- Aetna Sharply Curtails Coverage for Power Morcellation
- June 17, 2015
- Law Firm: Waters Kraus LLP - Dallas Office
- Insurance giant Aetna Inc. will no longer cover routine laparoscopic procedures using a power morcellator. Aetna is the third-largest health insurance plan in the United States.
Some surgeons used power morcellators — often in hysterectomies — to remove benign uterine fibroids. The power morcellator is inserted through tiny incisions to cut up the fibroids or the entire uterus and then remove them through a slender vacuum. Unfortunately, dangerous undetected cancers can be caught up by the morcellator, spinning tiny bits of cancerous cells into surrounding tissue and organs. The result is that a woman’s survival rate drops considerably.
Nation’s Third Largest Health Insurer Refuses to Cover Power Morcellation in Routine Hysterectomies and Fibroid Removal Surgeries
In 2014, the U.S. Food and Drug Administration cautioned that the risk that women undergoing fibroid removal surgery have undetected sarcoma is 1 in 350. Given the risk, the FDA warned that power morcellation should not be used in the vast majority of hysterectomies. In addition, morcellator manufacturers were told to include a “black-box” warning on their products that discloses the risk.
Under Aetna’s new coverage rules, doctors must receive prior approval for any morcellation surgery. The health insurer may consider exceptions for premenopausal women who wish to have children and cannot undergo any other type of fibroid removal procedure.
Aetna is also encouraging health providers to inform patients of the risks involved in morcellation surgery. Aetna is the largest U.S. health insurance provider to take this stance against power morcellators. It is not the only one, however. Health insurers covering more than 90 million Americans are reviewing a limitation of coverage or have already implemented one.