Thought this might help someone else with Kaiser requirements.

[Was a humpty dumpty 35]

I found this, and thought it might help someone else who is wondering if they quaify with Kaiser for WLS.

Referring Physician's Statement: review the three statements below prior to submitting eReferral

The patient has been under my care long enough that I am familiar with the patient's medical and psychosocial status. Patient has failed previous attempts of weight management therapy. Based upon this knowledge and the clinical indications, I recommend a multi-disciplinary comprehensive educational program to prepare for bariatric surgery.

I understand that the Kaiser Permanente pre-surgery educational program will coordinate required labs for the patient. The medical team may review labs and make necessary adjustments in medications and treatment protocols. The program team will coordinate the referral for surgery after the completion of the educational program if the patient meets all the requirements.

This educational referral does not guarantee a surgical referral for the patient. The patient will be required to meet the program and surgical requirements.

BODY MASS INDEX (BMI) 40 - 49.9:

With one co morbid condition from Category 1 - OR -

Any two co morbid conditions from Category 2 - OR -

Special circumstances: Patients with BMI 40-49.9 with no comorbid conditions may be referred for assessment by a bariatric specialist if recommended by the Primary Care Physician

Category 1 Criteria

1-Moderate Obstructive sleep Apnea Respiratory Disturbance Index (Apnea/Hyperpnoea Index) defined by apnea plus hyperpnoea/ hours of sleep greater than 19.

2-Difficult to control Diabetes Mellitus HgA1C greater than 7.5 while on two medications.

3-Degenerative Joint Disease (DJD) of the hips or knees .

4-Severe GERD as documented by endoscopy or imaging with failure of standard medical treatment and a recommendation from a gastroenterologist or general surgeon for invasive therapy

5-Hypoventilation Syndrome

Category 2 Criteria

Mild Obstructive Sleep Apnea

Degenerative Joint Disease (DJD) hips, knees, ankles, feet and lumbosacral spine.

Diabetes Mellitus defined as two fasting blood sugars 126 or above

Hypertension which requires pharmacologic treatment.

Polycystic ovarian syndrome with clinical manifestations .

Cardiomyopathy with cardiology recommendation.

Lower Extremity Edema.

Ventral Hernia.

Hyperlipidemia as per Kaiser Permanente Clinical Guidelines for drug treatment of hyperlipidemia.

Urinary Incontinence

Gastroesophageal Diseases evidenced by endoscopic or imaging data or persistent need for H2 blockers or proton pump inhibitors

Asthma