Review Board Rules Health Insurance Must Cover Robotic Exoskeletons
They're expensive, but "medically necessary."
A medical review board ruled that a health insurance provider in the United States is obligated to provide coverage and reimbursement for a $69,500 ReWalk robotic exoskeleton, in what could be a major turning point for people with spinal cord injuries.
A press release from ReWalk says the health insurance provider is from the Northwestern US, but does not provide any other information on the company. The unnamed health plan initially denied coverage, but after an independent review board dug into the beneficiary's case and the current state of exoskeleton technology, it ruled that the exoskeleton was "medically necessary."
While the patient applying for coverage (a surgeon) currently uses a wheelchair, the review board determined that the exoskeleton was necessary because it allowed the patient to walk. This ruling implies that walking is not a luxury for patients with spinal injuries, but a right—and that if the technology exists and is mechanically sound, insurance companies must cover them.
ReWalk CEO Larry Jasinski was pleased by the decision, stating in a press release, "Health benefit providers have historically been hesitant to acknowledge the clinical benefits in their case assessments. This ruling, and subsequent coverage and reimbursement will help ReWalk in our efforts to facilitate greater patient access to the device."
The ReWalk personal system mechanically powers hip and knee movement, allowing the patient to walk, but also helping with a number of ailments commonly suffered by the wheelchair-bound. The press release from ReWalk lists "improved bladder and bowel function, improved mental health, improved sleep, reduced fatigue, decreased body fat, decreased pain and improved posture and balance." According to the release, ReWalk's exoskeleton is currently the only such product approved for personal at-home use by the FDA for patients with spinal cord injury.
The release doesn't say whether the studies suggesting these benefits were conducted by the company or by a third party, but it's hard to imagine being able to walk (albeit robotically) would not improve patients' mental health at the very least.