Category: US Pain Foundation

CMS Announces a Huge Step Forward for Chronic Pain Management

Posted on by Grayson

The following is from an email that Cindy Steinberg, Director of Policy & Advocacy at US Pain Foundation, sent this morning (7-18-22).

Dear Pain Warriors,

CMS announced their intention to improve pain care for Americans over 65 or disabled by paying separately for physicians to spend more time with chronic pain patients creating and modifying treatment plans and coordinating team-based comprehensive chronic pain care.

CMS explained their proposal in the recently released draft Medicare Physician Fee Schedule (PFS) for 2023 and are seeking comments on this proposal by September 6, 2022. The PFS is a 2000-page document that we are reviewing but we wanted to make you aware of this important development. We intend to issue a call to action in the coming weeks with more detailed information on what is being proposed, how to comment and points you may consider making in your comment.

Here are some questions and answers you may have now:

Why should pain patients care about this?

Many people with chronic pain report that they are unable to find doctors who will treat them. One reason this is the case is that chronic pain is complex and finding the right treatments that will help patients can be a lengthy trial and error process. Doctors often do not have enough time with each patient to make this economically viable for them. We hope that payment for additional time spent with patients will incentivize doctors to spend more time helping people with pain.

Is this definitely going to happen?

It is highly likely this will go forward but in order to ensure that it does, people with pain need to comment and express support for this proposal.

What is the number one finding and recommendation from the PMTF Report that CMS is taking action on?

Finding: Current best practice in pain management is an individualized, multidisciplinary treatment approach combining a number of different treatment modalities.

Recommendation 1: Encourage coordinated and collaborative care that allows for best practices and improved patient outcomes.

How do I find the document that CMS released?

Click here. (Chronic Pain Management is discussed in Section 33.)

Extending Telehealth for Medicare Recipients

Posted on by Grayson

The following is an email from the US Pain Foundation dated yesterday, March 21:

Since access and coverage of telehealth has been a wonderful and safe convenience for people with chronic pain during the pandemic, we have been closely following government policy around telehealth coverage and want to update you on recent developments.

Last week, President Biden signed into law HR 2471, the Consolidated Appropriations Act of 2022 which finalized the fiscal year 2022 federal budget and included a number of provisions to extend Medicare telehealth coverage implemented as part of the government’s response to COVID-19. The COVID-19 Public Health Emergency (PHE) has not yet officially ended but is expected to end sometime in the next few months. HR 2471 will extend Medicare telehealth coverage for 151 days or approximately five months after the PHE ends. These extensions include the following:

  • Patients’ Location – Medicare beneficiaries can continue to receive coverage for telehealth services from wherever they are located within the U.S., including their homes. Before the PHE, telehealth coverage was restricted to beneficiaries being located in hospitals and certain provider locations in order to receive coverage for telehealth.
  • Eligible Practitioners – Medicare beneficiaries can continue to receive coverage for telehealth services from physical therapists and occupational therapists.
  • Mental Health Coverage – Medicare beneficiaries can continue to receive coverage for telehealth services from mental health providers without the requirement of an in-person visit within six months of the first telehealth service with that provider nor the requirement of an in-person visit every 12 months.
  • Audio-only Telehealth – Medicare beneficiaries can continue to receive coverage for telehealth services using audio-only technology.

This is great news for Medicare beneficiaries! However, although Medicare coverage policies tend to be a bellwether for changes in private payer and Medicaid coverage, please keep in mind that private payer and Medicaid coverage for telehealth services varies by state.

Forty-three states and the District of Columbia (DC) have laws that govern private payer reimbursement of telehealth but what specific services and providers are covered varies greatly. And, while all 50 states and DC now reimburse for some types of telehealth services in Medicaid, many of the reimbursement policies have restrictions and limitations. It is important to check with your state Medicaid program or private insurer to find out what telehealth services are covered.

You can learn more about the efforts that the US Pain Foundation takes around advocacy – including ways to get involved – here.

CDC Releases Draft of Revised Guidelines for Opioid Prescribing

Posted on by Grayson

The following is from the US Pain Foundation’s Director of Policy and Advocacy, Cindy Steinberg, in a press release dated February 18:

You may have heard by now that the CDC released an updated draft version of the Clinical Practice Guideline for Prescribing Opioids – 2022. This new Guideline will take the place of the 2016 version. You can read the full version here.

The document is 200 plus pages which I am currently reviewing and will draft a formal comment to the docket on behalf of the U.S. Pain Foundation that we will share with you when it is ready. However, we wanted to summarize the changes in the new version for you. (Please see below.) We have prepared a head-to-head comparison of each of the twelve 2022 Guideline statements with the twelve 2016 Guideline statements that you can see here.

We also wanted to let you know that you can and should write into the docket with your views on the revised Guideline. All comments will be read by CDC. The deadline to submit comments is April 11, 2022. To submit your comments, click here.

Changes to the Guidelines

Overall, this revised Guideline is an improvement over the 2016 version. It is less dogmatic, more balanced and urges a more flexible approach to individual patient needs.

The greatest change is the removal of dosage cautions and limits in Guideline 5. The number of days of treatment duration for acute pain have also been removed from Guideline 6.

The newly released Guideline has softened recommendations around patient surveillance advising clinicians to periodically review state PMP data and consider using toxicology. The 2016 version directed clinicians to check the state PMP prior to every script or at least every 3 months and urged urine testing prior to starting opioid therapy and at least annually thereafter.

In this latest version, the CDC has also strengthened warnings to clinicians regarding not abruptly or rapidly reducing opioid dosages.

Again, we urge you to make your views known on this latest version by writing your comments to the docket. After April 11, CDC will review all comments and release the final draft of the updated Guideline later in 2022.