Oregon Medicaid Opioid Policy Drawing Fire

By Ed Coghlan.

A proposed policy that would restrict Oregon chronic pain patients on Medicaid access to opioids for chronic pain may be hitting a wall of resistance. A group of individuals called the Oregon Pain Action Group organized a protest on Thursday and it attracted media coverage both in Oregon and through an article on the National Pain Report.

The Oregon Health Evidence Review Commission (HERC) and its subcommittee Value-based Benefits Subcommittee (VbBS)will be submitting their proposed changes to Medicaid to discontinue long term opioids for chronic pain and fibromyalgia before August 9th meetings. The result of the media coverage is an increase in public comments to HERC from people living in Oregon and beyond which will become part of the public record.

More comments are expected.

While this policy is aimed specifically at Oregon’s Medicaid population, organizers in Oregon believe that whatever policy is adopted will be adopted by every insurance company.

Reaction to our story was swift and overwhelmingly critical. In less than a day several dozen persons, mostly chronic pain patients, wrote in the comment section of the National Pain Report and were unanimously opposed to the forced taper provision.

Other leaders from the pain community also weighed in over the weekend.

Bob Twillman, Ph.D., is the Executive Director for the Academy of Integrative Pain.  On Twitter, he said, “Beware the negative unintended consequences! This is just WRONG! Need patient-centered care, not draconian blanket regulations.”

Richard “Red” Lawhern, who is Co-Founder and Corresponding Secretary of the Alliance for the Treatment of Intractable Pain already has submitted a comment to HERC that included the following. “No non-pharmacological therapies for chronic pain have yet completed Phase II or Phase III trials.  Proposals to substitute these experimental methods for FDA-approved opioid therapy comprise a profound violation of widely accepted standards of medical evidence.  Denial of opioid therapy also constitutes a substantive risk to patient welfare and even life itself.”

Terri Lewis, Ph.D. pointed out the Oregon situation is another example of where states are pursuing policy in the absence of a national approach. It’s creating chaos for chronic pain patients.

“The situation in Oregon illustrates clearly the problem of our failure to uniformly define the range of public health care interventions that must be maintained to serve people on a continuum of health care no matter their age, illness, or geographic location. The cure for this conversation is for us to legislative append a definition of palliative care into Medicare law that is consistent with existing world health organization language.

“CMS should then define and flow down to Medicaid and other insurance plans the palliative care codes that enable appropriate care and require states to provide evidence that they are meeting the obligation to provide for and maintain resources for those with multiple chronic comorbid conditions.

“What is the matter with the Oregon Health Authority, that they believe it is okay to deny palliation for their citizens?  Have they found a cure that they refuse to share with the rest of us?  This is not the practice of medicine and it will cause great harm to their citizens.”

If you want to comment on the policy, you may via email. The address is herc.info@state.or.us. The Oregon Pain Action Group suggest you submit the comment by August 2nd. The limit, by the way, is 1000 words.

The comments are limited to 1000 words and it is recommended you put “VbBS” in the subject line to assure your comment is part of the record.

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