Blue Shield of California Dropping Viscosupplementation Coverage 6/1/18

04-10-2018

April 10th, 2018

In the past year, Blue Shield of California (BSC) has begun the process of dropping their coverage of viscosupplements (intraarticular hyaluronic acid injections) for osteoarthritis of the knee.

As of June 1st, 2018, patients covered under Blue Shield of California commercial health insurance, will no longer receive ANY coverage for viscosupplementation treatment for osteoarthritis of the knee. This change has been implemented based on scientific reviews and guidelines that have determined this method of treatment is not considered to be “medically necessary.” Medically necessary is defined by Medicare.gov as a healthcare service or supply needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.

For those patients who have received an approved authorization for viscosupplementation:

  • Treatment plan will need to be completed prior to June 1st in order to be covered.

For those patients who have been prescribed a series of three viscosupplementation injections

  • All three treatments will need to be done prior to June 1st.

NOTE: It is anticipated that other health insurance plans may follow BSC’s lead and also stop coverage of viscosupplementations. We will attempt to update our Blog with any new information. However, it is best to contact your health plan directly to confirm authorization approval for this type of treatment.

If you have any questions about treatment options, give us a call at (949) 722-7038 and set up an appointment with your doctor.

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