EndoGastric Solutions said today that new Medicare Administrative Contractors Noridian Health Care Solutions and National Government Services have been granted reimbursement access for the transoral incisionless fundoplication procedure using its Esophyx device.
The Redmond, Wash.-based company’s TIF procedure is designed to prevent stomach acids refluxing back into the esophagus by reconstructing the gastroesophageal valve.
Noridian, which provides coverage for more than 10.7 million Medicare beneficiaries in 13 states, made the reimbursement decision effective October 27, while NGS, which covers approximately 10.1 million beneficiaries in 10 states, will make its decision effective December 1.
“The need exists for safe, dependable treatment options to address reflux beyond invasive surgical operations and proton pump inhibitor dependence. The TIF 2.0 procedure provides a well-tested and proven therapeutic alternative to patients seeking lasting relief,” gastroenterologist Dr. Kenneth Chang of UC Irvine Health said in a prepared statement.
“The robust body of clinical evidence which supports the TIF 2.0 procedure continues to demonstrate durable, positive outcomes for patients experiencing troublesome GERD symptoms. Now, patients who wish to avoid or discontinue PPI use and want a less invasive procedure than traditional surgery has access to sustained symptom relief with the TIF 2.0 alternative,” Dr. Kevin Reavis of the Oregon Clinic said in a preared release.
Other Medicare administrative contractors have already granted coverage to the EsophyX device, including Cahaba GBA, CGS Administration, Novitas and Palmetto, which cover a collective 19.4 million Medicare patients in 15 states.
“Further payer expansion of our TIF 2.0 procedure to more than 80% of Medicare lives, coupled with the 93% reimbursement increase from CMS, are testaments to the value proposition that our safe, minimally invasive, and highly effective long-term treatment option offer patients suffering from GERD. More than 94 million patients are now covered for the TIF 2.0 procedure following these coverage expansion decisions, further illustrating the need for safe and effective treatment options for patients suffering from GERD and the physicians who care for them,” prez & CEO Skip Baldino said in a press release.
In July, EndoGastric Solutions said it won reimbursement coverage through U.S. health insurer Health Care Service Corporation for TIF procedures using its EsophyX device.