ReWalk Robotics has been at the forefront of negotiating insurance coverage for medical exoskeletons, especially its ReWalk 6.0 powered walking assist device. Â There are two major recent developments that are worth covering:
- A representative of ReWalk Robotics took advantage of our catalog page to issue much-needed clarifications on current coverage practices for ReWalk exoskeleton products
- ReWalk put out a press release regarding progress with German statutory health insurer to provide coverage of robotic exoskeletons for individuals with spinal cord injuries
“ReWalk has not claimed any US insurer has a policy to cover the exoskeleton device. We do submit – when plans allow – for prior authorizations on a case by case basis. The press release related to the Cigna policy is pasted here, reflecting that:
When discussing ReWalk ownership with a candidate we give an overview of the process, in which we determine if the person is a candidate via a physical evaluation and also perform a benefits analysis. In some cases we can submit to the insurer, in others the insurer will not even accept an application for prior authorization due to ReWalk not being contracted with the insurer, or the insurer has a negative coverage policy. Naturally, we would not share a device candidate’s personal information or situation in this forum, but these are common causes of inability to submit for a device on a candidate’s behalf – which ReWalk does at no cost to them.
Unfortunately case by case coverage for any device is unpredictable and generates disappointment all too often. That being said over 170 ReWalk devices have been paid for by third parties, in addition to success in the US VA system and inclusion on the official list of medical aides in Germany. The disinformation on this topic is frustrating for all, so we strive to be upfront and avoid false hope. We never promise coverage, nor do we rule it out. We say we will submit when we can, whether the insurer accepts it is their decision.
Disinformation can also be harmful to others. We recently saw a post on a YouTube video which featured a ReWalker who received his device from his insurer after a work injury. A poster wrote that the video was untrue because without a HCPCS code an insurer cannot accept a submission. The poster in effect called the device recipient – a retired police officer who was injured in the line of duty – a liar despite viewing a video of the person walking in their own device.
This is just one example of the issues caused by the complexity and unpredictability of insurance coverage of newer devices, and the misinformation spread by uninformed parties.
We are hopeful for more systematic coverage going forward. As of now there is not a HCPCS code for any exoskeleton device so we cannot submit for Medicare coverage, but we did announce on our recent earnings call that we have submitted an application for one. We will also continue to engage payors with the goals of removing negative coverage policies and creating positive policies for coverage.
Any candidate can visit ReWalk.com/contact and we can discuss the physical criteria for using ReWalk and discuss their potential coverage pathway.” – ReWalk Robotics, March 3, 2020
Second, the company recently announced an agreement with a group of health insurers to allow eligible individuals with a spinal cord injury in Germany to pursue full coverage of a ReWalk 6.0 exoskeleton:
MARLBOROUGH, Mass. and BERLIN, March 18, 2020 /PRNewswire/ —Â ReWalk Robotics, Ltd. (Nasdaq: RWLK) (“ReWalk” or the “Company”), a leading manufacturer of robotic medical devices for individuals with lower limb disabilities has announced the finalization of an agreement with a group of German statutory health insurer (SHI) to allow any eligible beneficiary with a spinal cord injury (SCI) in the country to seek procurement of a ReWalk 6.0 exoskeleton system.
This agreement, the first in a series of anticipated national policies from German insurers, is expected to have a significant impact for spinal cord injured individuals. Under this agreement, eligible beneficiaries will be able to obtain a ReWalk 6.0 exoskeleton device for use in the home that will enable them to stand and walk again, after successful training and verification by the medical service. As a result of the finalization of this agreement, three SCI beneficiaries from this insurance group have already received ReWalk 6.0 personal systems under the coverage provided by the SHI.
In 2018, the ReWalk 6.0 personal exoskeleton system was added to the German National Health Insurance Agency’s National Medical Device Directory (“MDD”), which includes all medical devices that are principally and regularly reimbursed by German SHI providers. That addition was a critical turning point, enabling any of Germany’s 105 SHIs to pursue national policies for ReWalk procurement.
“This is the first in a series of contracts with German insurers that will benefit paralyzed individuals nationwide. These policies, which have been in development since our addition to the MDD, will make the procurement process predictable for patients; after successful training and approval for procurement by the insurer, patients will be able to take home a device for daily personal use,” said ReWalk CEO Larry Jasinski. “We are so pleased to get these devices to people who need them more quickly and provide access to life-changing technology.”
Based on the language used, this could be interpreted that physically eligible individuals with spinal cord injury (mainly those with sufficient trunk control and arm strength) will not be automatically denied coverage for the ReWalk 6.0 but be considered on a case-by-case basis.
Investors reacted favorably to the announcement with ReWalk Robotics stock price jumping roughly 20% during trading. Â Unfortunately, the stock price gain was erased by the global COVID-19 economic rout.
References:
ReWalk Announces Progress with German Statutory Health Insurer to Provide Coverage of Robotic Exoskeletons for Individuals With Spinal Cord Injuries, ReWalk Robotics Press Release, March 18, 2020, http://ir.rewalk.com/news-releases/news-release-details/rewalk-announces-progress-german-statutory-health-insurer
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