Last week, AIPM, along with our partners at the U.S. Pain Foundation, issued a joint letter to the U.S. Senate Committee on Finance (the Committee with jurisdiction over the Centers for Medicare and Medicaid Services, or CMS) that identified ways to overcome the current barriers to utilization of non-pharmacological treatments for pain, how payment incentives can be used to promote evidence-based care, and what innovative projects from the state-level and private sector could be replicated at the federal level. This letter was in response the Finance Committee’s request seeking policy recommendations for addressing the opioid crisis that would fall within their purview.
We recommend that CMS:
Reimburse primary care physicians and pain specialists for longer initial visits and frequent follow-up visits with chronic pain patients.
Allow a greater number of physical and occupational therapy sessions annually, and allow patients to access physical and occupational therapy without first acquiring a referral or prior authorization.
Provide full coverage of chiropractic adjustments and osteopathic manipulations and other techniques and modalities and should allow a greater number of sessions annually.
Provide full coverage for acupuncture, massage therapy, biofeedback, yoga, and tai chi.
Provide coverage of behavioral health services for the prevention, treatment, or management of physical health problems.
Provide grants to experienced pain patient organizations who have developed support group leader training that teaches self-management skills and provides ongoing guidance to lay leaders.
Provide coverage of medical devices that are FDA-approved for the treatment of chronic pain.
Longitudinally track changes in chronic pain prevalence, impact, and costs to enable evaluation of the effectiveness of interventions at the population health level.
Fund efficacy studies for a wide range of pain management therapies.
Set aside funds for more innovative demonstration projects using integrated, non-pharmacological treatments for chronic pain care. Examples of such programs include the Colorado Medicaid Waiver for Spinal Cord Injury Pain, the Rhode Island Medicaid Pain Management Program, Oregon Health Plan (Medicaid) Back Pain Services, and the Vermont Medicaid Acupuncture Pilot for Chronic Pain.
Increase access to specialized pain management consultation/education for primary care providers to enable them to feel more comfortable treating patients with chronic pain through programs such as Project ECHO and MCPAP.