“We are pleased with the growing body of commercial health care plans offering exclusive reimbursement policies for the iFuse Implant System,” said Jeffrey Dunn, President, Chief Executive Officer, and Chairman. “We continue to make progress expanding our market leadership in providing minimally invasive surgical products for the sacroiliac joint and improving patient lives.”
CareFirstis the largest health care insurer in the Mid-Atlantic region, covering 3.2 million members in Maryland, the District of Columbiaand parts of Northern Virginia. CareFirst’s iFuse only policy took effect January 1, 2019. Premera Blue Crossis the largest health plan in the Pacific Northwest, covering over 2 million lives throughout Washingtonand Alaska. The Premera exclusive iFuse policy became effective February 1, 2019.
- Excellus BlueCross BlueShield policy took effect
December 20, 2018and provides access to the iFuse Procedure for almost 1.5 million customers in central and upstate New York.
All three of these recent positive and exclusive coverage policies for iFuse were based on review of published clinical evidence and conclude that published results from two randomized controlled trials of iFuse versus conservative care, in addition to several cohort studies and numerous case series, demonstrate that evidence is sufficient to determine the effect on health outcomes and therefore treatment of SI joint dysfunction with triangular titanium implants may be considered medically necessary for appropriately diagnosed patients.
The iFuse Implant System is intended for sacroiliac fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruption and degenerative sacroiliitis. This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted postpartum for more than 6 months. There are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit.
Source: SI-BONE, Inc.