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The Health Evidence Review Commission (HERC), will reopen discussions this winter on the coverage guidelines related to neck and back pain implemented in 2016.
OHA and HERC leadership say new evidence regarding opioid therapy and opioid tapering that have emerged over the past year warranted another look at the back pain guidelines. At its May 16 meeting HERC will continue its deliberations on the chronic pain proposal currently under consideration, lifting a pause requested by OHA leadership while a third-party review was underway.
In 2016 HERC expanded Oregon Health Plan coverage for neck and back pain, newly approving non-pharmacological services such as physical and occupational therapy, cognitive behavioral therapy, acupuncture and yoga. The benefit package also included a one-year timeline to taper neck and back pain patients from long-term opioid therapy.
In 2017 OHA convened the Chronic Pain Task Force to explore whether a similar expansion of services should be offered for OHP patients with five other chronic pain conditions: chronic pain due to trauma, post-procedural chronic pain, chronic pain syndrome, other chronic pain, and fibromyalgia. Currently, these conditions are not intended to be covered by OHP.
The proposal that was informed by the task force garnered considerable concern and attention from advocates, providers and experts across the country, prompting deeper dives into the evidence. Most recently OHA commissioned a third-party review by Washington-based Aggregate Analytics Inc. (AAI) to evaluate how closely the proposal aligned with available evidence.
HERC deliberations on chronic pain proposal to continue
On May 16 the HERC will be presented with findings from AAI’s report alongside their options to consider regarding coverage for the five chronic pain conditions.
The three options OHA staff will present for HERC’s consideration include:
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Option 1: Make no changes to the coverage for five chronic pain conditions and their treatments due to insufficient evidence of effectiveness.
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Option 2: Adopt the modified Chronic Pain Task Force proposal for reprioritization of the five conditions and their treatments, as presented at the March 2019 Value-based Benefits Subcommittee (VbBS)/HERC meetings
- Adds coverage for various non-pharmacologic therapies such as cognitive behavioral therapy, physical therapy and acupuncture.
- Adds coverage for non-opioid pharmacologic therapies such as gabapentin, pregabalin and duloxetine.
- Adds coverage for opioid therapy for four of the five conditions for appropriate patients.
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Option 3: Adopt a further revised proposal for reprioritization, informed by the recent AAI evidence appraisal and public input, as modified by OHA staff.
- Adds all benefits from option 2.
- Additional options for consideration related to long-term opioid therapy coverage, including for fibromyalgia.
HERC will meet Thursday from 1:30 to 4:30 p.m. at the Clackamas Community College Wilsonville Training Center, Rooms 111-112, 29353 SW Town Center Loop E in Wilsonville. The full meeting materials, including the AAI report, are available on the OHA website.
 Two Oregonians living with mental illness tell their stories in a video released by OHA Tuesday as part of Mental Health Awareness Month. The purpose of the video and other activities this month is to to raise awareness, fight stigma and encourage struggling individuals to seek help. Learn more on our Community Mental Health webpage.
Oregon’s public health system is making good on its pledge to reduce communicable diseases, by improving child immunizations and tackling rising rates of sexually transmitted infections.
That's the take-away from two reports the Oregon Health Authority published this week.
The annual Public Health Accountability Metrics Annual Report from the Public Health Division gives an in-depth look at how Oregon’s public health system is doing compared to a year ago on key health issues.
And the latest Public Health Modernization Implementation report updates how eight regional partnerships are using Oregon legislative funds to transition from a traditional to a modern public health system statewide in three priority areas: communicable disease control; health equity and cultural responsiveness; and assessment and epidemiology.
"These reports show we are making progress on key health issues like childhood immunization and the rapid rise in sexually transmitted infections," says Oregon Public Health Director Lillian Shirley. The Accountability Metrics Report also looks at progress toward reducing tobacco use and prescription opioid mortality, and improving access to clean water and active transportation modes.
Learn more:
OHA Public Health Division Accountability Metrics.
OHA Public Health Modernization.
If you missed the monthly Stakeholder Meeting on May 8, you can listen to a recording of the event and download the meeting presentation on the OHA Government Relations webpage.
The meeting covered OHA bills still pending in the Legislature and other topics.
Pending bills include those dealing with Medicaid funding, Healthy Starts, public health modernization, health care transformation and more.
Important dates coming up at the Legislature include:
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May 15 is the statewide revenue forecast. This forecast identifies how much money will be available, under current law, in the General Funds, Lottery Funds, and other statutorily set funds.
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May 24 is the deadline for bills to be passed out of work session in the second chamber.
The May 24 deadline does not apply to bills in certain committees, mostly budget committees such as the Joint Ways and Means.
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