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ISIS Meets with Blue Cross Blue Shield Regence to Address Coverage Concerns

Posted By Administration, Thursday, May 10, 2012
ISIS continues to address problems arising from payers misinterpreting Health Technology Assessment (HTA) Clinical Committee's findings on spinal injections, to inappropriately restrict or eliminate coverage. Last week, Dr. Paul Dreyfuss met with several Medical Directors of Regence BCBS to address Uniform Medical's non-coverage policy on facet joint interventions and explain ISIS' concerns and positions. Mutual understanding was reached in the meeting. We are now hopeful that it will result in a reasonable coverage policy.

As ISIS continues to work to address these issues, we ask that our members remain vigilant and contact ISIS immediately at, if any payer, anywhere in the country, cites the WA State HTA Findings and Coverage Report to support an inappropriately restrictive coverage decision. It is crucial that the WA State HTA Coverage Report be appropriately interpreted when used by payers nationwide.

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 across the country. 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.

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