Program likely will pay for some spinal injections

OLYMPIA -- Patients who receive spinal injections for chronic pain and get their medical bills paid by the state have until May 10 to comment on a decision that would stop coverage for the treatments under some circumstances.

The state's Health Technology Assessment Program published a draft decision last week outlining an 11-member committee's decision to continue paying for some spinal injections.

The decision applies to patients on Medicaid, people receiving medical care from the Department of Corrections, or whose medical bills are covered by programs under the Department of Labor & Industries such as workers compensation.

The committee reviewed information about the safety and effectiveness of spinal injections, which typically involve injection of an anesthetic or anti-inflammatory agent into or around spinal nerves and joints to relieve pain, at its March 18 meeting.

A preliminary decision made at that meeting would continue coverage for lumbar epidurals, cervical-thoracic epidurals and sacroiliac joint injections, but stop payments for nerve block injections, intradiscal injections and facet injections.

Coverage for the approved forms of spinal injections would be limited to certain conditions, including a failure of other pain management therapies, according to the documents published this week.

Spinal injection treatments were selected for review by the program in late 2009. The program identifies health care technologies to review for safety and effectiveness, essentially making sure the state and patients are getting the best bang for their buck.

The program was created by the Legislature and is directed by statute to evaluate medical technologies for safety, efficacy and cost-effectiveness.

The program evaluates about a dozen technologies each year.

The report includes information from medical literature as well as whatever public comments are submitted by doctors, patients or the general public.

Researchers don't make any recommendations about whether the state should continue paying for a type of treatment. That decision is made by an 11-member committee of health care professionals.

The report on spinal injections, prepared by a company called Spectrum Research, found from a review of medical literature that there was little or no benefit to patients from the use of spinal injections, such as epidurals, to manage back and neck pain.

But doctors and patients disputed that information, arguing the treatments are more effective than narcotic pain medicines and less costly than surgeries.

The draft decision on spinal injections is available online at hta.hca.wa.gov/spinal_injections.html.

Comments can be submitted by email to shtap@hca.wa.gov until 5 p.m. May 10.

The committee's next meeting is June 17 at the Sea-Tac Airport Conference Center.

This story was originally published May 1, 2011 at 12:00 AM with the headline "Program likely will pay for some spinal injections."