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Cigna’s Coverage Denial for Spinal Surgery OK’d by 11th Cir.

Oct. 24, 2019, 2:35 PM

Cigna Health & Life Insurance Co. doesn’t have to pay for a woman’s multi-level spinal fusion surgery on the grounds that it’s an experimental and unproven treatment, the Eleventh Circuit ruled Oct. 24.

Cigna’s decision was based on a uniform, longstanding policy developed in connection with “multiple peer-reviewed, evidence-based, scientific articles,” the court said. Those articles supported the idea that multi-level spinal fusion surgery wasn’t a safe and effective treatment for Sharon Pierce’s degenerative disc disease, the court said.

Spinal fusion is a surgical procedure that attempts to alleviate back pain by welding together two or more vertebrae to create...

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