Medium impact
Fecal Incontinence (CPB 0611, reviewed 2026-02-25)
Aetna·Effective Feb 25, 2026
Aetna updated its fecal incontinence policy (CPB 0611) effective February 25, 2026, establishing clear medical necessity criteria for diagnostic tests, conservative treatments, and invasive procedures. The policy requires a 3-month trial of at least 2 conservative treatments before approving surgical interventions (sphincter repair, colostomy) or advanced devices (Acticon Neosphincter, sacral nerve stimulation). Multiple experimental procedures are listed as non-covered, including anal slings, graciloplasty, injectable bulking agents, magnetic sphincter augmentation, and regenerative medicine approaches.