Health Care Service Corp. to continue controversial morcellator coverage

After some debate, Health Care Service Corp. (HCSC) has decided to continue covering procedures that use laparoscopic power morcellators, reported the Wall Street Journal.

The nation's fourth-largest insurer considered deeming the morcellator "not medically necessary" but decided against the policy, which would have taken effect June 1, HCSC spokeswoman Lauren Perlstein told the WSJ.

"Based on the thoughtful input we've gathered from industry experts during the draft policy review process, we believe the use of the power morcellator tool is best determined through dialogue between the provider and patient," said Perlstein.

In November, the Food and Drug Administration warned against the use of morcellators on woman. The device uses a fast-spinning blade to remove benign growths called fibriods, but in women who have uterine sarcoma, a procedure using a morcellator could disperse the cancer into the abdominal cavity, FierceHealthPayer previously reported.

Despite the industry's hesitation, HCSC based its decision on recommendations from the American College of Obstetricians and Gynecologists, which told the insurer that providers need to be up front with patients regarding the risks of such devices as well as the benefits of the procedures, noted the WSJ.

Because there's no specific code to track morcellator use--another growing concern throughout the industry--Perlstein told the WSJ that HCSC "will continue to monitor this issue, maintain our dialogue with the health-care industry, and make further adjustments, as necessary."

Elsewhere, Aetna decided last month to stop covering the routine use of morcellators, the WSJ reported, as has Highmark. Meanwhile, Anthem and UnitedHealth Group recently required doctors to get prior authorization before performing most inpatient hysterectomies.

For more:
- here's the Wall Street Journal article

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