Dr. John Prunskis urges Congress to reverse CMS anesthesia reimbursement policy

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Interventional pain specialist John Prunskis, MD, delivered remarks at a congressional roundtable July 29, citing recent CMS decisions that he said could lead to an increase in opioid use.

Dr. Prunskis is the CEO and medical director of the Elgin-based Illinois Pain and Spine Institute and the CMO of DxTx Pain and Spine, a network of affiliate interventional pain and spine practices.

In his remarks, he criticized CMS' decision to issue a local coverage determination where only two arthritic joints in the spine can be treated, saying the decision "makes little sense" because arthritis can affect multiple joints in the spine. 

He also criticized CMS' issuance of a local coverage determination that requires seniors to make out-of-pocket payments for "intravenous anesthetic sedatives for painful spinal injections into their arthritic joints or spine area nerves."

"Now seniors, instead of having their problem potentially fixed, may turn to opioid narcotics when their spinal arthritis and nerve problems are more widespread," he said. 

Dr. Prunskis also recommended that CMS develop a "site-of-service parity where identical procedures would be reimbursed the same whether done in a hospital or ambulatory surgery center."

He asked Congress to compel CMS to reverse these changes.

"Without intravenous anesthesia sedation, the pain from these procedures can be barbaric," he said. "If patients are unable to afford this new self-payment, they are forced to continue masking their pain with opioid narcotics.  

 

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