Highmark First Insurer to End Uterine Morcellation Coverage

Published on August 4, 2014 by Sandy Liebhard

Highmark Inc., one of the nation’s largest insurance companies, announced over the weekend that it will no longer cover laparoscopic uterine surgeries that involve the use of the a power morcellator. The company is the first to announce such a move since the U.S. Food & Drug Administration (FDA) warned in April that morcellation can spread undetected uterine cancer cells throughout a woman’s body.

The company will stop covering gynecological morcellation as of September 1^st, according to a report from The Wall Street Journal. Highmark, which covers 5.2 million customers through Blue Cross/Blue Shield plans in Pennsylvania, West Virginia and Delaware, is the believed to be the first insurer to end payments for such procedures.

“We determined that it was in the best interest of our members to cease paying for this procedure,” a Highmark spokesperson told The Wall Street Journal. According to this individual, the insurer has been studying the risks associated with uterine morcellation since the FDA issued its April alert, and had looked at medical evidence and data, the risks of alternative methods and the implications to patients if the procedure were no longer covered.

FDA Warning Discourages Uterine Morcellation

The FDA’s April warning specifically discouraged doctors from using power morcellators in laparoscopic hysterectomies and fibroid removals because of the risk that the devices, which are used to shred uterine tissue, could disseminate any cancer cells that are lurking undetected in that tissue. According to the FDA, 1 in 350 women undergoing such procedures have undiagnosed uterine sarcoma, and spread of those cells beyond the uterus can greatly diminish a woman’s chances of long-term survival.

Since the FDA issued its alert, victims of morcellator cancer and their survivors have urged the agency to ban the use of power morcellators in gynecological procedures. A study published last month in the Journal of the American Medical System suggested that the fears surrounding uterine morcellation were well founded. And Johnson & Johnson’s Ethicon, Inc. unit, which was already named a defendant in several morcellator lawsuit filings, announced last week that it would pull three of its morcellation devices from the market because of the continuing uncertainty surrounding their safety.