An exciting announcement from MDedge. Click here for more information. Medicare will now cover the use of facial fillers for beneficiaries whose facial lipoatrophy resulting from treatment for HIV infection has contributed significantly to depression, the Centers for Medicare and Medicaid Services announced yesterday. The decision, which applies only to fillers specifically approved for use in facial lipoatrophy, became effective immediately, according to the agency's national coverage determination memo.
Thank you! Lipodystrophy is a disturbance of lipid fat metabolism that involves the partial or total absence of fat and often the abnormal deposition and distribution of fat in the body. Other conditions that may be associated with lipodystrophy include insulin resistance, diabetes, a high triglyceride level hypertriglyceridemia , and fatty liver. While agents used for weight gain or cosmetic purposes may not be covered under the Medicare Part D benefit, current Part D guidance specifies that drugs used to treat AIDS wasting and cachexia are not excluded from coverage. We are seeking a clarification to the Part D coverage guidance to clearly state that treatments for lipodystrophy that results from use of ARVs are covered by Medicare. CMS determined that coverage of these treatments is reasonable and necessary for HIV-infected beneficiaries manifesting depression as a result of the physical stigma of HIV treatment. As the NCD only relates to coverage under Part B, for two specific therapies, we remain concerned that health plans will not provide important and necessary access to similar treatments for other lipodystrophy effects.
Medicare to Cover Facial Fillers for Lipoatrophy in HIV Patients
Fat is needed for the body to function. It plays an important role in keeping the skin and hair healthy, protecting body organs, and maintaining body temperature. Fat is also stored energy. There are different types of fat found in the body.