HARTFORD — The third largest health insurer in the country is implementing its newest policy with regards to the power morcellator surgical device.
As of May 15th, Aetna will cease insurance coverage for the routine use of the laparoscopic power morcellator. In order to use the device, doctors will have to acquire prior approval and only in specific exempted circumstances. A doctor my request approval to use the power morcellator for pre-menopausal women looking to preserve the fertility and who have no other option for treatment, or for women for which another type of procedure would be life-threatening.
Aetna’s refusal to pay for the use of power morcellators in common procedures like fibroid removal and hysterectomies represents a growing trend of the medical industry recognizing the risk of the device and taking steps to limit its use. The Wall Street Journal reported that across the country, insurers covering 93 million Americans have limited or are considering policy changes to limit the use of the power morcellator.
Earlier this year, the UnitedHealth Group – the largest insurer in the country with 40 million policyholders – changed its policy so that doctors needed to obtain prior authorization from the insurer for all hysterectomies. Health Care Services Corp – the fourth largest insurer in the country – is planning to label power morcellation as “not medically necessary,” which typically means the procedure will be ineligible for insurance coverage.
A popular Medicaid insurer, AmeriHealth Caritas, did the same.
Blue Shield of California classified the use of power morcellators for fibroid removal as “investigational” thus making the procedure uninsured in most cases.
UPMC Health Plan of Western Pennsylvania stopped providing coverage/reimbursement to hysterectomies performed with the device and Blue Cross Blue Shield of Massachusetts is also ceasing coverage.
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