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In January 2024, Humana issued Medicare Advantage policy HUM-1140-000 [PDF], excluding from coverage peripheral nerve stimulators (PNS) for treating chronic pain. This policy contradicts Medicare's longstanding practice of covering and paying for the reasonable and necessary use of PNS for chronic pain management and appears inconsistent with the Noridian Local Coverage Decision and the CMS National Coverage Decision (NCD 160.7). Working with the Multi-Society Pain Workgroup, NANS issued a statement [PDF] on behalf of 12 medical societies to Humana and CMS administrators objecting to the policy.
2 Comments
3/20/2024 01:19:00 pm
The lack of Advantage Medicare coverage for these PNS treatments significantly impacts patients suffering from chronic pain conditions, limiting their options for effective pain management. This discrepancy in coverage highlights the need for a more comprehensive approach to ensure that patients have access to advanced and beneficial treatments without unnecessary restrictions imposed by insurance plans.
Marwan Shuayto, MD
3/21/2024 10:51:06 pm
It is a shame that Humana is taking this approach on something that Medicare patients should have access to. PNS have been a life changer for so many of our patients. CMS should be notified immediately as advantage plans should cover everything that Medicare covers. Your comment will be posted after it is approved.
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