Highmark 1st private payer with exclusive coverage for Paradigm's coflex: 5 highlights

Spinal Tech

Highmark issued a new medical policy, "Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)."

Here are five highlights:

 

1. This policy makes Highmark the first private payer with exclusive positive coverage for Paradigm Spine's coflex Interlaminar Stabilization treatment for lumbar spinal stenosis.

 

2. The coverage does not cover any other interspinous distraction or interlaminar stabilization devices besides coflex.

 

3. The coverage applies to 5 million members in Pennsylvania, West Virginia and Delaware under the Highmark and affiliated operating health insurance plans.

 

4. The policy is dated Nov. 6.

 

5. Coflex is a non-fusion, motion preserving stabilization implant. The device has FDA premarket approval for lumbar spinal stenosis treatment. Surgeons may also leverage the device with a decompression or in place of a spinal fusion.


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Medtronic CEO Omar Ishrak: 5 key points on the future of value-based care for device companies

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