Radiology groups push UnitedHealthcare and Cigna to update payment policies for key service
Ten medical societies in radiology and other specialties are urging UnitedHealthcare and Cigna to update their payment policies pertaining to a critical imaging-guided service.
The American College of Radiology and others recently wrote to the two commercial insurers to voice their frustrations. They’re concerned about coverage for peripheral nerve stimulation, or PNS, a minimally invasive procedure used to treat chronic pain.
Both insurers have labeled the service as experimental and unproven, despite clinical evidence to the contrary.
“Peripheral nerve stimulation has been widely studied and utilized for over two decades, with increasing evidence supporting its effectiveness for patients suffering from conditions such as chronic migraines, neuropathic pain and complex regional pain syndrome,” ACR et al. wrote to UHC and Cigna in separate letters dated March 9.
Those signing the message also included the Society of Interventional Radiology, American Society of Spine Radiology, American Society of Anesthesiologists and others. They note that evidence supporting the benefits of PNS continues to grow. Large-scale studies and peer-reviewed papers have documented numerous benefits across multiple indications. Some studies have reported over 70% average pain reductions in knee, shoulder, foot/ankle and low back pain alongside “significant functional improvement.”
Peripheral nerve stimulation also comes with little risk of adverse events. The procedure has a “particularly favorable risk profile,” the societies noted, with lower rates of revisions on device-related complications compared to other established surgical interventions, the groups wrote.
“We urge [Cigna/UnitedHealthcare] to review the most current literature and medical guidelines on PNS and consider revising the policy to reflect the evolving evidence that supports its use in managing chronic pain,” ACR et al. wrote. “By doing so, you would acknowledge the positive impact PNS has on patients' well-being and ensure that members have access to a proven, effective alternative to more invasive procedures and pain management strategies.”
The college highlighted the issue in a news update to its members, published on Thursday. ACR urged radiologists who perform these procedures to “share recent research with payers to help ensure fair access for patients across all plan types.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.