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Medicaid Can Cover Obesity-Related Services, Helping Beneficiaries Reduce the Risk of Chronic Disease

Many preventable chronic diseases and other health problems are associated with obesity, making the increased prevalence of obesity in the U.S. a serious public health challenge. Medicaid and CHIP programs help address this challenge by providing access to screenings and interventions to reduce obesity and promote healthy eating and physical activity. Medicaid and CHIP can cover a range of services to prevent and reduce obesity including Body Mass Index (BMI) screening, education and counseling on nutrition and physical activity, prescription drugs that promote weight loss, and, as appropriate, bariatric surgery. Children have access to such services through EPSDT. States can decide what services to cover for adults, and a survey (PDF, 133.39 KB) (PDF 133.39 KB) of state Medicaid programs found that a growing number of states cover services like obesity screening and counseling on healthy diet. In addition, the Affordable Care Act calls for states to design public awareness campaigns to educate Medicaid enrollees on the availability and coverage of preventive services, including obesity-related services.

Michigan is one state that has taken concrete steps to reduce childhood obesity:

In June 2009, the Michigan Department of Community Health MDCH sent a letter to Medicaid providers with information regarding billing and reimbursement for obesity-related services for children in Medicaid. The letter encouraged providers to conduct height, weight and nutrition assessments as part of all well-child visits, consistent with the recommendations of the American Academy of Pediatrics. In addition, the state Medicaid program selected childhood obesity as a topic for managed care Performance Improvement Projects (PIPs) in the 2011-2012 and 2012-2013 reporting cycles. Fourteen health plans implemented initiatives to improve rates of BMI screening and documentation and referral for nutrition and physical activity counseling or programs. One plan, Priority Health, partnered with a community-based program to develop, FitKids 360, an eight-week class for overweight kids and their families addressing nutrition, physical activity and self-esteem. After the program’s initial success at multiple sites in southwestern Michigan, two additional locations - one in Detroit and one in rural Fremont - started the program in 2013.

Learn more about how Medicaid promotes prevention and obesity-related services.

CMS is offering links/charts for informational purposes only, facts should not be construed as an endorsement of the organization's programs or activities

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