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Insurer Bucks Trend, Lets Docs, Patients Decide on Morcellation

HCSC decides against a "not medically necessary" label.

Published: June 11, 2015

Insurance giant Health Care Service Corp. has done an about-face and decided not to join the stampede of health insurers restricting or eliminating coverage of procedures done with laparoscopic power morcellators.

HCSC, the nation's 4th-largest health insurer, considered labeling morcellation "not medically necessary," but decided instead that whether to use the tool "is best determined through dialogue between the provider and the patient," spokeswoman Lauren Perlstein tells the Wall Street Journal.

Last summer, Highmark, Inc., announced that it would stop paying for the procedure. UnitedHealth Group announced this spring that it would require physicians to obtain authorization for all hysterectomies that used morcellation, and last month, Aetna also stopped covering routine use of morcellators.

The controversy surrounding the device, which gained widespread attention in 2013, stems from the revelation that it can spread undetected uterine cancer. The FDA issued a black box warning after conducting hearings, and has estimated that as many as 1 in 350 women may be vulnerable. Others say that estimate is much too high and argue that if morcellation is made unavailable, other complications, and deaths, will increase dramatically.

Johnson & Johnson, which had the largest market share for the device, withdrew it from the market last year and asked customers to return their morcellators. Other companies' versions remain available, however.

Jim Burger


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