Harvard Pilgrim’s Gastroesophageal Reflux Disease (GERD): Endoscopic Treatments Medical Policy lists certain procedures that are not covered for the treatment of GERD, due to being considered investigational/experimental and unproven. After a review of clinical literature, Harvard Pilgrim has identified an additional procedure that is not considered medically necessary, and has updated this policy accordingly.
Effective April 1, 2017 Harvard Pilgrim will not cover transoral incisionless fundoplication (TIF) for the treatment of GERD. In addition, Harvard Pilgrim is removing the Bard EndoCinch system from the policy, as it is no longer on the market.
For complete information, including the full list of non-covered procedures, please see the updated Gastroesophageal Reflux Disease (GERD): Endoscopic Treatments Medical Policy and Non-Covered Services Payment Policy.