New coverage decisions by private payers and Medicare for OAB and urge incontinence

Nov 27 2012

Uroplasty, Inc. (NASDAQ: UPI), a medical device company that develops, manufactures and markets innovative proprietary products to treat voiding dysfunctions, today announced significant new coverage decisions by private payers and Medicare. 

Effective October 2012, Health Net^®, one of the largest private insurance payers in California, began covering posterior tibial nerve stimulation (PTNS) for the treatment of overactive bladder (OAB) and associated symptoms of urgency, frequency and urge incontinence.  Health Net plans cover approximately 2.5 million beneficiaries, primarily in California, as well as in Arizona and Oregon.    

Also as of October, Medica^®, a Minnesota-based private payer added PTNS coverage for approximately 1.7 million beneficiaries in Minnesota, North Dakota, South Dakota and Wisconsin. Further, Health First of Florida acknowledged coverage of PTNS for approximately 120,000 regional beneficiaries.

Additionally, three Medicare administrators, Noridian^® Administrative Services LLC and Palmetto GBA^®  J1 and J11, have expanded PTNS coverage from 1 to 2 years based upon recently published data demonstrating sustained therapeutic effects from continued PTNS treatments. Noridian^® Administrative Services LLC is the Medicare administrator for Arizona, Alaska, Idaho, Montana, North Dakota, South Dakota, Utah, Washington and Wyoming. Palmetto GBA^®  J1 is the Medicare administrator for California, Nevada and Hawaii and Palmetto GBA® J11 is the Medicare administrator for North Carolina, South Carolina, Virginia and West Virginia.  This extension will ensure that Medicare beneficiaries with OAB who are currently being treated successfully with PTNS will be able to continue to receive this effective therapy.

Three-year PTNS data, presented in October 2012 at the Western Section of the American Urological Association in Waikoloa, HI, also demonstrated sustained therapeutic effects from continued PTNS treatments, and is expected  to be available for publication in the near future.

"This expanded coverage demonstrates that more payers understand the role of PTNS in treating OAB. The additional coverage provides physicians and over 4.3 million newly covered patients another treatment option for OAB. As payers and providers recognize that PTNS is a viable OAB treatment option, the paradigm of care for this often debilitating condition is changing dramatically," said David Kaysen, President and CEO of Uroplasty, Inc.

"We believe strong clinical data and inclusion in the American Urological Association/Society for Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction's recently published national OAB treatment guidelines led to the expanded coverage," continued Mr. Kaysen. "We are very pleased to see a growing number of payers develop coverage policies for this minimally invasive, safe and effective OAB treatment option. We continue to work with other payers across the country to include Urgent PC in their coverage policies to meet the goal of creating national access to PTNS treatments for OAB patients."  

SOURCE Uroplasty, Inc.