Surgical Weight

A fat loss surgeon performs bariatric surgery, bypass surgery, gastric banding and obesity surgery. Surgical weight control is an option for very overweight who cannot lose pounds with only a healthy diet and exercise. Weight loss surgery limits the amount of food a person can intake. Some operations also restrict the amount of food the stomach can digest. Many people who have fat loss surgery lose weight quickly. If patients follow all diet and exercise recommendations, most can keep the weight off. Like all surgeries, fat loss surgery has risks and complications, including infections, hernias and blood clots. Men who are at least 100 pounds overweight and women who are at least 80 pounds overweight are eligible for this surgery. If candidates somewhat less overweight, surgery still might be an option if they also have diabetes, heart disease or sleep apnea. Bariatric surgery, or weight loss surgery, is a type of procedure that doctors perform on people who are dangerously obese. This procedure achieves weight loss by surgical reduction of the size of the stomach by means of an implanted gastric banding device, through removal of a portion of the stomach or by re-sectioning and re-routing the small intestines to a small stomach pouch as gastric bypass surgery. Long-term studies show the procedures result in significant long-term weight loss, recovery from diabetes, improvement in cardiovascular risk factors and a reduction in mortality of 23 percent to 40 percent. The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40.

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HIGH MEDICAID FACILITY

  (F) HIGH MEDICAID FACILITY DESCRIBED.—oAs added
by section 1106(2)(D) of HCERA. A high Medicaid facility
described in this subparagraph is a hospital that—
(i) is not the sole hospital in a county;
(ii) with respect to each of the 3 most recent
years for which data are available, has an annual percent
of total inpatient admissions that represent inpatient
admissions under title XIX that is estimated to
be greater than such percent with respect to such admissions
for any other hospital located in the county
in which the hospital is located; and
(iii) meets the conditions described in subparagraph
(E)(iii).
(G) PROCEDURE ROOMS.—In this subsection, the term
‘procedure rooms’ includes rooms in which catheterizations,
angiographies, angiograms, and endoscopies are performed,
except such term shall not include emergency
rooms or departments (exclusive of rooms in which catheterizations,
angiographies, angiograms, and endoscopies
are performed).
(H) PUBLICATION OF FINAL DECISIONS.—Not later than
60 days after receiving a complete application under this
paragraph, the Secretary shall publish in the Federal Register
the final decision with respect to such application.
(I) LIMITATION ON REVIEW.—There shall be no administrative
or judicial review under section 1869, section
1878, or otherwise of the process under this paragraph (including
the establishment of such process).
(4) COLLECTION OF OWNERSHIP AND INVESTMENT INFORMATION.—
For purposes of subparagraphs (A)(i) and (D)(i) of paragraph
(1), the Secretary shall collect physician ownership and
investment information for each hospital.
(5) PHYSICIAN OWNER OR INVESTOR DEFINED.—For purposes
of this subsection, the term ‘physician owner or investor’
means a physician (or an immediate family member of such
physician) with a direct or an indirect ownership or investment
interest in the hospital.
(6) CLARIFICATION.—Nothing in this subsection shall be
construed as preventing the Secretary from revoking a hospital’s
provider agreement if not in compliance with regulations
implementing section 1866.’’.
(b) ENFORCEMENT.—
(1) ENSURING COMPLIANCE.—The Secretary of Health and
Human Services shall establish policies and procedures to ensure
compliance with the requirements described in subsection
(i)(1) of section 1877 of the Social Security Act, as added by
subsection (a)(3), beginning on the date such requirements first
apply. Such policies and procedures may include unannounced
site reviews of hospitals.
(2) AUDITS.—Beginning not later than May 1, 2012, the
Secretary of Health and Human Services shall conduct audits
to determine if hospitals violate the requirements referred to
in paragraph (1). oAs revised by section 10601(b).