Minimally Invasive Stretta Therapy Gains Momentum as HCSC BCBS Adds Coverage for 16 Million New Patients
We’ve all been there. In our doctor’s office, or on the phone with their billing manager, being told that a drug or procedure we hoped for is not covered by our insurance plan. After weeks or even months of researching online, talking to other patients, and comparing alternatives, we’ve been told that our insurance plan simply will not cover that solution. Our frustration is shared by the doctor, who has had success with that procedure or drug on patients just like us.
Medical device companies are in the middle of this. We feel the frustration of the doctor and patient, but we also understand the responsibility the insurance company has to make evidence-based decisions on what is safest and most effective for their population. With new technology being introduced continually, insurance companies have a lot to consider, and decisions are not made lightly.
So how does change happen? Insurance companies change their coverage policies, after they are presented with high quality evidence that convinces them that the procedure is safe, reliable, and effective, both medically and in terms of cost. This takes legitimate peer-reviewed, published clinical studies incorporating hundreds or thousands of patients and a lot of effort and organization to present the right information to the right people, such as the insurance companies’ medical directors and clinical coding teams.
Since acquiring Mederi Therapeutics in 2018, Restech has focused on driving the process to see expanded coverage for Stretta. It has been a challenge, but through the efforts of our dedicated team, and the advocacy of our physicians users and their patients, we are making great progress.
Restech is pleased to announce that Stretta Therapy is now available to more reflux patients than ever before. Beginning on 02/01/2021, 16 million Blue Cross Blue Shield patients in Texas, Illinois, Oklahoma, New Mexico, and Montana can be considered for the benefits of Stretta Therapy. This unprecedented expansion is a testament to the advocacy of our physicians, patients, and clinical outcomes – with recent studies suggesting that upwards of 90% of selected patient cohorts could benefit from Stretta Therapy.
HCSC’s BCBS coverage decision follows BCBS of North Dakota’s positive coverage determination and Palmetto GBA’s Medicare coverage in Alabama, Georgia, Tennessee, South Carolina, North Carolina, Virginia, and West Virginia. In addition, First Coast Service Options Inc provided a similar change in coverage determination for Medicare patients in Florida, Puerto Rico, and the US Virgin Islands. Private payers such as Highmark, and Medicare providers such as Novitas continue to cover Stretta Therapy. Veterans Administration patients nationwide have long had access to Stretta Therapy.
Debra Krahel, President and CEO of Restech commented, “HCSC’s positive coverage determinations and the addition of 16 million covered lives are the culmination of hard work from our team, our physicians, and the thousands of patients requesting a minimally invasive approach to reflux. Stretta provides a safe, effective alternative to medication and anatomy altering surgery with an impressive history of clinical documentation – we are gratified that insurance providers are responding to patient and physician demand. Coverage determinations, such as this, help fuel our growth as a company and represent an exceptional opportunity to our investors and shareholders.”
For further information about Stretta coverage, please contact our team at 1-800-352-1512 or write to us at firstname.lastname@example.org.