Advocacy at IASP
IASP – International Advocates for Spine Patients – acts on the behalf of spine patients that have been denied coverage or reimbursement for spine care treatments and procedures by either public or private payors.
IASP advocacy efforts are being developed and undertaken by luminaries of the spine surgery community to advocate for the best spine care for patients.
IASP responds to public policy agencies that request information in support of spine procedures and treatments to provide evidence of the efficacy and influence policy decisions.
In the video testimonial below, Dr. Morgan Lorio responded to the US-based Agency of Healthcare Research and Quality request for comments on spinal fusion for painful lumbar degenerative disc or joint diseases:
IASP is taking on the task of expanding advocacy efforts for spine patients through advocacy activities that are outside the scope of the educational mission of our sister organization ISASS.
Advocacy at ISASS
ISASS – The International Society for the Advancement of Spine Surgery – supports spine patient advocacy efforts through the development of public policy statements supporting spinal procedures based on evidence based efficacy. This role includes the establishment of the ISASS Coding and Reimbursement Task Force and the rapid dissemination of Advocacy Alerts to develop and assist grass-roots advocacy efforts at the local level.
Recent Advocacy News at ISASS
ISASS President Steven Garfin rebuts the HCSC/BCBSIL draft policy changes noted in last week’s advocacy alert. “While many patients with degenerative disc disease or facet syndrome will not have that diagnosis as their sole indication, there are patients with chronic low back pain who have not responded to appropriate non-operative treatment and who will benefit from a surgical procedure. Those patients may now lose the opportunity of a clinically meaningful improvement.”
Earlier this week, HCSC, the parent corporation for Blue Cross/Blue Shield plans in Illinois, New Mexico, Oklahoma, and Texas, issued a new draft policy for Lumbar Spinal Fusions. Concerns have been raised that this new policy rules out access to lumbar fusion for patients where the sole indication is a disc herniation or neurostructure compression (initial discectomy / laminectomy), and patients with a sole indication of degenerative disc disease or facet syndrome. ISASS is preparing a response to HCSC and recommends that spine surgeons in those states review the draft policy and respond at the local level before the May 31, 2012 deadline.
ISASS President Steven Garfin, MD, has written a response to the Centers for Medicare & Medicaid Services Division of Outpatient care regarding the agency considering the removal of cervical disc arthroplasty from the Medicare “Inpatient Only” list.
“ISASS supports Medicare policies that will help spine surgeons deliver better and novel treatments to our patient population. Our experiences have shown us that cervical disc arthroplasty in selected patients can be safely performed in the outpatient setting, just as cervical fusion is now being conducted.”
March 2012 – Advocacy Alert: BCBS Minnesota Revises BMP Medical Policy IV-85
Orthopedics This Week is reporting that the Scoliosis Research Society and ISASS advocacy efforts regarding BMP Medical Policy IV-85 have resulted in review and change of their controversial policy. BCBS Minnesota “has rescinded a recent controversial policy of denying payment for ANY part of a surgery if BMPs are used off-label. [….] BCBS’s Vice President and Chief Medical Officer, Greg Gilmet, M.D., M.P.H., made good on the promise to consider revisions and informed SRS that the previous controversial policy was, ‘reviewed, modified, and posted,’ on the company’s website, effective March 9, 2012.”