Nevro wins multiple coverage options for spinal cord stimulation

The Senza system [image from Nevro]Nevro (NYSE:NVRO) today announced positive updates to multiple spinal cord stimulation (SCS) coverage policies.

Aetna’s new SCS policy explicitly covers PDN (painful diabetic neuropathy), effective Aug. 29, 2022. Aetna’s health plan covers approximately 22 million commercial lives.

Novitas and First Coast, Medicare Administrative Contractors (MACs) that represent 12 states, also provided a positive update. They published draft local coverage determinations (LCDs) that proposed updated coverage criteria to include PDN. This includes PDN refractory to conventional medical management for SCS devices with an explicit FDA approval to treat PDN.

The LCDs — if finalized — mean Medicare patients in all 50 states will receive coverage for PDN. This would add approximately 17 million covered Medicare lives, according to a news release. The review for the proposed LCDs is ongoing with finalization dates yet to be determin…

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DTW: What in the world will Thrive Earlier Detection do with $257 million?

In this week’s podcast, two executives from Thrive Earlier Detection explain how the “turbo-charged” diagnostics company intends to upend how, when and where cancer is diagnosed.

Dr. Isaac Kinde, co-founder and head of research and innovation, walks us through the company’s CancerSEEK test and how the company is marrying new technology with an innovative clinical approach. Meanwhile, CFO Isaac Ro, tells host Tom Salemi how the company closed on $257 million (hint: lots of Zoom) and why he left a career on Wall Street to join this innovative start-up.

Chris Newmarker, executive editor of life sciences at MassDevice, also counts down on the biggest newsmakers in this week’s MassDevice.

Don’t miss an episode! Subscribe to DeviceTalks Weekly on your podcast players. It’s available on Apple Podcasts, Spotify and other podcast channels.

DeviceTalks by MassDevice · What in the world will Thrive Earlier Detection do with $257 million?
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The top 5 MassDevice stories of the week — July 31, 2020

The past week has seen a slew of Q2 earnings reports from medical device companies — and the picture overall hasn’t been pretty amid the COVID-19 pandemic.

Still, medtech CEOs during their earnings calls said they’re starting to see some signs of hospital procedures recovering a bit even as the southern U.S. deals with a coronavirus wave. Some of the top MassDevice stories this week actually involved companies providing more solutions to improve management of the pandemic.

Want to hear more about the week’s top news? Executive editor Chris Newmarker and Tom Salemi will discuss during our DeviceTalks Weekly podcast. Without further ado, here’s this week’s MassDevice Top Five:

5. A few bright spots amid the COVID-19 financial toll

Dexcom (NSDQ:DXCM) proved to be one of the few bright spots among medtech Q2 earnings reports, blowing away the Wall Street consensus forecast as it successfully pivoted to making its continuous glucose monitors avail…

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Aetna accuses Conformis of trying to use patient’s lawsuit to compel coverage

[Image from Unsplash]

Joint replacement implant maker Conformis (NSDQ:CFMS) is improperly using a Colorado man’s denial of benefits lawsuit to force Aetna to cover its customized knee implants, the health insurer recently argued in a federal court filing.

Billerica, Mass.-based Conformis joined John Michael Schaub of Golden, Colo., in his lawsuit against Aetna, filed in May in U.S. District Court in Massachusetts.

The lawsuit, according to Aetna’s lawyers, turns the federal Employee Retirement and Income Security Act on its head.

“Conformis is a Massachusetts-based medical device manufacturer that has no rights or standing to sue under ERISA. The complaint is Conformis’ novel, but improper, attempt to co-opt Mr. Schaub’s ERISA denial of benefits claim, and convert that claim into something it is not: a quasi-class action intended to force Aetna to cover the Conformis custom total …

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