Sight Sciences Announces Withdrawal of Final LCDs on MIGS from Five Medicare Administrative Contractors

In a major decision that could a have wide-reaching effect on the future of reimbursement and access to care for glaucoma patients, five Medicare Administrative Contractors (MACs) decided to withdraw their final local coverage determinations (LCDs) for certain Micro-Invasive Glaucoma Surgery (MIGS) procedures that were scheduled to take effect on January 29, 2024.

On October 26th, WPS Government Health Administrators, (WPS), a MAC, published an LCD L39620 Micro-Invasive Glaucoma Surgery (MIGS), that identifies certain procedures as investigational in patients over the age of 18 for glaucoma management. These procedures included canaloplasty in combination with trabeculotomy ab interno.

View EyewireTV's coverage of the prevision MAC guidance here. 

All five MACs (WPS Government Health Administrators, Palmetto GBA, Celerian Group Company, National Government Services, and Noridian Healthcare Solutions) have now issued statements that the final LCDs will not go into effect on January 29, 2024.

The company most directly impacted by that decision was Sight Sciences, the maker of the OMNI Surgical System. In a news release, Sight Sciences voiced its support of the decision.

“We appreciate that the MACs and the Centers for Medicare & Medicaid Services (CMS) carefully and thoughtfully considered all stakeholder concerns with the LCDs and the serious potential risks to patient health and access to effective glaucoma care,” Paul Badawi, co-founder and CEO of Sight Sciences, said in a company news release. “We look forward to continued engagement with the MACs and CMS to ensure glaucoma patients and their physicians maintain appropriate and fair access to medically reasonable and necessary MIGS procedures and technology. We would like to thank the many passionate glaucoma surgeons around the country and the national and state eye care societies including notably the American Academy of Ophthalmology, the American Glaucoma Society, the American Society of Cataract and Refractive Surgery, and the Outpatient Ophthalmic Surgery Society, who all worked collaboratively and tirelessly to provide valuable and critical feedback to the MACs, CMS, and Congressional offices during this rigorous review process. Additionally, we appreciate the support from the Medical Device Manufacturers Association (MDMA) and numerous patient advocacy groups.”

Investors also applauded the decision with shares of Sight Sciences soaring about 80 percent in the 2 days following the decision.