LifeNet Health is proud that Cigna Health Insurance is now covering Dermacell when used in association with covered medically necessary breast reconstruction procedures. Dermacell AWM has also been approved for coverage as medically necessary for diabetic foot ulcers when the following criteria are met: partial- or full-thickness diabetic foot ulcers of greater than four weeks duration for which standard wound therapy has failed; the treated foot has adequate blood supply as evidenced by either the presence of a palpable pedal pulse or an ankle-brachial index (ABI) of ≥ 0.70.
When the medical necessity criteria are met, the following conditions of coverage apply: treatment is limited to two applications in a 12- week treatment period when evidence of wound healing is present (e.g., signs of epithelialization and reduction in ulcer size). The new Cigna Policy#0068 – Tissue Engineered Skin Substitutes went into effect on February 15, 2017.
Cigna covers over 15 million lives globally with policy holders in Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Maryland, Missouri, North and South Carolina, Tennessee, Texas and Virginia. Cigna recognized the transition to Dermacell from other ADMs in major US breast care centers. These centers include: Georgetown University, Duke University, the Fox Chase Cancer Center, the MD Anderson Cancer Center, the University of Southern California, the INOVA Health System and Stanford University.
Bud Brame, Vice President of Strategic Product Planning and Reimbursement Services at LifeNet Health said, “We believe the positive results from recent Dermacell publications, including our randomized clinical trial, as well as growing surgeon demand for the graft contributed to this favorable outcome.”
To read the full LifeNet Health press release, click here.