Is there a time limit on how long a device can be considered ExperimenTtal?

[Kim_Dean\'sWife]

I'm wondering if anyone knows... is there a time limit on how long insurance companies can consider a newly approved device to be "experimental?"

(I feel like I should already know the answer to this, with all of the research I've done!)
Thanks!
Kim

[LBP]

This is an excellent question. Does anyone have access to Westlaw to do a little legal research on this issue. I know with my denials, the problem was "no proven long term success" meaning US published studies more than 2 years...but I don't know how many years it takes before they cant make that agrument...Technically I think the FEHB (feds ins) policy is the way to argue....once it's FDA approved you cant call it experimental and investigation.

[SeanTheFireman]

My wife has access to Westlaw, what do you need to be looked up? The more info you can give me the better due to her not having alot of time right now because she is studying for the Bar exam

[LBP]

Sean,

I PM'd you regarding Westlaw.