Florida insurer drops stomach stapling

Blue Cross Blue Shield of Florida won't cover gastric bypass surgery because of risks, skyrocketing costs
By
|hrreporter.com|Last Updated: 03/15/2004

B

lue Cross Blue Shield of Florida has decided it will stop covering gastric bypass surgery at the end of 2004.

The insurance firm, based in Jacksonville, said safety is the main reason it is dropping stomach stapling from its list of covered items, according to an

Associated Press

report. The surgery typically costs $30,000 US and is considered a last resort for people who are morbidly obese.

The chief medical officer for the insurance company said about three in every 1,000 patients die from the surgery and up to 20 per cent return for a second procedure. The report also said there has been a spike in demand for the surgery, which would have cost Blue Cross Blue Shield about $200 million US over the next couple of years, leading to higher premiums for employers.

The move is being criticized by some in the medical profession. Anthony Terracina, a doctor specializing in gastric bypass surgery, said he is planning on closing his Florida practice and moving to Virginia where state law mandates insurers must cover stomach stapling.

“It just doesn’t make any sense that insurance companies would do this,” Terracina told the

AP

. “Obesity is the number one health problem in the United States. Why wouldn’t you help those patients and keep them out of the hospital?”

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