Policyholder Services

Does my OMIC policy cover me for botox injections?

Updated 8/23/2016

Beginning in 1989, the FDA has approved various botulinum toxins for the therapeutic treatment of spastic disorders such as acute spastic entropion, hemifacial spasm, myokymia, benign essential blepharospasm, Meige Syndrome, and strabismus. The first to be approved for the cosmetic treatment of glabellar lines was Botox in 2002, followed by Dysport and Xeomin.  These botulinum toxins, plus Myobloc (only FDA approved for the treatment of cervical dystonia), are also used off-label for the cosmetic treatment of other facial wrinkles.

OMIC’s policy covers the use of botulinum toxin for therapeutic purposes. It also covers claims arising from their use for cosmetic treatment of facial wrinkles. Whether performing such treatments in a medical office or in a non-clinical setting such as the patient’s home, the physician should follow basic risk management principles:

• Maintain a medical record with treatment notes for each patient undergoing treatment with botulinum toxin.
• Obtain and document informed consent.
• Follow appropriate sterile technique.
• Develop and follow protocols for handling potential emergencies that may arise.
• Due to patient confidentiality concerns and the potential for HIPAA violations, do not administer botulinum toxin treatments at “home Botox parties” or other public venues.
• Patients should not imbibe alcohol or take other drugs prior to consent or treatment.
• Federal law requires that advertisements comply with all FTC and FDA regulations, and the OMIC policy excludes coverage for claims based on false or misleading advertising or guaranteed results.

OMIC offers a sample Botox consent form (download above), developed by Dr. Tamara Fountain, a practicing oculofacial plastic surgeon and former Chair of the OMIC Board.