Rep. Tom Emmer
In continued efforts to fight America’s opioid crisis, U.S. Rep. Tom Emmer (R-MN) recently expressed concerns with a currently proposed local coverage determination (LCD) for non-opioid forms of pain management that he thinks could exacerbate the public health crisis.
“Now is not the time to decrease access to other forms of pain management,” the congressman wrote in an Oct. 7 letter sent to Tamara Syrek Jensen, director of the Coverage and Analysis Group for the Centers for Clinical Standards and Quality, and Dr. Stephen Boren, medical director at National Government Services.
Specifically, the proposed LCD on Epidural Procedures for Pain Management services was announced on June 10 as a nationwide coverage policy by the Centers for Medicare & Medicaid Services, which continues to work on the proposal.
“The proposed LCD reduces epidural injections to an unmanageable number, includes a list of conditions eligible for epidural treatments that is far too limited, and eliminates important procedures that have been performed for 25 years,” Rep. Emmer wrote in his letter.
In a related statement also released on Oct. 7, he pointed out that by reducing the use of epidural injections to an “unmanageably low level,” the proposed LCD also “fails to consider the previously eligible patients in desperate need of pain management who depend on this procedure.”
“Non-opioid relief choices are already limited and, for some patients, this option has been relied on for 25 years,” the lawmaker added.
The restrictions in the proposed LCD also could impose higher costs on patients who continue to use them, as well as require them to take potentially duplicative COVID-19 tests, according to Rep. Emmer’s letter.
In accordance with evidence-based policies put forth by the Multi-jurisdictional Committee, an advisory committee tasked with analyzing the quality of evidence used to make a determination, Rep. Emmer “strongly encouraged” several revisions to the LCD, such as providing coverage for multiple procedures in the same session, when reasonable and necessary; expanding the inclusion criteria for indications and medical necessity; and increasing the number of procedures during the diagnostic or initial phase.
“The opioid epidemic has devastated families and communities across this nation, and our government must support all available forms of non-opioid pain management for patients struggling with chronic pain,” according to Rep. Emmer’s statement. “Changes must be made to the LCD before it is too late.”