Si-Bone wins Nebraska BCBS coverage for iFuse implant system

Si-Bone said today Blue Cross Blue Shield of Nebraska updated its medical policy to provide coverage for minimally invasive SI joint fusion procedures.

The move makes BCBS of Nebraska the 2nd BCBS plan, following BCBS of Michigan, to approve a positive coverage policy for MIS SI joint fusion procedures, San Jose, Calif.-based Si-Bone said.

“BCBS of Nebraska joins BCBS of Michigan along with a growing list of leading edge private insurers as well as Medicare nationwide to provide coverage for iFuse.  This positive coverage decision provides access to appropriate care for Blue Cross Blue Shield members throughout Nebraska who have been suffering with chronic SI joint dysfunction due to degenerative sacroiliitis or SI joint disruption,” Si-Bone health outcomes & reimbursement veep Michael Mydra said in a press release.

The policy change came based on published clinical literature, Si-Bone said, which validated fusion and stabilization procedures of the sacroiliac joint for treating back pain. The company said that references cited in the new policy included studies specific to the company’s iFuse device.

“I see patients in my practice on a regular basis who have suffered from chronic sacroiliac joint dysfunction for years and no longer respond to non-surgical treatment.  Many of these patients are surgical candidates. I am pleased that I can now offer my BCBS Nebraska patients the only minimally invasive procedure supported by two year outcomes data and give them a chance to have a better quality of life,” Dr. John Hain of Omaha’s Nebraska Spine Hospital said in a prepared statement.

In June, Si-Bone said  it raised a $20 million funding round, hot on the heels of the regulatory and reimbursement wins.

Nine investors participated in the equity round, Si-Bone said in a regulatory filing; in a June 20 press release, the company said all of its prior backers participated, along with new investor Arboretum Ventures.

The proceeds are slated for funding a U.S. sales team expansion, Si-Bone said.

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