ArticleObesity surgery2020
Insurance Coverage Criteria for Bariatric Surgery: A Survey of Policies.
Article in Obesity surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed.
- Effect of Social Vulnerability on Efficacy of Bariatric Surgery Versus Medical and Lifestyle Intervention for Type 2 Diabetes: Analysis of the ARMMS-T2D Consortium of Randomized Trials.Annals of internal medicine · 2026Trial
- Randomized Controlled Trial Based US Commercial Payor Cost-Effectiveness Analysis of Endoscopic Sleeve Gastroplasty Versus Lifestyle Modification Alone for Adults With Class I/II Obesity.Obesity surgery · 2024Trial
- Impact of the COVID-19 pandemic on racial disparities in adolescent bariatric surgery: an MBSAQIP analysis.Surgical endoscopy · 2026Article
- Bariatric Surgery in the Era of GLP1RA: A Narrative Review.Advances in therapy · 2026Review
- Are Glucagon-Like Peptide 1 Receptor Agonists and Bariatric Surgery the Answer to Childhood Obesity?Current atherosclerosis reports · 2025Review
- Triglycerides, Glucose Metabolism, and Type 2 Diabetes.International journal of molecular sciences · 2025Review
- Pediatric Metabolic and Bariatric Surgery and Antiobesity Medications: Weighing Efficacy, Risks, and Future Directions.The Journal of pediatrics · 2025Article
- Definition and diagnostic criteria of clinical obesity.The lancet. Diabetes & endocrinology · 2025Review
- Characterization of trends in preoperative hemoglobin A1c testing prior to metabolic and bariatric surgery: a retrospective, observational study.Perioperative medicine (London, England) · 2025Article
- Tackling the complexity of obesity in the US through adaptation of public health strategies.Frontiers in public health · 2025Review
- Analysis of Online Crowdfunding Among Patients Pursuing Metabolic and Bariatric Surgery in the United States.Obesity surgery · 2025Article
- Adoption of the Polish Bariatric and Metabolic Surgery Care Standards: a nationwide survey.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2024Article
- Comment on: Ambulatory discharge of patients undergoing sleeve gastrectomy results in significantly more adverse outcomes.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2024Article
- The Role of Informal Social Support for Patients Undergoing Bariatric Surgery.Obesity surgery · 2024Article
- Generalizability of Randomized Clinical Trial Outcomes for Diabetes Control Resulting From Bariatric Surgery.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Article
- Using Claims Data to Predict Pre-Operative BMI Among Bariatric Surgery Patients: Development of the BMI Before Bariatric Surgery Scoring System (B3S3).Pragmatic and observational research · 2024Article
- The Long-term Value of Bariatric Surgery Interventions for American Adults With Type 2 Diabetes Mellitus.Annals of surgery · 2023Article
- Thirty-One Years Maybe Desirable for Antique Cars But Not for Patient Care.Obesity surgery · 2023Article
- The durability of revisional sleeve gastrectomy and Roux-en-Y gastric bypass after previous adjustable gastric band.Surgical endoscopy · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBariatric surgery remains underutilized at a national scale, and insurance company reimbursement is an important determinant of access to these procedures. We examined the current state of coverage criteria for bariatric surgery set by private insurance companies.
methodsWe surveyed medical policies of the 64 highest market share health insurance providers in the USA. ASMBS guidelines and the CMS criteria for pre-bariatric evaluation were used to collect private insurer coverage criteria, which included procedures covered, age, BMI, co-morbidities, medical weight management program (MWM), psychosocial evaluation, and a center of excellence designation. We derive a comprehensive checklist for pre-bariatric patient evaluation.
resultsSixty-one companies (95%) had defined pre-authorization policies. All policies covered the RYGB, and 57 (93%) covered the LAGB or the SG. Procedures had coverage limited to center of excellence in 43% of policies (n = 26). A total of 92% required a BMI of 40 or above or of 35 or above with a co-morbidity; however, 43% (n = 23) of policies covering adolescents (n = 36) had a higher BMI requirement of 40 or above with a co-morbidity. Additional evaluation was required in the majority of policies (MWM 87%, psychosocial evaluation 75%). Revision procedures were covered in 79% (n = 48) of policies. Reimbursement of a second bariatric procedure for failure of weight loss was less frequently found (n = 41, 67%).
conclusionsA majority of private insurers still require a supervised medical weight management program prior to approval, and most will not cover adolescent bariatric surgery unless certain criteria, which are not supported by current evidence, are met.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.