12 physician groups object to Humana's 'unproven' label for spinal therapy

Twelve physician groups expressed their "profound objection" to Humana's classification of a spinal procedure as "unproven" in a letter to the healthcare insurer.

The letter, sent Oct. 9 to Manisha Dhuria, MD, the payer's associate vice president of physician leadership, addresses Humana Medicare Advantage's plan that removed closed-loop spinal cord stimulation therapy. Humana removed procedure coverage due to it being "experimental, investigational, and/or unproven."

"We express our profound objection to the current characterization by your commercial coverage policy of closed-loop spinal cord stimulation therapy as experimental, as it is our firm belief that such a classification does a disservice to patients and neglects the scientific research, rigorous clinical trials, and evidence supporting the eTicacy of closed-loop SCS therapy," the associations wrote.

The associations and groups point to studies that have found closed-loop SCS demonstrated substantial improvements in pain, enabled patients to taper opioid therapy, improved sleep, function, mood and quality of life. 

"The scientific community at large recognizes closed-loop SCS as an evolutionary and proven advancement, offering patients a level of personalized care that was once unimaginable," the letter said. "Dismissing it as 'experimental, investigational, and/or unproven' not only undermines the years of dedicated research but also restricts patient access to a treatment that has the potential to transform lives… We urge you to reevaluate your commercial position and acknowledge the overwhelming evidence supporting closed-loop SCS therapy."

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