US : Health Insurer to Stop Covering Uterine Procedure

A health insurer with 5.2 million customers in Pennsylvania, West Virginia and Delaware said Saturday it will stop covering a procedure that uses a gynecological surgical tool that can spread cancer.

Highmark, Inc., which is one of the largest Blue CrossBlue Shield plans in the country, said it would stop coverage in its entire service area on Sept. 1 for laparoscopic power morcellation. In the procedure, a bladed device is used to cut up common uterine masses called fibroids, often in hysterectomies, so the tissue can be removed through tiny incisions in minimally invasive surgery.

The Wall Street Journal said the privately held Highmark is the first insurer to drop coverage of the procedure. The U.S. Food and Drug Administration said in April it would re-evaluate the safety of the procedure and advised doctors against using it in the interim. The Ethicon unit of Johnson & Johnson (NYSE:JNJ) suspended sales of all its morcellation devices and recalled them from customers last week.

A representative of the Pittsburgh-based Highmark, Aaron Billger, said it was “in the best interest of our members” to stop covering the procedure. UPMC, the biggest hospital group in western Pennsylvania, said Friday it would stop performing the procedure Sept. 1, the Pittsburgh Business Times reported.

Morcellation is a minimally invasive procedure that helps speed recovery, limit scarring and blood loss, and reduce the risk of infection. The Business Times reported recent studies indicate 250 of every 100,000 women undergoing the procedure suffer advanced cancer.

Agencies/Canadajournal