Federal Update: Anthem Threatens Hyaluronic Acid Injections Treatment Coverage for Patients
posted: September 22, 2017
Anthem has announced that, effective October 1, 2017, Hyaluronan injections to treat osteoarthritis in the knee will be revised from medically necessary to not medically necessary. Any patients carrying an Anthem - sponsored health plan will no longer have their Hyaluronan injections covered, and must elect to pay the entire cost out-of-pocket in order to continue receiving this treatment.
Numerous studies have confirmed the safety and efficacy of Hyaluronan injections in treating osteoarthritis of the knee, which are clinically meaningful for patients. In addition, Hyaluronan injections have proven to reduce overall resource utilization by osteoarthritis patients, delaying TKR and reducing use of NSAIDs, corticosteroids, and opioids.
The American College of Rheumatology (ACR) and the Coalition of State Rheumatology Organizations (CSRO) are currently finalizing comments that the OAR will review and consider supporting.
Anthem Clincial UM Guideline