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…