Cigna expands glaucoma coverage to include canaloplasty, goniotomy
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Key takeaways:
- Cigna now covers canaloplasty and goniotomy procedures for the treatment of primary open-angle glaucoma.
- The updated policy went into effect on June 15.
Cigna Healthcare has updated its glaucoma surgical procedure policy to cover both ab interno canaloplasty and goniotomy to treat primary open-angle glaucoma, according to a press release from Sight Sciences.
Under the updated policy, Cigna members will have access to outflow restorative procedures performed with the Omni surgical system, which is indicated for canaloplasty followed by goniotomy (trabeculotomy) to reduce IOP.
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The policy update went into effect on June 15.
“We are pleased that Cigna’s clinical review resulted in expanded coverage of certain non-implant, minimally invasive glaucoma surgery procedures including canaloplasty and goniotomy for its patients,” Paul Badawi, founder and CEO of Sight Sciences, said in the release. “We believe Cigna’s decision affirms the shift towards safer, less invasive, but more comprehensive surgical inventions, and cements the role that Omni’s technology serves within the glaucoma treatment paradigm for surgeons and patients.”
Perspective
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Glaucoma is an irreversible blinding disease, and for many patients, topical therapy is ineffective and traditional glaucoma surgery is too risky. Procedures such as canaloplasty and goniotomy can be performed with or without cataract surgery, and covering these procedures gives glaucoma patients much-needed treatment options in their battle against this serious blinding and irreversible disease.
Procedures such as goniotomy and canaloplasty can positively benefit the quality of life of glaucoma patients and save money by preventing future surgeries, as well as allow patients to be functional in the workforce and with their families.
Cigna likely decided to cover canaloplasty and goniotomy because of a robust and powerful negative response from the glaucoma community when these procedures’ reimbursements were threatened by payers, as evidenced recently with a powerful uproar against Medicare local coverage determinations threatening to deny coverage for these critical vision-saving glaucoma procedures.
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