Efforts to gain coverage for bariatric surgery will remain an
ongoing activity over the next few years. States are gearing
up to select the next essential health benefit plan, which
creates an opportunity to influence the outcome.
leaders in each state, including the governor, director
of the state exchange, insurance commissioner, speaker
of the House, president of the Senate, and leadership
in the Republican and Democratic parties.
Four states—Arkansas, California, Louisiana, and
Mississippi—considered bills requiring coverage for
obesity treatment services, including bariatric surgery.
The Arkansas bill would have covered only state/public
employees; this bill, along with the Mississippi and California bills, died in committee.
In Louisiana a bill, S.B. 173, was introduced that
would have expanded access to bariatric surgery.
Although it passed in the Senate, it failed to advance
out of the Louisiana House Committee on Insurance. The bill, introduced by Sen. David Heitmeier,
OD (D), would have required group health plans to
cover bariatric surgery, physician office visits, health
and behavior assessments, nutrition education, patient
self-management education training, and therapeutic
exercises. The Louisiana Chapter of the ACS played an
important role in getting the bill introduced and intends
to work with the legislature to advance S.B. 173 in 2016.
Efforts to gain coverage for bariatric surgery will
remain an ongoing activity over the next few years.
States are gearing up to select the next essential health
benefit plan, which creates an opportunity to influence
The UEVHPA, created by the Uniform Law Commission, a nonpartisan commission of lawyers established
in 1892 and endorsed by the College in 2009, permits
licensed physicians and other professionals to enter
a state and practice their profession without medical
board clearance in the event of a declared emergency.
To date, 14 states and the District of Columbia have
enacted the UEVHPA.
In 2014, the focus of the UEVHPA centered largely
on southeastern states because they are most likely
to experience the brunt of severe hurricanes. Initial
conversations on the introduction of the model bill
were held with chapter leaders/executive directors
and commissioners of the Uniform Law Commission
(some of whom are state legislators) in Alabama,
Florida, Georgia, Mississippi, North Carolina, and
South Carolina. Alabama and North Carolina have
statutes that policymakers within those states believe
provide similar protections as the UEVHPA, so they
were removed from the list, leaving Florida, Georgia,
Mississippi, and South Carolina as targets for 2015. In
addition, Pennsylvania considered a bill in 2014 that
remained active for 2015.
In Florida, political drama and strategic concerns
derailed UEVHPA efforts for 2015. In 2016, an emphasis on how the UEVHPA will serve as an important
component of disaster preparedness within the Florida
emergency management program will be used to help
to get the bill introduced.
The Georgia bill was introduced near the end of
the legislative session and will serve as placeholder
legislation for the 2016 legislative session. The Georgia
Society of the ACS made this development possible and
is working to facilitate passage next year.
The UEVHPA was introduced in Mississippi, and
Hugh A. Gamble II, MD, FACS, a former ACS Governor, championed the bill. Similar to Alabama and
North Carolina, some officials expressed their belief
that Mississippi already has a process in place similar
to the one in UEVHPA. The bill stalled as a result.
At press time, it was unclear whether the UEVHPA
in Pennsylvania would make it out of the Senate Veterans Affairs Committee, where it sat for months as
part of a larger emergency medical services/disaster
preparedness bill; there was hope the entire bill would
pass earlier in the session.
Delays in identifying a surgeon champion in South
Carolina slowed efforts to introduce the UEVHPA and
provided an opportunity for further investigation into
the need for this legislation.
Indiana surgeons played a key role in ensuring the
defeat of two legislative attempts to weaken the
state’s medical liability system in 2015. The Senate
voted down S.B. 55, which would have increased the
threshold for filing a liability claim against a physician