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Uroplasty Provides Update On PTNS Reimbursement

Wed, 12/04/2013 - 6:30am
PR Newswire

Uroplasty, Inc., a medical device company that develops, manufactures and markets innovative proprietary products for the treatment of voiding dysfunctions, today provided an update on reimbursement coverage for Percutaneous Tibial Nerve Stimulation (PTNS) procedures delivered via the Company's Urgent® PC Neuromodulation System for treatment of overactive bladder (OAB) and associated symptoms of urinary urgency, urinary frequency and urge incontinence.

"The number of patients with insurance coverage for PTNS procedures delivered via our Urgent PC system continues to grow and presents us with the opportunity for sustainable strong growth," said Rob Kill, President & CEO.  "Based on the latest reimbursement developments, including the decision of National Government Services (NGS) to continue its existing non-coverage policy for PTNS, we anticipate Urgent PC will exit calendar 2013 with approximately 40 million Medicare lives under coverage, an increase from 37 million a year ago, and approximately 106 million private insurer lives under coverage, up from 87 million a year ago."

The Centers for Medicare and Medicaid Services (CMS) released the final 2014 Physician Fee Schedule, and the Relative Value Units (RVUs) for PTNS reimbursement are substantially the same as the proposed reimbursement published in July. The final reimbursement amount for 2014 is subject to any potential Congressional action as it relates to the Medicare Sustainable Growth Rate (SGR) formula.  Further, PTNS was one of several hundred codes that were noted as a potentially misvalued code earlier this year.  While many of these codes had reimbursement reductions, CMS has indicated further review of PTNS is warranted, and as a result, CMS will be gathering additional feedback before a final decision is made.  The final decision could result in an increase, a decrease or no change in the reimbursement rate for PTNS. Any change to the reimbursement rate due to this review is not expected to be published until November 2014 and will become effective beginning in January 2015.

In addition, the Company reported today that Health Care Service Corporation (HCSC), the largest customer-owned health insurance company in the United States, recently announced extended PTNS coverage for treatment of OAB. Effective December 15, 2013, HCSC Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma and Texas will extend coverage of PTNS treatment for up to three years for patients showing continued improvement after the first year of treatment. 

"Our sales organization is successfully executing our initiatives, and we continue to expect our fiscal third quarter year over year revenue growth rate for U.S. Urgent PC will be in the high teens," added Mr. Kill.  "With Uroplasty and other therapies currently penetrating less than one percent of the OAB market for patients who fail drug therapies, we believe there is more than ample opportunity to  grow our business."

Uroplasty is participating in the 25th Annual Piper Jaffray Healthcare Conference today, and management expects to provide an update on these developments as well as other corporate initiatives during a webcast broadcast of a fireside chat beginning at 3:30 pm ET.  Those interested in joining the webcast may access it through Uroplasty's website at www.uroplasty.com. An archived replay of the presentation will be available for 90 days following the event.

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