The American Academy of Physical Medicine and Rehabilitation (AAPM&R), in collaboration with an allied coalition, has helped drive strong bipartisan congressional engagement to protect patient access to peripheral nerve blocks (PNBs).
U.S. Representatives Brittany Pettersen (D-CO-7) and Claudia Tenney (R-NY-24) led a bipartisan congressional sign-on letter to the Centers for Medicare & Medicaid Services (CMS) expressing grave concerns with recently proposed Local Coverage Determinations (LCDs). The proposed LCDs would, if implemented, restrict Medicare coverage for PNBs, an established and efficacious non-opioid pain management procedure.
This congressional effort followed advocacy by AAPM&R and its partners in the Pain Medicine Coalition, including the American Society of Anesthesiologists, the American Society of Regional Anesthesia and Pain Medicine, and the International Pain and Spine Intervention Society. These efforts included direct engagement with policymakers, formal comments submitted to Medicare Administrative Contractors (MACs) and continued elevation of the clinical evidence supporting PNBs as an effective treatment for chronic pain. The Academy also launched a grassroots advocacy campaign in support of this congressional effort, which resulted in Academy members sending more than 140 messages to their congressional representatives urging them to join this sign-on letter.
Peripheral nerve blocks are commonly used by PM&R physicians and other pain medicine physicians to manage chronic pain, improve function and enhance quality of life, often helping patients avoid or reduce reliance on opioid medications. AAPM&R has consistently raised concerns that overly broad coverage restrictions would limit access to these important treatments and negatively impact Medicare beneficiaries living with chronic pain.
In their letter to CMS, lawmakers echoed these concerns, warning that restricting access to non-opioid pain treatments could have unintended consequences for patients and undermine broader efforts to address pain responsibly. The letter ultimately garnered support from 25 bipartisan members of Congress, underscoring the strength of the clinical and patient access arguments advanced by the Academy and its partners.
AAPM&R thanks the U.S. Representatives who joined this important sign-on letter and all of the Academy members who contacted their congressional representatives in support of this effort, and remains committed to advocating for policies that allow physiatrists to deliver high-quality, evidence based care and protect patient access to appropriate pain management and treatment options.
AAPM&R will continue to monitor implementation of these LCDs and advocate for coverage policies that reflect clinical evidence and allow physiatrists to continue providing appropriate peripheral nerve block procedures for patients with chronic pain.
We encourage all PM&R physicians to: