Centers for Medicare & Medicaid Services (CMS) Request for information (RFI) regarding issues related to the Essential Health Benefits (EHB) under the Patient Protection and Affordable Care Act (ACA). OMA believes that a thorough examination of how our nation defines essential health care under the ACA is critical to ensuring that comprehensive obesity care becomes standard across all public and private health plans. The Obesity Medicine Association (OMA) is the largest organization of physicians, nurse practitioners, physician assistants, and other health care providers working every day to improve the lives of patients affected by obesity. OMA members are the clinical experts in obesity medicine. They use a comprehensive, scientific, and individualized approach when treating obesity, which helps patients achieve their health and weight goals. Obesity advocates have argued – both during the congressional development of the ACA and the continuing federal regulatory and state implementation of the health care reform law – that, as a chronic disease, treatments for obesity should be viewed as “essential” under the ACA’s mandated 10 EHB categories. For example, metabolic and bariatric surgery should be covered under the “hospitalization” category; Food & Drug Administration (FDA) approved anti-obesity medications (AOMs) should be covered under the “prescription drug” category; and behavioral health and counseling services should fall under the broad “preventive and wellness services and chronic disease management” category pursuant to the relevant USPSTF recommendations. Soon after the ACA was passed, the American Medical Association (AMA) adopted formal policy recognizing obesity as a complex and chronic disease and “supporting patient access to the full continuum of care of evidence-based obesity treatment modalities such as behavioral, pharmaceutical, psychosocial, nutritional, and surgical interventions.” OMA was pleased to be a driving force behind AMA’s recognition of obesity as a disease in 2013 and believe this event was the catalyst behind numerous other organizations coming out in support for ensuring patient access to obesity care, such as the National Council of Insurance Legislators, National Lieutenant Governors Association, National Hispanic Caucus of State Legislators, and the National Black Caucus of State Legislators. REVIEW OF EHB