Articles
Draft LCD Deems Arthrodesis of the SI Joint Not Medically Necessary
NANS joins the Multisociety Pain Workgroup to object to Palmetto’s draft local coverage determination for minimally invasive arthrodesis of the sacroiliac joint.
New CIGNA Policy Calls Peripheral Nerve Stimulation “Not Medically Necessary”
In March, CIGNA released policy 0539, characterizing peripheral nerve stimulation (PNS) as “not medically necessary.” NANS is working with the PNS Subcommittee to respond to this categorization.
NANS’ Efforts Ensure Coverage for Closed-loop SCS with Cigna and EviCore
NANS led efforts on behalf of the Multi Society Pain Workgroup to object to insurers’ classification of closed-loop spinal cord stimulation (SCS) as experimental, investigational and/or unproven. Cigna and EviCore revised their policies to include coverage of closed-loop SCS.
NANS leads response to Humana’s new policy that excludes coverage of PNS
In January 2024, Humana issued Medicare Advantage policy HUM-1140-000, excluding from coverage peripheral nerve stimulators (PNS) for treating chronic pain. NANS issued a statement on behalf of 12 medical societies objecting to the policy.
Restoring Medicare Physician Payments in 2024 Appropriations Bill
Recently, 32 U.S. Senators sent a bipartisan letter to Senate leaders calling for a legislative solution to protect access to Medicare services by canceling the 3.37% cut to physician Medicare payments that went into effect on January 1, 2024.
NANS signs on to urge Congressional leadership to reverse Medicare Physician Payments Cut
In January, NANS and other national medical specialty societies and state medical associations strongly urged Congressional leaders to quickly pass legislation to reverse the 3.37% Medicare physician payment cuts that took effect at the beginning of 2024.
NANS leads effort as more insurers deem closed-loop SCS “experimental, investigational and/or unproven”
NANS was alerted that several insurers, including Cigna, eviCore, Excellus, Humana, and UPMC, adopted policies calling closed-loop SCS experimental, investigational, and/or unproven.
Washington State poised to extend coverage for SCS
NANS led advocacy efforts on behalf of 13 medical societies to extend coverage for SCS in Washington State. The State’s Health Technology Clinical Committee met to hear from stakeholders on the issue.
Update to CMS Final 2024 Medicare Physician Fee Schedule Rule
On November 2, CMS released its calendar year 2024 final rule for the physician fee schedule, cutting the conversion factor by 3.4%, to $32.74 in CY 2024.