Twenty-seven Blue Cross Blue Shield health care plans covering more than 50 million Americans now have positive “iFuse only” coverage policies for MIS SI joint fusion

SANTA CLARA, Calif., Feb. 04, 2019 (GLOBE NEWSWIRE) — SI-BONE, Inc. (Nasdaq: SIBN), a medical device company that pioneered minimally invasive surgery of the sacroiliac (SI) joint with the iFuse Implant System^® (iFuse) announced the addition of several exclusive coverage policies.

 “We are pleased with the growing body of commercial health care plans offering exclusive reimbursement policies for the iFuse Implant System,” said Jeffrey Dunn, President, Chief Executive Officer, and Chairman. “We continue to make progress expanding our market leadership in providing minimally invasive surgical products for the sacroiliac joint and improving patient lives.”

CareFirst  BlueCross BlueShield, Premera Blue Cross Blue Shield and Excellus BlueCross BlueShield have published positive coverage policies for MIS SI joint fusion when performed exclusively with the triangular iFuse Implant System (iFuse) providing coverage for over 6.5 million lives.  In total, there are 32 Blue Cross Blue Shield plans that now cover MIS SI joint fusion, 27 of which are exclusive to the triangular iFuse Implant System based on published clinical evidence.

• CareFirst is the largest health care insurer in the Mid-Atlantic region, covering 3.2 million members in Maryland, the District of Columbia and parts of Northern Virginia. CareFirst’s iFuse only policy took effect January 1, 2019.
• Premera Blue Cross is the largest health plan in the Pacific Northwest, covering over 2 million lives throughout Washington and Alaska.  The Premera exclusive iFuse policy became effective February 1, 2019. 
• Excellus BlueCross BlueShield policy took effect December 20, 2018 and provides access to the iFuse Procedure for almost 1.5 million customers in central and upstate New York.

All three of these recent positive and exclusive coverage policies for iFuse were based on review of published clinical evidence and conclude that published results from two randomized controlled trials of iFuse versus conservative care, in addition to several cohort studies and numerous case series, demonstrate that evidence is sufficient to determine the effect on health outcomes and therefore treatment of SI joint dysfunction with triangular titanium implants may be considered medically necessary for appropriately diagnosed patients.

About SI-BONE
SI-BONE is a medical device company that pioneered the iFuse Implant System, a minimally invasive surgical system for fusion of the sacroiliac joint to treat sacroiliac joint dysfunction.  The SI joint is believed to be the last major joint with a clinically proven surgical treatment.  The iFuse Implant, commercially available since 2009, is believed to be  the only SI joint fusion device supported by multiple prospective clinical studies showing improved pain, patient function and quality of life resulting from treatment.  There are over 60 peer-reviewed publications supporting the safety, effectiveness, and biomechanical and economic benefits unique to the iFuse Implant (www.si-bone.com/results).  This body of evidence has enabled multiple government and private insurance payors to establish coverage of the SI joint fusion procedure exclusively when performed with the iFuse Implant System.

The iFuse Implant System is intended for sacroiliac fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruption and degenerative sacroiliitis.  This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted postpartum for more than 6 months.  There are potential risks associated with the iFuse Implant System.  It may not be appropriate for all patients and all patients may not benefit. 

SI-BONE and iFuse Implant System are registered trademarks of SI-BONE, Inc. ©2019 SI-BONE, Inc. All Rights Reserved. 10310.020419

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