Public Financing of Pain Management: Leaky Umbrellas and Ragged Safety Nets

Abstract:     
The undertreatment of pain has increasingly been recognized in recent years as a major problem. Many persons in pain are dependent upon public health care financing programs for their medical care. Limitations in these programs is a significant contributing factor to the undertreatment of pain. This article analyzes gaps and deficiencies in the Medicare and Medicaid programs with respect to pain management. Particular problems in Medicare include its lack of coverage of outpatient medications, its skilled nursing home standards, and its restrictions on hospice coverage. Problems with Medicaid drug coverage and drug use limitations are also explored. Finally, the effect of Medicare and Medicaid fraud and abuse law in potentially deterring adequate pain management is also considered. The article includes recommendations for covering and encouraging proper pain management in Medicare and Medicaid.

JEL Classifications: I11, I12, I18

Accepted Paper Series