Public Policy

December 15, 2010

Advocacy Alert: BCBS/NC Lumbar Fusion Response

December 15, 2010 Don W. Bradley, M.D. Senior Vice President, Healthcare & Chief Medical Officer Blue Cross and Blue Shield of North Carolina 5901 Chapel Hill Road Durham, NC 27707 Subject: BlueCross BlueShield of North Carolina Lumbar Spine Fusion Surgery “Notification” Dear Dr. Bradley: The American Association of Neurological Surgeons (AANS), the American Association of Orthopaedic Surgeons (AAOS), the Congress of Neurological Surgeons (CNS), the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves, the International Society for the Advancement of Spine Surgery (ISASS), the North American Spine Society (NASS), the North Carolina Neurosurgical Society (NCNS), the Pediatric Orthopaedic Society of North America (POSNA) and the Scoliosis Research Society (SRS) would like to thank BlueCross and BlueShield of […]
December 2, 2010

Advocacy Alert: SAS Will Engage Payers on Spine Surgery-Related Procedures

Recently, SAS alerted its members to policy changes proposed by North Carolina BC/BS for lumbar fusion procedures. This proposed policy would unfairly reduce or eliminate fusion surgery as an option for many patients who would greatly benefit from such procedures. Our membership alert has generated a significant response, and will help inform and strengthen our advocacy with North Carolina BC/BS. Indeed, we are now working with myriad other medical societies, our industry partners, and individual surgeons to strongly express our concerns about this overly restrictive policy, and to request that it be modified to ensure patient access to appropriate surgical solutions to spine-related diseases and conditions. Concurrently, we have initiated a process to develop a Position Statement on lumbar fusion […]
November 17, 2010

Advocacy Alert: Changes to Spine Fusion Insurance Reimbursement Policy

The SAS is alerting our membership regarding recent changes to a US insurance reimbursement policy covering spine fusion procedures. The revised policy may affect all SAS members, including international members, in the future. As past SAS President Chun-Kun Park, MD, PhD said: “Such changes are likely to have an impact on the reimbursement policy quite a bit even in the other countries, because as you know, ‘bad news travels fast’ in the recent information society with advanced telecommunications. So, it can lead to a grave international issue.” We want to bring your attention an issue that may adversely impact patient access to necessary spine fusion procedures: We have learned that North Carolina Blue Cross/Blue Shield Insurance (BC/BS NC) has issued […]
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. […]