Clermont Times

Today, Rep. Brad Wenstrup issued a statement following the House Ways and Means Committee's votes to advance two significant health care bills aimed at expanding coverage of weight loss treatments for Medicare beneficiaries and increasing access to breakthrough medical devices.

H.R. 4818, the Treat and Reduce Obesity Act, as amended, seeks to expand Medicare coverage for FDA-approved weight loss treatments. Currently, patients transitioning into Medicare cannot continue their prescribed weight loss treatments under the existing coverage. This legislation aims to rectify this issue by allowing continued coverage under Medicare. According to the Congressional Budget Office, this measure is projected to prevent approximately 1.25 million patients from losing coverage over the next decade as they transition into Medicare. H.R. 4818 was favorably reported to the full House by a vote of 36-4.

H.R. 1691, the Ensuring Access to Critical Breakthrough Products Act, as amended, proposes providing Medicare patients with four years of temporary coverage for FDA-designated breakthrough devices following FDA approval. Currently, these patients face extended delays in accessing such devices due to a lengthy separate coverage determination process by CMS. The bill also mandates that Medicare make a permanent coverage determination within the four-year transition period. H.R. 1691 was favorably reported to the full House by a vote of 36-5.

"As a physician and lawmaker, I have worked to ensure patients can access critical health care treatments they need," said Dr. Brad Wenstrup, D.P.M. "The House Ways and Means Committee's actions today are a strong step towards that goal."

“With two out of three adults in the United States currently obese or overweight,” noted House Ways and Means Committee Chairman Jason Smith, “Congress has a responsibility to remove inappropriate barriers to new medications that can help us fight back against chronic diseases linked to obesity.”

Smith added: “The era of modern medicine has produced incredible breakthrough medical devices that are helping patients achieve longer, healthier lives.” He emphasized that Congressman Wenstrup’s bill would streamline the process for ensuring timely access to these devices.

Background:

The updated version of the Treat and Reduce Obesity Act includes provisions for:

- Providing Medicare Part D coverage for anti-obesity medications (AOMs) for individuals aging into Medicare.

- Re-evaluating Medicare's National Coverage Determination of Intensive Behavioral Therapy (IBT).

- Requiring MedPAC to report on AOMs' usage in pre-Medicare markets.

The updated version of the Ensuring Access to Critical Breakthrough Products Act includes provisions for:

- Tightening criteria for eligible breakthrough devices.

- Mandating clinical trial information inclusive of the Medicare population.

- Granting CMS greater discretion in determining device eligibility.

- Allocating $10 million annually through 2030 for establishing this new pathway.