ISASS Comments on Independence Blue Cross Spinal Fusion Policy

On August 25, 2020, ISASS sent a comment letter to Independent Blue Cross (IBC), the Blue Cross affiliate for the Greater Philadelphia area, regarding their recent Spinal Fusion Policy.

The IBC policy calls for attestation of failure of conservative treatment by a physiatrist.  The letter from Dr. Frank Phillips, ISASS president, stated “ISASS believes that this intrusion has already been shown to create significant barriers to efficient care. ISASS questions the Level of Evidence supporting an additional consultation with a physiatrist to document that a patient has exhausted nonsurgical options. ISASS further maintains that the spine surgeon, rather than the physiatrist, is solely capable of the surgical decision making required to deliver spine surgery.”

ISASS will continue to follow the Spinal Fusion policy and seek opportunities to engage with IBC on this issue.

Read the IBC Spinal Fusion policy here: https://medpolicy.ibx.com/ibc/Commercial/Pages/Policy/6C6218B5CEC0F18085258588005C4080.aspx

ISASS Letter Regarding IBC Medical Policy 11.14.27d

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