'Its position has become untenable': Why 3 neurosurgeons are fed up with Aetna
By Admin | October 02, 2023
In March, Aetna, which insures an estimated 22 million individuals, announced that it was expanding coverage to include Centinel Spine's Prodisc L lumbar total disc replacement system, which it previously considered "experimental and investigational."
The insurer has also been wrapped up in a class action lawsuit over its coverage of lumbar total disc replacements.
Three neurosurgeons — Luis Manuel Tumialán, MD, Praveen Mummaneni, MD, and Anthony DiGiorgio, DO — issued a statement to Becker's on their frustrations with Aetna and the fights many surgeons have been enduring with the insurer for years over a particular type of spine implant.
Editor's note: Statement has been edited for length and clarity.
"One commercial payer routinely frustrates spine surgeons performing anterior cervical discectomy and fusion: Aetna. During prior authorization, Aetna routinely denies coverage for interbody spacers in anterior cervical discectomy and fusion. Two decades of scientific research publications have documented the science of surface technology and osteoblastic ingrowth into biomechanical spacers. Yet, Aetna is the only major commercial insurer that deems the use of polyetheretherketone and metallic spacers as "experimental and not medically necessary" for routine ACDF.
"Curiously, Aetna has approved the use of...(More)
For more info please read, 'Its position has become untenable': Why 3 neurosurgeons are fed up with Aetna, by Becker's Spine Review
