State Spending for Weight-Loss Surgery Increases

As the numbers of obese in Texas have swelled, so has the comfort of state and federal lawmakers with spending taxpayer dollars on weight-loss surgery for the elderly and the poor.

A Texas Tribune analysis of federal and state health care expenditures shows Medicare spending for weight-loss surgeries for Texas seniors — including gastric bypass and gastric banding — grew by nearly 400 percent between 2006 and 2010, to $1.7 million from $340,000. Since 2009, the number of bariatric procedures covered by Medicaid, the state health provider for the disabled and the very poor, has more than doubled. And annual Medicaid spending has jumped to $2.7 million from $290,000 in the last three years, the bulk of which was supplemental payments made to managed care plans.

This state subsidized weight-loss surgery has seen a boom in Hidalgo County along the Texas-Mexico border, where, according to Medicaid records, doctors have been reimbursed for 443 weight-loss surgeries in the last five years, at a cost of more than $340,000. That is dozens more — and more than twice the cost — than have been performed in Dallas County, which has nearly 150,000 more people on Medicaid than Hidalgo County.

Border surgeons say that they are simply responding to demand: Their region has the highest rate of Medicaid patients in the state, and patients roll into the medical hubs of McAllen and Edinburg from across southern Texas.

“There is no single diet right now that helps patients lose weight and keep it off,” said Dr. Luis Reyes, a McAllen bariatric surgeon who has filed nearly 300 Medicare and Medicaid claims for weight-loss surgeries over the last six years and earned about $220,000 for them, according to state and federal data. “Bariatric surgery has been able to help these patients to lose weight, to keep it off and to get rid of their comorbidities, which are very expensive,” he said, referring to medical conditions caused by obesity.

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