On June 10, 2021, a new proposed Medicare LCD (Local Coverage Determination) policy aimed at limiting patient access to interventional pain procedures was set in motion. This proposed nationwide Medicare policy contains many tedious preauthorization requirements that will detrimentally affect the patient’s ability to access pain care. At a minimum, in order to be scheduled for interventional pain procedures, patients will need to provide documentation of the following:

  • Pain duration of at least four (4) weeks.
  • Radicular pain that is severe enough to cause a significant degree of functional disability or vocational disability
  • Radiological image-based diagnostic testing (MRI or other) performed within the past 12 months that supports the diagnosed pain condition.
  • A documented inability to tolerate noninvasive conservative care (formal physical therapy program) or medical documentation of failure to respond to four (4) weeks of noninvasive conservative care.

    • If this policy is adopted, patients being referred for pain management before these tasks are completed will experience either a delay in the scheduling process or ultimately be unable to receive treatment at the time of their appointment. As Physicians, we have an obligation to relieve pain to the fullest extent of our abilities. With policies like this that handicap the choices we have to offer for patients, we are continually faced to provide high quality pain care with one hand tied behind our back.

    It is not too late to let your voice be heard. We need your help today by sending your letter to the Members of Congress, asking them to intercede by contacting proper CMS and CMD’s. The American Society of Interventional Pain Physicians have simplified the process of submitting a letter to the Members of Congress. Simply follow the Voter Voice link below and follow the instructions to submit your information. https://www.votervoice.net/ASIPP/campaigns/87950/respond