Public Policy

November 15, 2010

Advocacy Alert: North Carolina-based SAS Members

We wanted to bring your attention to an issue that may adversely impact patient access to necessary spine fusion procedures. We have learned that North Carolina BC/BS has issued a new, more restrictive policy for lumbar fusion procedures, effective January 2011. View the Policy Here (PDF) (Note: Policy document removed from BC/BS NC web site.) Our initial read of this policy is that it is overly restrictive; specifically, there are several common scenarios where the standard of care includes fusion; however, this more restrictive policy may make it more difficult for those patients suffering low back pain due to spondylolisthesis to receive needed surgeries. These scenarios include: Patients with degenerative spondylolisthesis who don’t have as much leg pain as back pain. […]