Open enrollment for Medicare Advantage runs October 15 - December 7. If you see Medicare patients, encourage them to review all their options when considering which type of Medicare plan they want. If they are looking at Medicare Advantage plans, they need to know that all plans are not the same.
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Physicians should be aware that Humana’s Medicare Advantage plan has some of the most rigorous and strict prior authorization requirements when it comes to neuromodulation therapies like spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS).

Last December we alerted you to coverage issues around closed-loop SCS. Humana, Evicore, Cigna, and UPMC all had policies that characterized the therapy as “experimental, investigational and/or unproven.” Thanks to the efforts of the Multi-Society Pain Workgroup, Evicore and Cigna both revised their policies this spring. At the end of this summer, Humana followed suit but left the language in place for commercial coverage. Earlier this month, NANS led efforts with the MPW to issue this letter to Humana, urging them to follow the example of their Medicare Advantage plan to revise their policy.