Press Releases

Today, Rep. Wenstrup released a statement following the House Ways and Means Committee overwhelming votes to advance two key health care priorities he has championed to expand coverage of weight loss treatments for Medicare beneficiaries and increase access to critical breakthrough medical devices.

H.R. 4818, the Treat and Reduce Obesity Act, as amended, would expand Medicare coverage of Food and Drug Administration (FDA) approved treatments for weight loss. Currently, patients who are on prescribed weight loss treatments as they age into Medicare cannot continue to receive coverage for their existing prescriptions. This legislation will alleviate this disparity by allowing coverage of these successful treatments to carry over to their Medicare insurance plan. This is a strong first step that will prevent an estimated 1.25 million patients from losing coverage over the next decade as they transition into Medicare, according to the Congressional Budget Office. H.R. 4818 was favorably reported to the full House by a vote of H.R. 4818 was favorably reported to the full House by a vote of 36-4. You can watch Rep. Wenstrup's remarks below. 

H.R. 1691, the Ensuring Access to Critical Breakthrough Products Act, as amended, would give Medicare patients four years of temporary Medicare coverage for FDA-designated breakthrough devices following FDA approval. Currently, Medicare patients face multi-year delays in gaining access, even though these devices have been deemed safe and effective by the FDA, due to a separate and too often lengthy coverage determination process by the Centers for Medicare & Medicaid Services (CMS). The bill would also require Medicare to 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. Watch Rep. Wenstrup's full remarks below. 

"As a physician and lawmaker, I have worked to ensure patients can access critical health care treatments they need. The House Ways and Means Committee's actions today to increase access to critical breakthrough medical devices and expand coverage of weight loss treatments and medications for Medicare beneficiaries are a strong step towards that goal," said Dr. Brad Wenstrup, D.P.M.  "I look forward to a full House vote so we can continue to work to make America the healthiest nation on the planet."

“With two out of three adults in the United States currently obese or overweight, Congress has a responsibility to remove inappropriate barriers to new medications that can help us fight back against the chronic disease epidemic in America that is linked to obesity. There are currently solutions and medications on the market that have shown to be effective in treating obesity for millions of patients, helping them live healthier lives and driving down the long-term costs of health care, but Medicare’s coverage policies are more than twenty years old and not reflective of these drugs’ current benefits. Thanks to Dr. Wenstrup’s leadership, this legislation will allow millions of seniors entering Medicare to maintain their treatment on anti-obesity medication, ensuring continuity of care and driving down their long-term health care costs," said House Ways and Means Committee Chairman Jason Smith. “The era of modern medicine has produced incredible breakthrough medical devices that are helping patients achieve longer, healthier lives. When a new breakthrough device comes online, Medicare has a responsibility to work diligently to review and determine how best to get beneficiaries access to these devices in a timely manner. Congressman Wenstrup’s bill will help streamline the coverage determination process for breakthrough devices to ensure patients can receive access to these devices quicker and through a more transparent, predictable, and efficient process.”

Background: 

The updated version of the Treat and Reduce Obesity Act would:

• Provide Medicare Part D coverage of anti-obesity medications (AOMs) to individuals aging into Medicare who are currently being treated by an AOM, ensuring they do not lose coverage for their effective therapies.
• Require Medicare to re-evaluate its National Coverage Determination of Intensive Behavioral Therapy (IBT) so that seniors can be effectively treated through diet and exercise.
• Require MedPAC to report on the coverage of AOMs in pre-Medicare markets and how use among those populations may affect usage by enrollees to lay the groundwork for expanded coverage to more individuals.

The updated version of the Ensuring Access to Critical Breakthrough Products Act would:

• Tighten criteria for what breakthrough devices are eligible for coverage and remove unnecessary add-on payments.
• Require all breakthrough devices approved by the FDA to have clinical trial information that includes the Medicare population.
• Grant CMS greater discretion to determine whether devices are eligible for coverage.
• Provide $10M/year through 2030 for CMS to establish this new coverage pathway.

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