TennCare Pays for Gastric Bypass, Won’t Pay Dietitians

NASHVILLE, Tenn. (AP) — Tennessee is one of the fattest states in the U.S., but TennCare won’t pay for counseling by dietitians. However, it will pay for gastric bypass surgery.
“It’s like saying we’re going to fill your cavities, but we’re not going to ever pay for you to get your teeth cleaned or teach you how to brush your teeth,” dietitian Sarah-Jane Bedwell told Nashville radio station WPLN.
Almost all state Medicaid programs cover bariatric surgery, but only about half pay for services like those Bedwell provides, such as helping people modify their eating habits and going grocery shopping with them.
She charges $75 an hour while the average price of bariatric surgery to TennCare is about $20,000.
To Bedwell, the savings are obvious.
But TennCare Chief Medical Officer Wendy Long said there is no proof that paying for dietitians would save the program money. And she said TennCare is legally required to cover bariatric operations.
And TennCare does pay for dietary counseling by physicians, she said.

Jane Leck weighed more than 250 pounds before TennCare paid for her gastric bypass operation.
She figures the surgery has saved the program money because she’s now off the heart and blood pressure medicine she was taking before. And without the stomach surgery she believes she would have needed heart surgery and other operations.
To show how much weight she has lost, she pulls out her old size 3X jacket.
“Before surgery I could barely zip it,” she says. “And now me and another person can get in it and zip it, so I’ve lost a whole person.”
Dr. Ronald Clements, head of bariatric surgery at Vanderbilt University Medical Center, said he doesn’t know whether diet counseling could keep some people from becoming morbidly obese, but once they reach that point most of them are unable to keep weight off by any means other than surgery.
“The biggest bang for the buck in treatment of obesity is bariatric surgery. Hands down nothing else comes close,” Clements said.
Patients have to be particularly obese and possibly sick before they’re even considered for an operation, however.

4 thoughts on “TennCare Pays for Gastric Bypass, Won’t Pay Dietitians

  1. victoria

    I am 5’4″ or 5’5″ not really sure, i am 200lbs. Do you think i would qualify for this surgery? And also, what are the possible side effects to having this surgery?

  2. jessica

    i am 29 have health issues am 350 and 5’9″ i have osteo atheritis and ra let alone more than enough other problems as well , tenncare said they do not pay for the surgery ? why am i being denied that right ?

  3. Cheyenne

    I am on tenncare and my Dr approved for me to have by pass surgery because of my weight and health issues. I am 5’8, 295lbs. I have asthma and COPD. The Dr in Knoxville told me I to pay $1500 and I’m on disability and don’t have that kind of money. Is there a Dr that doesn’t have these counseling fees?

  4. Jamie

    I just started this process and they told me that as of Feb 2013 that most insurance companies will pay 100% but you still have to call your insurance company to verify! I am going for my consulation visit July 18th 🙂 the insurance won’t however pay for the nutritionist

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