FEHB Plans Told to Cover Anti-Obesity Drugs

FEHB carriers must cover in 2015 FDA-approved anti-obesity drugs in addition to benefits they already provide such as wellness activities, health coaching and nutrition counseling. OPM said that many carriers currently do not cover such drugs on grounds that they do not fit standard definitions of medical necessity but they should include them in diet and physical activity regimens as appropriate. It added that because some of those drugs act as stimulants and may be subject to misuse, carriers should impose strict controls on their use, including on duration of the prescription. OPM also said that bariatric surgery should be covered at facilities beyond those on a central government list of centers that perform that surgery. The instructions came in a directive following up on the recent “call letter” setting terms of FEHB coverage for 2015.