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Inappropriate Coverage Restrictions

Posted By Administration, Monday, March 26, 2012

ISIS has just addressed a serious issue affecting coverage of spine intervention procedures. It appears that several public and private payers may be misinterpreting a Washington State Health Technology Assessment (HTA) Clinical Committee's finding on spinal injections to inappropriately restrict or eliminate coverage. Last week, ISIS intervened and worked with the HTA Administration to address such an issue and correct the inappropriate policies. As ISIS continues to work to address these issues, we ask that our members remain vigilant and contact ISIS immediately if any payer, anywhere in the country, cites the WA State HTA Findings and Coverage Report to support an inappropriately restrictive coverage decision.


As our members may recall, ISIS spearheaded a tremendous year-long effort to protect our patients' access to important interventional procedures during the Technology Assessment process to review spinal injections based on a very negative, flawed, evidence report. This review, report and resulting coverage decision is expected to be the basis for coverage policies of public as well as private payers. As a direct result of our efforts, access to the majority of crucial procedures has been preserved. Click here to read the Final WA State HTA Findings and Coverage Decision and the Summary of ISIS Efforts.


It is crucial that the WA State HTA Coverage Report be appropriately interpreted when used by payers nationwide. Therefore, ISIS members are asked to be on alert and review any new or proposed coverage policies. If any misrepresentations of the WA State HTA report are identified, ISIS members are encouraged to contact ISIS immediately at  

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