Home >> Professional Blog

MiMedx Announces Expansion Of Health Plan Coverage

MiMedx Group, Inc. (NASDAQ: MDXG), the leading regenerative medicine company utilizing human amniotic tissue and patent-protected processes to develop and market advanced products and therapies for the Wound Care, Surgical, Orthopedic, Spinal, Sports Medicine, Ophthalmic and Dental sectors of healthcare, announced the updated status of the Company's payer coverage from commercial health plans and state Medicaid programs.

First Quarter of 2015 Coverage Highlights include:

* 53 million covered lives added from 27 new plans during the quarter
* 10 Blue Cross/Blue Shield plans encompassing 20 states added during the quarter
* Commercial covered lives grow to approximately 150 million during the quarter
* Medicare Beneficiaries eligible for coverage totals 36 million
* 29 state Medicaid programs have now confirmed coverage

Parker H. "Pete" Petit, Chairman and CEO said, "We are very pleased with the significant progress we have made, particularly in this quarter, in gaining coverage for our allografts from commercial as well as Medicaid payers. This intensive initiative to attain coverage started over three years ago. At present, there remain a relatively small number of commercial payers with whom we are still in the process of gaining coverage. Attaining coverage from these additional commercial payers remains a top priority."

"Our relatively rapid success in securing written coverage from commercial health plans, state Medicaid and Federal programs is founded on our published studies. Our portfolio of numerous clinical and scientific studies has proven to be a pivotal factor in our rapid success in securing eligibility for payer coverage. This strategy served us extremely well in prior years as we quickly secured coverage awards from all of the Medicare Administrative Contractors ("MACs") with jurisdictions encompassing the entire United States. We have continually accelerated our investments and resources dedicated to our clinical and scientific trials. As a result, our comprehensive Compendium of clinical and scientific studies continues to be augmented with a growing list of studies. Our Compendium includes Randomized Controlled Trials ("RCTs"), cross-over clinical studies, scientific studies, and since November of 2014, the first multi-center randomized comparative effectiveness study examining the performance, outcomes, wastage and cost of two advanced wound care products. The statistically significant results of these peer-reviewed, published scientific and clinical studies continue to play a decisive role in our on-going successes in gaining payer coverage. These recent coverage confirmations are testimony to the impact that the expansion of our peer-reviewed clinical and scientific studies have on coverage decisions," added Mr. Pete Petit.

Bill Taylor, President and COO, commented: "Health plans place a high level of scrutiny on the clinical efficacy of the products they evaluate for coverage. Our ability to present our body of evidence demonstrating that our allografts will clinically benefit their members and provide effective care are the foundational building blocks in their decisions to award coverage. As they realize the potential impact of our allografts on their covered populations, they make the determination that the benefit to their members can be substantial and should be an essential part of their covered services."

"It is important to note that these coverage confirmations are added to the payer's health policy documents specifying the covered etiologies and intended uses, the number of applications and the intervals of application. Coverage confirmations also mean that the specified product has a billable and payable code with the payer, and that all health plan members who receive prescribed care according to the health policy specifications are eligible for reimbursement from the payer. These policy decisions are quite different from the rare approval to cover a treatment on a patient-by-patient exception basis occasionally granted by a health plan. Unfortunately, some of our competitors seem to communicate these one-time consents in the same vein as a coverage confirmation in a payer's written medical policy," concluded Taylor.

Safe Harbor Statement

This press release includes statements that look forward in time or that express management's beliefs, expectations or hopes. Such statements are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements include, but are not limited to, the Company's belief that the success in gaining coverage from payers is grounded in scientific and clinical study data and compelling results presented to those payers, that expanding the Company's clinical and scientific studies has an impact on coverage decisions, that the Company's allografts will clinically benefit commercial health plan members and provide effective care, that the benefit of the Company's allografts can be substantial, and that gaining coverage from the remaining commercial health plans will result in an even greater number of patients having access to the Company's allografts and being able to benefit from their outstanding clinical results. Among the risks and uncertainties that could cause actual results to differ materially from those indicated by such forward-looking statements include that the Company does not gain coverage from additional commercial payers or that the Company's growth is not impacted either positively or negatively by coverage decisions of additional commercial payers, that the Company's scientific and clinical study data and results are not compelling or that physicians or payers fail to embrace the Company's products regardless of these results, that the Company's allografts do not clinically benefit commercial health plan members and/or provide effective care, and the risk factors detailed from time to time in the Company's periodic Securities and Exchange Commission filings, including, without limitation, its 10-K filing for the fiscal year ended December 31, 2014. By making these forward-looking statements, the Company does not undertake to update them in any manner except as may be required by the Company's disclosure obligations in filings it makes with the Securities and Exchange Commission under the federal securities laws.

To view the original version on PR Newswire, visit the link below:


SOURCE MiMedx Group, Inc.

Michael Senken, Phone: (770) 651-9100