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Insurer To Stop Covering Hysterectomy Procedure Amid Cancer Warnings

Insurer To Stop Covering Hysterectomy Procedure Amid Cancer Warnings

August 5, 2014 — One of the nation's largest Blue Cross Blue Shield health plans is ending coverage of laparoscopic power morcellation amid FDA scrutiny of the procedure's safety, the Wall Street Journal reports.

The insurer, Highmark, provides coverage for about 5.2 million residents in Delaware, Pennsylvania and West Virginia. According to the Journal, it is the first insurer to end coverage of procedures involving laparoscopic power morcellation, which can unintentionally spread cancer during hysterectomy procedures (Levitz, Wall Street Journal, 8/2).

Background

Laparoscopic power morcellation was developed as an alternative to invasive surgery for women who undergo hysterectomies to treat symptomatic uterine fibroids. The method uses a power device to grind uterine tissue so it can be removed through a tiny incision and is used in about 50,000 procedures annually in the U.S.

The technique has come under fire for its potential to spread a type of cancer -- known as a uterine sarcoma -- within the body. A recent study in the Journal of the American Medical Association estimated that one in 368 women undergoing morcellation had uterine cancer that was undetected until after the procedure (Women's Health Policy Report, 8/1).

FDA has advised doctors not to use the technique and is weighing whether to take further regulatory action.

Highmark's Decision

Highmark spokesperson Aaron Billger said the company studied the issue for months and determined that the procedure's risks outweighed its benefits. He said the insurer evaluated medical evidence and data, including patient outcomes, potential risks of alternative methods and the implications for halting coverage. Highmark will end the coverage effective September 1.

Billger said the Highmark-owned Allegheny Health Network, a multi-hospital health system, also has stopped providing the procedure.

Meanwhile, the University of Pittsburgh Medical Center on Saturday announced it also no longer offers the procedure (Wall Street Journal, 8/2).