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Aetna Drops Coverage of Routine Morcellator Surgeries

Aetna Drops Coverage of Routine Morcellator Surgeries

May 6, 2015 — Aetna Inc. will stop providing coverage for routine hysterectomies and fibroid surgeries involving power morcellators, according to the Wall Street Journal.

Aetna has 23 million members, making it the third-largest health provider in the United States. As of May 15, the company will require doctors to obtain clearance before using power morcellators. There will be exceptions in certain cases, such as patients who do not have other options.

Health plans covering about 93 million Americans have already restricted the use of morcellators, according to the WSJ. The procedure has been designated as “investigational” or “not medically necessary,” which would generally make the procedure not eligible for coverage.

Power morcellators were once used in over 50,000 surgeries per year. That all changed last year, when the FDA issued a Safety Communication to warn against using the devices in the “vast majority of women.”

According to the FDA, about one in 350 women who has surgery to remove fibroids actually has undiagnosed uterine sarcoma — and one in 500 has highly-aggressive leiomyosarcoma. When a power morcellator is used to grind up tissue, it can easily leave behind cancerous cells and greatly worsen the patient’s prognosis.

The FDA warns:

“Uterine tissue may contain unsuspected cancer. The use of laparoscopic power morcellators during fibroid surgery may spread cancer and decrease the long-term survival of patients.”

Do I have a Morcellator Lawsuit?

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