President’s Message: Standing Up for Patient Access
This has been a big month for pain care advocacy. Thank you to all our members for supporting patient access to peripheral nerve blocks for chronic pain. AAPM stands for multidisciplinary and personalized pain care. Though injection therapies are only one tool for diagnosing and treating pain, they can be life-changing. The CMS proposal to cut access to injection therapies could be devastating for hundreds of thousands of patients with high-impact chronic pain.
More than 30 experts volunteered to help draft AAPM’s response to the local coverage determination (LCD). Thanks to our experts, especially our Policy Committee Chair, James Babington, we will submit our response to CMS by November 8th and share it with you soon.
I have been hugely impressed by our pain community and members. Thank you for all you are doing to raise awareness about this potentially catastrophic change. We had powerful representation and impactful presentations from pain medicine specialists and leaders across our pain societies.
Shout-outs to Trent Emerick, Jennifer Hah, and Nat Schuster for also representing AAPM during the open meetings. Last Thursday, I presented at the NGS MAC in my procedure suite in solidarity with the incredible nurses who help me care for our patients with chronic pain.
During the open meetings, I not only urged CMS to rescind the proposed LCD, but I also gave examples of the patients who this will harm the most:
My patient Anna, who came to me feeling like she had a knife in her vagina. She was isolated from friends and family and struggled to function on high doses of pregabalin. We started pudendal nerve blocks, and she became a completely different person and was able to decrease her sedating medications. She even traveled to Bahamas and wore a bathing suit for the first time in years.
My patient Carmela who is 91 years old with inoperable knee pain and is wheelchair bound. She asked me to share her story and pictures from her genicular radiofrequency procedure today to urge CMS to dismiss their proposal denying access to nerve blocks and ablations for patients like her.
I encourage you to share your patient stories and have your patients send in commentary to the MACs! Links are below.
AAPM respectfully urges CMS and the MACs to withdraw the proposed LCD in its current form and to collaborate with pain medicine specialists in revising the policy. We highlight long-standing clinical evidence and flaws in their proposal. A revised LCD should:
- Acknowledge the established clinical role of diagnostic, prognostic, and therapeutic peripheral nerve blocks in multidisciplinary pain management.
- Incorporate appropriate evidence appraisal methods that reflect the realities of procedural research and real-world clinical practice.
- Ensure equitable patient access to non-opioid, multimodal pain care consistent with national pain strategy goals.
- Engage specialty expertise from AAPM and related professional societies in the policy’s refinement and implementation.
AAPM stands ready to assist CMS in developing a balanced, scientifically grounded, and patient-centered policy framework. Together, we can ensure that Medicare beneficiaries continue to receive compassionate, effective, and evidence-informed pain care that reduces suffering, restores function, and advances the shared national goal of minimizing reliance on opioids, decreasing hospitalizations and surgeries, while improving health and quality of life.
Your voice matters too! It’s not too late! I encourage you to
- Submit your comments and patient stories to all 5 regional MACs by November 8th and
- Sign this petition on change.org in support of our patients’ access to care.
Comments may be submitted directly through each Medicare Administrative Contractor (MAC) by using the links provided below:
- NGS (DL40267): Open Comment Period: closes 11/8
- Noridian (DL40265): Open Comment Period: closes 11/8
- Palmetto (DL40263): Open Comment Period: closes 11/8
- CGS (DL40261): Open Comment Period: closes 11/8
- WPS (DL40300): Open Comment Period: closes 11/22
Thank you for all you do for our patients with chronic pain.
With gratitude,
Antje Barreveld, MD
AAPM President
LinkedIn: @antje-barreveld
X: @AntjeBarreveld
