Government regulators said yesterday that Medicare, the federal insurance program, planned to deny coverage for artificial disks implanted in the lower spines of older patients.
The preliminary decision, which is expected to become final in August, extends to the ProDisc-L made by Synthes a national coverage ban imposed a year ago on the Charité lumbar disk made by Johnson & Johnson; the Food and Drug Administration cleared the Pro Disc-L for sale last summer. It also signaled that Medicare will not cover Medtronic’s Maverick lumbar disk when that device reaches the market.
Yesterday’s decision applies to patients over 60, which is most of the 43 million people Medicare covers. Local administrators of Medicare benefits will continue to be able to pay for the devices in younger disabled patients on case by case.