Oregon to Reconsider Coverage of Low Back Pain Injections

Members & Publications


February 9, 2017

After hearing statements on February 2nd from physicians, patients, and experts, the Oregon Health Authority’s (OHA) Evidence-based Guidelines Subcommittee (EbGS) has elected to reconsider its initial ruling, and explore more thoroughly the research that demonstrates lumbar radicular pain relief provided by transforaminal epidural steroid injections.

In May, your Academy, as part of the Multi-Society Pain Work Group, signed on to a letter commenting on the Oregon Health Authority’s (OHA) decision to eliminate coverage of epidural steroid injections (ESI).

On July 1, 2016, without awaiting release of the coverage guidance under development by the OHA’s Health Evidence Review Commission (HERC), OHA eliminated coverage for epidural steroid injections, leaving thousands of patients covered by Oregon Health Plan without access to interventional spine procedures. Most no longer have access to surgery and none have the option of palliative care with long-term opioid treatment. OHA currently recommends acupuncture, manipulation, massage, medications (excluding long-term opioid treatment), cognitive behavioral therapy, physical therapy/occupational therapy, and yoga as the only viable treatments for back pain. On November 8, 2016, the HERC issued draft coverage guidance strongly recommending against coverage for epidural, facet joint, medial branch, and sacroiliac joint corticosteroid injections for low back pain regardless of etiology. 

The EbGS is scheduled to meet next on April 6th

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.