Bariatric Times

NOV 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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20 ASMBS State Chapter Spotlight Bariatric Times • November 2017 T he Florida state chapter evolved from the "Florida Coalition" that was born out of a crisis in 2005 when Blue Cross/Blue Shield (BC/BS) terminated coverage for bariatric surgery. One of their senior administrators said, "Gastric bypass is extremely risky and of questionable benefit," which galvanized a strong response from Florida surgeons. Although doctors from the area believed that BC/BS based their decision on financial considerations, the physicians knew the explosive growth of bariatric surgery had attracted enterprising surgeons that lacked appropriate training. Their poor outcomes tantalized the media, which made the BC/BS decision seem justifiable to the public and state officials. By serendipity, Michel Murr, MD, FACS, met Rep. Sandra Murman and pleaded his case. She offered to raise awareness and suggested hiring a lobbying firm. Selling the idea of political action to the conservative executive council of the American Society for Metabolic and Bariatric Surgery (ASMBS) was especially challenging. Florida was not the only state that wanted to organize, and advocacy required substantial funding. In the interim, Murr called on his local congressman, Adam Putnam, and then visited John O. Agwunobi, MD, MBA, MPH, the Florida Secretary of Health, and Harvey Sugerman, MD, who is a Floridian and Past President of the ASMBS. The secretary directed Murr and Sugerman to the chief financial officer (CFO), who regulated insurance companies. Disappointed by their meeting with the secretary of health, but not deterred, Murr appealed to the ASMBS for funding. Dealing with the same crisis in Virginia, Neil Hutcher, MD, FACS, then President of ASMBS, worked with Murr to secure the necessary funding, which came from ASMBS members, including partners, and, most importantly, the Florida surgeons. With a lobbying firm on board, Murr and his delegates got timely access to more than 15 elected and appointed officials in Tallahassee. The delegation to Tallahassee included Murr, Sugerman, and Murman, as well as Bob Marema, MD, FACS, and Vincent Zeringue. Other members of the steering committee were Jeffrey Lord, MD; Raul Rosenthal, MD, FACS, FASMBS; Patricia Beyers, MD; and Keith Kim, MD. Together, the delegation submitted a 'Position Paper' to the CFO of Florida, Tom Gallagher, which he used to bring BC/BS to the table. The insurance executives were annoyed by their strong action but continued to be evasive about reinstating coverage without instating quality measures first, which came later with Surgical Review Committee (SRC)/Centers of Excellence Program (COE). Dr. Daryl Peaden asked Murr and Lord to present the position paper to the Committee for Health, which he chaired. Committee members Peaden, Pruitt, Saunders, Fasano, and Dawson extended their support to the coalition to work on reinstating access to obesity management and bariatric surgery. Subsequently, they provided the scientific language to an Obesity Prevention Bill (Senate Bill 1324), and submitted a community-issue budget request to educate primary care providers about diagnosis and treatment of obesity, including bariatric surgery. In addition to legislative action, the chapter was very active in communicating with the media, generating more than 13 interviews. The chapter later convened an "Obesity Summit" to raise awareness. THIS MONTH: Florida, Puerto Rico, and the Caribbean State Chapter by SAMUEL SZOMSTEIN, MD, FACS, FASMBS, and MICHEL MURR, MD, FACS Bariatric Times. 2017;14(11):20–21. This column is dedicated to providing updates on the American Society for Metabolic and Bariatric Surgery State Chapters. American Society for Metabolic and Bariatric Surgery STATE CHAPTER SPOTLIGHT SAMUEL SZOMSTEIN, MD, FACS, FASMBS Samuel Szomstein, MD, FACS, FASMBS, is an associate chairman of the Bariatric and Metabolic Institute and Section of Minimally Invasive Surgery in the Department of General and Vascular Surgery for the Cleveland Clinic in Weston, Florida. STATE CHAPTER PRESIDENT From left: Michel Murr, MD, FACS; Vincent Zeringue, MD; Sandra Murman; Harvey Sugerman, MD; and Bob Marema, MD, FACS From left: Harvey Sugerman, MD; John O. Agwunobi, MD, MBA, MPH; and Michel Murr, MD, FACS

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