Radiology societies urge commercial insurers to align with Medicare on payment policy for key procedure
By Admin | May 08, 2023
Radiology societies are urging several commercial insurers to realign their payment policies for a key procedure to match with Medicare.
Nearly a dozen national medical groups voiced their concerns in a May 1 letter to Humana, Aetna and others. Their frustration stems from policies pertaining to coverage for a minimally invasive procedure to treat compression fractures in the vertebral body.
The American College of Radiology—alongside similar groups representing neuro, spine and interventional radiologists—criticized payer policies that forbid coverage for such surgery in the initial days following a fracture.
“We believe limiting surgical procedures to fractures over six weeks old should be revised/eliminated as this requirement has the potential to negatively impact patient outcomes and providers’ ability to deliver evidence-based, appropriate spinal care to all patients,” ACR et al. wrote. “Notably, recent literature supports this suggestion with positive impacts to patient biomechanical changes, pain scores, quality of life metrics, mortality rates, and long-term economic benefits.”
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