Neurosurgery Joins Spine Societies in Urging Aetna to Cover Spinal Cages with ACDF Procedures

  • Reimbursement and Practice Management
  • Howard J Marans, MD, MSc, FRCSC
    Executive Director, Medical Health Services
    Manager – Spine/Orthopedic SME Team
    Board Certified Orthopedic Surgeon
  • Lynn Fitzgerald, MD, PhD, FACS
    Spine Subject Matter Expert
    Board Certified – American Board of Neurological Surgery
  • Brian Kane
    Executive Vice President CVS Health
    President Aetna
    Cathy Moffitt, MD, FAAP, CHIE
    Chief Medical Officer Aetna

Robert McDonough, MD
Senior Director, Clinical Policy Research and Development Aetna

April 26, 2024
Dear Mr. Kane and Drs. Marans, Fitzgerald, Moffit and McDonough,
The aforementioned societies would like to request a change in Aetna’s policy ( to allow/include coverage for the use of biomechanical interbody devices in all Anterior Cervical Discectomy and Fusion (ACDF) surgeries.
Multiple physician societies have engaged Aetna in teleconferences, over many years, to discuss the relevant medical literature. Although our opinions differ on this matter, with Aetna maintaining that the literature presented is not compelling enough to modify their policy, we have appreciated the opportunity to converse with Aetna to this regard.
Aetna, however, continues to be the only insurance carrier who does not recognize the use of these devices as “standard of care” and who continues to restrict the use of biomechanical devices. This has created significant issues which need to be discussed and addressed. We would like to focus on these issues including unfair access restrictions, availability, and the practice of modern spinal surgery.

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