Medicare Policy Will Deny Coverage for Medically Necessary Treatments for Debilitating Pain and Potentially Increase Opioid Use, Misuse

CHICAGO – Millions of chronic pain patients may be forced to turn to opioids or less effective treatments for their conditions, at a time when the opioid epidemic continues to claim the lives of Americans at an alarming rate.  A newly proposed Medicare Administrative Contractors (MACs) policy aims to deny those suffering from chronic pain, coverage and access to peripheral nerve blocks (PNB) – a minimally invasive and historically effective, non-opioid treatment option for chronic pain. The American Society of Anesthesiologists (ASA) strongly denounced the policy and urged its reversal.

“For decades, chronic pain patients have received treatment from PNBs and ablation techniques that provide rapid and durable pain relief, enhance function and quality of life, and decrease reliance on systemic pain medications, including opioids,” said ASA President Patrick Giam, M.D., FASA. “We urge Medicare to consider the compelling clinical and functional evidence that supports coverage of PNBs and related procedures.”

In a formal communication to the MACs, ASA emphasized the strong clinical, scientific, and anecdotal evidence that exists to support the use of PNBs for chronic pain and restoring patients’ quality of life. ASA cited many medical society guidelines and expert consensus, as well as functional and real-world evidence to demonstrate the effectiveness and medical necessity of these procedures for patients in debilitating pain. A large portion of the communication also included numerous compelling patient success stories that reinforce the clinical value of these procedures in treating pain. As addressing the opioid epidemic is of great concern to ASA, the comments also noted that using non-opioid treatments like PNBs can help prevent opioid addiction by minimizing a patient’s initial exposure to narcotics. This can prevent opioid misuse in the nearly 4 million Americans who initiate long-term opioid use every year after a routine surgical procedure.

The formal comments to the MACs are only one piece of ASA’s response to this assault on access to effective pain treatments. ASA has taken a leading and proactive role in addressing insurer coverage denials of pain procedures that help patients in pain. ASA is actively collaborating with many other pain and medical societies to address the broad implications of these types of care denials and will continue to advocate for patient access to effective and necessary treatment options.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 60,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. Follow ASA on Facebook, X, Instagram, Bluesky, and LinkedIn.

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