Insurers Should Cover All Types of Pain Treatment January 05, 2016 15:02
No patient who is in severe chronic pain should be required to reduce their pain medication unless and until they have been provided with access to treatment that is at least as effective as their current opioid regimen.
Efforts to reduce use of opioids have driven legitimate pain patients to use of heroin and have not stemmed the opioid abuse epidemic. In fact, addiction and overdoses have only increased.
Preventing addiction is the key to saving lives. The best way to do this is to reduce the number of new prescriptions for opioids unnecessarily dispensed to pain patients. Fortunately, curtailing opioid prescriptions can be done without harm to pain patients because safer, more effective treatments exist.
However, significant barriers to access to alternative pain treatments exist. Financial obstacles because of lack of insurance coverage, inadequate availability of services, and lack of knowledge of alternatives by both patients and their physicians prevent patients from receiving the most appropriate care.
A significant factor that has led to inadequate availability of many pain treatments is the fact that non-physician in-network providers who are reimbursed by health insurers have not, for the most part, received any fee increases in over 35 years; whereas physicians have received numerous increases. These providers include chiropractors, physical therapists, occupational therapists, and mental health practitioners.
Availability of these services has decreased as more providers are leaving and fewer providers are entering these disciplines, because of a 65% decline in real wages owing to inflation.
To reduce these impediments to effective pain treatment, I propose a Pain Treatment Parity Act (PTPA), which would require all entities that pay for treatment of chronic pain -- including public and private insurers -- to cover all pain treatments that have credible evidence of effectiveness to the same degree that they cover pharmaceutical treatment of pain.
This includes both qualitative and quantitative limitations on care, such as equivalence in pre-treatment authorization requirements, limits on number of visits or dosage restrictions, copayment requirements, as well as equivalent fee schedules.
The Centers for Disease Control And Prevention (CDC) should champion this or similar legislation along with its opioid prescribing guidelines.
This Pain Treatment Parity Act is being promoted by Cindy Perlin - a Licensed Clinical Social Worker, certified biofeedback practitioner, chronic pain survivor and the author of “The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.”