Consequences on Private Insurance Coverage

The AAOS Clinical Practice Guidelines and Hyaluronic Acid Injections

The 2013 revision of the AAOS endorsement of Intra-Articular Hyaluronic Acid (from its original published position in 2008 advocating for its use), was the basis used for BCBS and other insurers in certain states to justify non-coverage of this procedure. The attached below, the updated position directly calls into question not only the flawed basis upon which the 2013 position was based, but also document the economic and physical determined to the commercially insured patient that that article created.

“Bedard et al. recently published a review on the impact of the 2013 American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline (CPG) on intra-articular (IA) hyaluronic acid (HA) injections, also referred to as viscosupplementation, and concluded that there were subtle but important changes in the use of IA HA following the publication of the AAOS CPG and that these changes were warranted because of the high cost of the injections, given their questionable efficacy. However, we believe that consideration of the additional data supports a different conclusion and that the CPG has had a more detrimental impact on patient care. We submit that continued endorsement of this guide- line may not be in the best interest of patients or the health-care system. Accordingly, we believe that the 2013 AAOS CPG should be reconsidered and modified to include a more comprehensive and perhaps more objective treatise on the guidelines for the non- surgical treatment of knee pain due to osteoarthritis (OA)…

We believe that a more judicious approach to appropriate OA treatment would be to adopt the more recent recommen- dations to optimize the outcomes of IA HA with better patient (57,67) selection and earlier treatment. Furthermore, we believe that restricting the availability of a safe and effective treatment option such as HA clearly does not help our patients, limits our treat- ment repertoire as clinicians, and therefore warrants the reeval- uation of the AAOS CPG on IA HA treatment.”

Integrative Practice Solutions (IPS) has developed an innovative clinical business model focused on resolving joint pain caused by osteoarthritis and/or injury. The Advanced Arthritis Relief Protocol™ (AARP Program) is a non-surgical, FDA approved treatment that is covered by both Medicare and commercial insurance.

The AARP Program follows a winning combination of fluoroscopic guided injections of hyaluronic acid, an at home physical therapy device, and the IPS OAide 3000™ Single Hinge Unloading Knee Brace. 

Should you have any additional questions about AARP Program and our client success stories, please feel free to contact us here at Integrative Practice Solutions.

Integrative Practice Solutions

Phone: (855) 854-6332

Fax: (727) 683-9536



About the Author: Lance Liberti is a nationally recognized healthcare consultant and new patient marketing professional with more than a decade of practical experience in the field. His experience spans multiple areas of practice including non-surgical spinal decompression, medically supervised weight loss, aesthetic medicine, and non-operative extremity pain management. The president and CEO of Integrative Practice Solutions, Inc. Mr. Liberti specializes in assisting health and wellness professionals integrate boutique medical services into their practices to offer non-surgical solutions to those suffering from various degenerative musculoskeletal conditions. To learn more about Mr. Liberti’s extensive experience and see examples of his work products view his LinkedIn profile here:

Legal Disclaimer: The information contained in this article is provided for informational purposes only and should not be construed as legal advice on any subject matter. You should not act or refrain from acting on the basis of any content included in this site without seeking legal or other professional advice. The contents of this site contain general information and may not reflect current legal developments or address your situation. We disclaim all liability for actions you take or fail to take based on any content of this article.