SI-BONE, Inc. Announces that Humana Establishes Exclusive Coverage for iFuse in MIS SI Joint Fusion Procedures
Humana is one of the 5 largest commercial payors in the U.S. and joins 36 other commercial health plans that offer coverage for the triangular iFuse Implant System only
SANTA CLARA, Calif., Dec. 16, 2020 (GLOBE NEWSWIRE) -- SI-BONE, Inc., (Nasdaq: SIBN) a Silicon Valley-based medical device company dedicated to solving musculoskeletal disorders of the sacro-pelvic anatomy, today announced that Humana has revised its coverage policies to cover minimally invasive SI joint fusion using triangular titanium implants (i.e., iFuse Implant System). Humana is one of the five largest commercial payers in the U.S., with over 12.7 million covered lives.
The revised policy, effective for procedures performed as of December 10, 2020, provides coverage for minimally invasive sacroiliac joint fusion for chronic low back pain due to sacroiliac joint dysfunction, provided certain criteria are met. The new coverage criteria, found in the revised Spinal Fusion Surgery policy, can be found here ().
“We are thrilled with Humana’s decision to cover MIS SI joint fusion procedures that use iFuse for its members, and with clinical criteria that aligns closely with guidelines from professional spine societies like NASS and ISASS,” said Jeffrey Dunn, President, Chief Executive Officer, and Chairman at SI-BONE. “Payors continue to rely on long-term outcomes from high-quality randomized controlled trials when establishing coverage criteria for new treatments which is a cornerstone of our culture. With this updated policy, Humana joins 36 other health plans that cover MIS SI joint fusion using the iFuse Implant System exclusively, as well as other large payors including United Healthcare, CIGNA and Aetna, which also provide positive coverage for iFuse procedures.”
About SI-BONE, Inc.
SI-BONE is a medical device company that pioneered minimally invasive surgery of the SI joint with the iFuse Implant System. Studies have shown that the SI joint can be a source of pain in 15% to 30% of chronic low back pain. The iFuse Implant™, commercially available since 2009, is the only SI joint fusion device supported by multiple prospective clinical studies, including two randomized controlled trials, showing improved pain, patient function and quality of life resulting from treatment. There are over 85 peer-reviewed publications demonstrating the safety, durable effectiveness, and biomechanical and economic benefits unique to the iFuse Implant (). This body of evidence has enabled multiple government and private insurance payors to establish coverage of the SI joint fusion procedure exclusively when performed with the iFuse Implant System.
The iFuse Implant System is intended for sacroiliac fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruption and degenerative sacroiliitis. This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted postpartum for more than 6 months. The iFuse Implant System is also intended for sacroiliac fusion to augment stabilization and immobilization of the sacroiliac joint in skeletally mature patients undergoing sacropelvic fixation as part of a lumbar or thoracolumbar fusion. In addition, the iFuse Implant System is intended for sacroiliac fusion in acute, non-acute, and non-traumatic fractures involving the sacroiliac joint. There are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit.
SI-BONE and iFuse Implant System are registered trademarks of SI-BONE, Inc. ©2020 SI-BONE, Inc. All Rights Reserved. 12162020
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