CMS Takes Action on AACIPM Recommendations Regarding Bundled Payments for Integrative Pain Management

In an exciting turn of events, the Centers for Medicare and Medicaid Services (CMS) have released a draft of the Physician Fee Schedule for 2023 for public comment—and it is clear that the collective efforts of AACIPM and its member organizations on the 2022 PFS have been highly influential in the development of the 2023 PFS!

In response to the proposed 2022 PFS, AACIPM had issued recommendations related to the creation of a standalone code that would support the use of team-based care through bundled payments, explaining that such a code would better enable CMS to determine quality, measurement, and outcomes. While CMS did not implement such a code last year, CMS is now proposing two new HCPCS codes for chronic pain management and treatment services.

While AACIPM is extraordinarily pleased to see CMS taking this step, it is vital that we once again weigh on in these important new codes to ensure they make it across the finish line. We are facilitating a stakeholder Zoom meeting on August 4 to discuss CMS’ proposal in detail, as public comments must be submitted no later than September 6, 2022

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AACIPM Aids in Development of Washington Health Alliance’s Tool for Low Back Pain

To support the work of the Washington Health Alliance, AACIPM arranged and facilitated a group call with patient leaders to bring in the perspective of people with pain as WHA developed their Acute Low Back Pain Care Pathway tool. This constructive call included representatives from seven patient organizations and ultimately resulted in a number of edits to the tool, including the removal and/or amendment of stigmatizing language. We appreciated the opportunity to collaborate and the feedback from WHA was just as positive, as they stated, “We learned an important lesson during this process which is to include AACIPM and other patient focused organizations in our initiatives from the start!”

National Updates

US Military Updates Practice Guideline on the Management of Opioid Therapy for Chronic Pain

The U.S. Department of Veterans Affairs and the Department of Defense have released an update to their joint guideline on managing pain: Use of Opioids in the Management of Chronic Pain (2022). The guideline is formatted as three algorithms and 20 evidence-based recommendations related to (a) determination of appropriateness for opioids for chronic pain, (b) initiation of treatment with opioids, and (c) maintaining, tapering, discontinuing, or switching from full agonist opioids.

In addition to the full guideline, VA/DoD has also provided a Provider Summary and a Pocket Card for convenience.

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Federal Funds Available Related to Pain Management and Telehealth Research

The federal government is currently a number of pain-related research initiatives:

Development of Therapies and Technologies Directed at Enhanced Pain Management (R43/R44 – Clinical Trial Required). Aims to support the development of therapies and technologies directed at enhanced pain management through the Small Business Innovation Research program. In addition, NIH is interested in new screening tools and models focused specifically on pain and development of pain therapies including digital tools.
Development of Therapies and Technologies Directed at Enhanced Pain Management (R43/R44 – Clinical Trial Not Allowed). Focused on applications for improving pain treatment, including the development of new non-addictive medications and devices and objective pain measurement. In addition, NIH is interested in new screening tools and models focused specifically on pain and development of pain therapies including the development of digital health technologies associated with pain and serious mental illness or suicide.
Notice of Special Interest: High Priority Pain Research. The National Center for Complementary and Integrative Health is inviting applications to focus on pain-related research topic areas that include remotely delivered interventions.

CMS Seeks Feedback to Improve Equity and Access in Medicare Advantage

Separate from CMS’ Physician Fee Schedule proposal, the agency is also seeking feedback related to the Medicare Advantage program, hoping to hear from the public on topics including health equity, expanding access and coverage to affordable and sustainable care, driving innovation to promote person-centered care, and developing partnerships with stakeholders.

The official Request for Information is expected to be published on August 1, 2022, but an unpublished version is currently available for review. Public comments will then be accepted for a period of 30 days.

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ICYMI: Supreme Court Refuses to Expand Criminal Liability in Opioid Prescribing Cases

In a 9-0 decision, the U.S. Supreme Court has unanimously held that physicians can only be convicted of violating the Controlled Substances Act when they intentionally or knowingly prescribe in an unauthorized manner. In the decision, Justice Breyer wrote that requiring a culpable mental state “helps to diminish the risk of ‘overdeterrence,’ i.e. punishing acceptable and beneficial conduct that lies close to, but on the permissible side of, the criminal line.”

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Message from the Director

I hope you are staying cool and enjoying summer. I’m very excited for you to see this month’s issue and the results of collective advocacy efforts that will have an important effect on patient care. The CMS PFS 2023 (see opening article above) is a great opportunity for our group to come together with patients, payors, providers and policymakers around a very complex issue of new HCPCS pain codes being proposed. We hope to hear from many of you as we work on our next group response due on 9/6.

I’m also proud of our assistance with helping the Washington Health Alliance get constructive feedback from the perspective of people living with pain, as they finalize their Acute Low Back Pain Care Pathway tool. These relationships are very important – and more importantly when leaders think ahead to include the patient voice, an often overlooked perspective.

The AACIPM team is working on new resources and a late-September program that will occur during Pain Awareness and Self Care Awareness Month. If you have activities being planned, please drop us a note so we can incorporate them to share with others.

Onward and Upward!
Amy