Private Payers' Varicose Vein Policies Are Inaccurate, Disparate, and Not Evidenced Based Which Mandates a Proposal for a Reasonable and Responsible Policy for the Treatment of Venous Disease.

Abstract Varicose veins afflict more than one in five Americans, and while varicose veins may be an asymptomatic cosmetic concern in some, many others experience symptoms of pain, aching, heaviness, itching and swelling. More advanced venous disease can result from untreated venous insufficiency. The complications of chronic venous disease, including bleeding, thrombosis and ulceration are seen in up to 2 million Americans annually. Numerous reports have documented venous disease adversely affects quality of life (QOL) and that treatment of venous disease can improve QOL. It has previously been documented that private insurers, and CMS subcontractors for that matter, have disparate policies that in many instances are self-serving, contain mistakes, utilize outdated evidence and disregard evidence based guidelines. The two leading venous medical societies, the American Venous Forum (AVF) and the American Venous and Lymphatic Society (AVLS), have come together to review the varicose vein coverage policies of seven major US private medical insurance carriers whose policies cover more than 150 million Americans. The authors reviewed the policies for venous disease and if significant gaps or inconsistencies are found we hope to point them out and finally, to propose a thoughtful and reasonable policy based upon the best available evidence.