NANS and Partner Societies Urge Carelon to Reconsider Restrictive SCS Policy

The North American Neuromodulation Society (NANS), alongside several leading medical societies, has submitted a formal letter to Carelon Medical Benefits Management in response to its recent policy denying coverage for spinal cord stimulation (SCS) in patients with non-surgical low back pain.

The letter, addressed to Carelon President Dr. Robert Mandel, outlines deep concerns about the policy’s failure to align with current clinical evidence and best practices in pain management.
 
It highlights several key issues, including:

• The inappropriate requirement for surgical evaluation prior to SCS approval, which delays care and limits access for non-surgical patients.
• The outdated view of SCS as a “last resort”, despite growing evidence supporting earlier use in the treatment continuum.
• Selective citation of literature, omitting recent high-quality studies that demonstrate SCS’s efficacy and cost-effectiveness.
• Lack of viable alternatives for carefully selected non-surgical patients, potentially forcing reliance on opioids or less effective interventions.

 
With over 70,000 members represented, the cosigned organizations emphasize the need for a more patient-centered, evidence-based approach to coverage policies affecting chronic pain care.
 
Read the full letter:

READ LETTER