肥胖治疗的覆盖范围：对医疗补助和州保险法的逐州分析。
Coverage of obesity treatment: a state-by-state analysis of Medicaid and state insurance laws.
机构信息
Department of Emergency Medicine, The George Washington University, Washington, DC 20037, USA.
出版信息
Public Health Rep. 2010 Jul-Aug;125(4):596-604. doi: 10.1177/003335491012500415.
OBJECTIVES
We determined whether state Medicaid programs cover recommended treatments for adult and pediatric obesity and to what extent states regulate the treatment and coverage of obesity by private insurers.
METHODS
We conducted a state-by-state document review of Medicaid manuals and private insurance laws and regulations.
RESULTS
Eight state Medicaid programs appear to cover all recommended obesity treatment modalities for adults. Only 10 states appear to reimburse for obesity-related treatment in children. In the small-group insurance market, 35 states expressly allow obesity to be used for rate adjustments, while 10 states do so in the individual market. Two states expressly allow obesity to be used in eligibility decisions in the individual market. Five states provide for coverage of one or more treatments for obesity in both small-group and individual markets.
CONCLUSIONS
Very few states ensure coverage of recommended treatments for adult and pediatric obesity through Medicaid or private insurance. Most states allow obesity to be used to adjust rates in the small-group and individual markets and to deny coverage in the individual market.
目的
我们旨在确定各州的医疗补助计划是否涵盖成人和儿童肥胖症的推荐治疗方法，以及各州在多大程度上规范私人保险公司对肥胖症的治疗和覆盖范围。
方法
我们对医疗补助手册和私人保险法规进行了逐州的文件审查。
结果
八个州的医疗补助计划似乎涵盖了所有针对成人肥胖症的推荐治疗方法。只有 10 个州似乎为儿童肥胖症相关治疗提供报销。在小团体保险市场中，35 个州明确允许将肥胖用于费率调整，而 10 个州在个人市场中也这样做。两个州明确允许将肥胖用于个人市场中的资格决策。五个州在小团体和个人市场中都为一种或多种肥胖症治疗提供了覆盖。
结论
通过医疗补助计划或私人保险，很少有州确保涵盖针对成人和儿童肥胖症的推荐治疗方法。大多数州允许将肥胖用于调整小团体和个人市场的费率，并在个人市场中拒绝提供覆盖范围。
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