Medicare Can't Curb Spine Fusion

Jun 23, 2014

Cigna has joined a growing number of private insurers that limit approvals for spinal-fusion surgery because it is frequently done on patients who will not benefit and could even be harmed.

But Medicare can't do that, as the Tampa Bay Times reports, because Congress has not given the Centers for Medicare and Medicaid Services authority to require pre-approval. The money to be made for doctors is only part of the problem; patients who have back pain often seek out the procedure for relief.

Auditors for the government insurance program for seniors and the disabled say $120 million in taxpayers' money was wasted on improper spinal fusions in 2012, the Times reports. 

The North American Spine Society has issued nine indications for lumbar fusions, the Times said. But the guidelines are voluntary.