Blue Cross Blue Shield of Michigan, USA, establishes positive coverage policy for sacroiliac joint fusion

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Blue Cross Blue Shield (BCBS) of Michigan, USA, the largest commercial insurer in the state of Michigan, has issued a positive medical policy statement for minimally invasive sacroiliac joint fusion.

BCBS of Michigan becomes the first of the 36 BCBS plans in the USA to establish a positive coverage policy. The new policy became effective on 1 March 2016 and states “the safety and effectiveness of minimally invasive sacroiliac joint fusion have been established and it may be considered a useful therapeutic option when supporting documentation substantiates appropriate patient selection criteria listed under inclusionary and exclusionary guidelines.” The patient selection criteria identified by BCBS of Michigan follows the International Society for the Advancement of Spine Surgery (ISASS) proposed recommendations/coverage criteria for minimally invasive sacroiliac joint fusion that were published last year.

“I have performed over 275 SI joint fusion surgeries using the iFuse implant system with excellent results that mirror the published literature. I am very pleased to see that BCBS of Michigan has joined Priority Health and WPS Medicare to take a leadership role in Michigan by establishing coverage,” says Jurgen Luders, a neurological surgeon in Grand Rapids, USA.

“This decision not only provides access to the iFuse procedure that will benefit so many patients in the state of Michigan but it also provides cost savings to BCBS of Michigan, which is so important given today’s high cost of healthcare. Hopefully, this decision will encourage BCBS health plans in other states to provide coverage and access to all those in need of this important therapy.”