- Howard J Marans, MD, MSc, FRCSC
Executive Director, Medical Health Services
Manager – Spine/Orthopedic SME Team
Board Certified Orthopedic Surgeon - Lynn Fitzgerald, MD, PhD, FACS
Spine Subject Matter Expert
Board Certified – American Board of Neurological Surgery - Brian Kane
Executive Vice President CVS Health
President Aetna
Cathy Moffitt, MD, FAAP, CHIE
Chief Medical Officer Aetna
Robert McDonough, MD
Senior Director, Clinical Policy Research and Development Aetna
April 26, 2024
Dear Mr. Kane and Drs. Marans, Fitzgerald, Moffit and McDonough,
The aforementioned societies would like to request a change in Aetna’s policy (https://www.aetna.com/cpb/medical/data/1_99/0016.html) to allow/include coverage for the use of biomechanical interbody devices in all Anterior Cervical Discectomy and Fusion (ACDF) surgeries.
Multiple physician societies have engaged Aetna in teleconferences, over many years, to discuss the relevant medical literature. Although our opinions differ on this matter, with Aetna maintaining that the literature presented is not compelling enough to modify their policy, we have appreciated the opportunity to converse with Aetna to this regard.
Aetna, however, continues to be the only insurance carrier who does not recognize the use of these devices as “standard of care” and who continues to restrict the use of biomechanical devices. This has created significant issues which need to be discussed and addressed. We would like to focus on these issues including unfair access restrictions, availability, and the practice of modern spinal surgery.
Click here to read more about Neurosurgery Joins Spine Societies in Urging Aetna to Cover Spinal Cages with ACDF Procedures.
