National Coverage Analysis (NCA) Tracking Sheet

Intensive Behavioral Therapy for Obesity

CAG-00423N

Issue

Over the past 25 years, the Congress has expanded the Medicare benefit to include various preventive services to the Medicare Part B program such as Pap smear and screening pelvic exams, screening mammograms, colorectal cancer screening tests, and diabetes screening tests. Effective January 1, 2009, CMS is allowed to add coverage of "additional preventive services" if certain statutory requirements are met, as provided under section 101(a) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275). Among other things, this new benefit allows CMS under 42 CFR 410.64 to cover "additional preventive services", if it determines through the NCD process that the service is recommended with a grade A (strongly recommends) or grade B (recommends) rating by the United States Preventive Services Task Force (USPSTF) and meets certain other requirements.

After reviewing various preventive services given a grade A or grade B recommendation by the USPSTF, CMS has decided to initiate a new national coverage analysis (NCA) on intensive behavioral therapy for obesity (IBTO), which is recommended with a grade B by the USPSTF. We would be interested in receiving any recommendations on the appropriate frequency of this therapy and those qualified to provide it, based on documentation from the medical literature, current clinical practice guidelines, or the USPSTF recommendations.

Benefit Category

Additional Preventive Services

Requestor Information

Requestor Name Requestor Letter
Internally generated N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
03/11/2011
Expected NCA Completion Date
11/29/2011
Public Comment Period
03/11/2011 - 04/10/2011
Proposed Decision Memo Due Date
Proposed Decision Memo Released
08/31/2011
Proposed Decision Memo Public Comment Period
08/31/2011 - 09/30/2011
Decision Memo Released
11/29/2011
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
Sarah Fulton, MHS
Sarah.fulton@cms.hhs.gov
410-786-2749
Lead Medical Officers
Joseph Chin, MD, MS

Medicare Benefit Category Determination Date

Actions Taken

March 11, 2011

Internally generated national coverage analysis (NCA). Initial 30-day public comment period begins.

The 30-day public comment period begins with this posting date, and ends after 30 calendar days. Instructions on submitting public comments can be found at http://www.cms.hhs.gov/Medicare/Coverage/InfoExchange/publiccomments.html. You can also submit a public comment by clicking on the highlighted word comment in the title bar at the top of this page. We strongly urge that all public comments be submitted through this website. Please do not submit personal health information in public comments. Comments with personal health information may not be posted to the website.

August 31, 2011

November 29, 2011