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Federal Government Continues Its Deep Look at Integrative Pain Care

Posted By Katie Duensing, Monday, March 12, 2018

In a flurry of activity that would have shocked the integrative pain care community just a few years ago, the federal government, at both the legislative and administrative levels, continues to take a deep look at how non-opioid and non-pharmacological treatments for pain can be better utilized to treat pain and reduce reliance on opioid analgesics.

Congress Asks for Advice Related to Pain Management, Alternatives to Opioids

As we mentioned last month, the Senate Finance Committee recently sought out comments related to how Medicare and Medicaid program incentives can be used for beneficiaries with chronic pain in ways that minimize the risk of becoming addicted to opioids. In response, two members of the Integrative Pain Care Policy Congress, AIPM and US Pain Foundation, submitted a joint letter to the committee recommending a long list of steps that CMS could take to remove barriers to high quality integrative pain care and improve data collection related to that type of care.

Following on the Senate committee’s heels, on February 27th, the House Ways and Means Committee sent a letter seeking feedback from a variety of stakeholders, asking a long list of questions related to opioids and pain management. The committee wants information related to incentives in Medicare, tools to prevent opioid abuse, medication therapy management, prescriber education, prescription monitoring programs, reimbursement, alternative options for the treatment of pain, and more. Comments are due no later than March 15, 2018.

CMS Proposes New Payment Policies, Asks for Advice re: Non-Pharmacological Interventions

Apart from the two legislative bodies responsible for overseeing CMS (both committees mentioned above), CMS itself recently asked for public comments related to their proposed payment policies for 2019. In addition to proposing new payment structures related to opioids, the proposed policy also stated that, “CMS and measure developers are exploring additional measurement concepts for future work, such as functional status, and use of non-pharmacological or non-opioid pain management interventions…” In response, AIPM submitted comments related to both limitations on opioids and the use of non-pharmacological and/or non-opioid pain management interventions.

CARA 2.0 Act of 2018

The second iteration of the Comprehensive Addiction and Recovery Act, or CARA 2.0, has been introduced by the Senate Health, Education, Labor & Pensions (HELP) Committee. The legislation is intended to make improvements to the original CARA, and while the bill-as-introduced is lacking in certain pain provisions, Senate leadership from HELP and Finance Committees have expressed their openness to the inclusion of pain-related provisions. Forty-two organizations, including numerous members of the Integrative Pain Care Policy Congress, have signed on to a document outlining what they would like to see included in the legislation related to pain. The House is also working on their own version of this legislation, and there will be a few substantive hearings later this month. More details to come soon. 

Application Deadline for CMS Bundled Payments is March 12

As shared in a previous update, if you are interested in applications for the Bundled Payments for Care Improvement Advanced (BPCI Advanced) model, the application deadline is March 12, 2018.  More information about this process can be found here.

Integrative Pain Care Policy Congress Next Steps

The Integrative Pain Care Policy Congress continues to make progress in working together to advance integrative pain care. Based on survey results, the Congress is launching three new workgroups: (1) Coverage and Constraints, (2) Promoting Comprehensive, Integrative Pain Care, and (3) Strategic Communication. In the surveys that helped to form these workgroups, participants also indicated their interest in helping above and beyond meeting participation and with the strategic direction of these workgroups. On that note, Workgroup leadership will be meeting by phone on March 19-20, so you can expect to hear more about these workgroups next month!

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