Reimbursement Coverage News

Increasing Patient Access to Care

Ethicon's Reimbursement & Healthcare Economics team partners with healthcare payors, government agencies, advocacy groups, employers and health plans to increase patient access to care. Listed below are recent coverage changes resulting from these innovative partnerships:

• HEALTH CARE SERVICES CORPORATION (HCSC), PARENT COMPANY OF BCBS OF IL, TX, OK & NM, HAS ELIMINATED THE MANDATORY SIX MONTH WEIGHT LOSS REQUIREMENT PRIOR TO BARIATRIC SURGERY: January 2012
• MISSISSIPPI ADDS BARIATRIC BENEFIT FOR STATE AND SCHOOL WORKERS: November 2012
• BARIATRIC SURGERY PILOT PROGRAM FOR OKLAHOMA STATE AND SCHOOL EMPLOYEES: September 2012
• REGENCE BCBS, COVERING 2.2 MILLION IN THE PACIFIC NORTHWEST & MOUNTAIN STATES, EXPANDING BARIATRIC SURGERY COVERAGE TO INCLUDE SLEEVE GASTRECTOMY: September 2012
• CIGNA MODIFIES AND REDUCES THE MEDICAL MANAGEMENT COMPONENT OF THEIR NATIONAL BARIATRIC SURGERY COVERAGE POLICY FROM 6 CONSECUTIVE MONTHS TO 3 MONTHS: May 2012
• ILLINOIS MEDICAID MAINTAINS BARIATRIC SURGERY BENEFITS: July 2012
• KANSAS MEDICAID-BARIATRIC BENEFIT ADOPTED: July 2012
• TUFTS HEALTH PLAN COVERS BARIATRIC SURGERY: July 2011
• BCBS OF TENNESSEE ADDS LAPROSCOPIC SLEEVE GASTRECTOMY TO LIST OF COVERED WEIGHT-LOSS PROCEDURES: July 2011
• BCBS OF ALABAMA ADDS LAPROSCOPIC SLEEVE GASTRECTOMY TO LIST OF COVERED WEIGHT-LOSS PROCEDURES: July 2011