SUBJECT: S. 586, Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act
Dear Senators Capito, Shaheen, Portman and Manchin:
On behalf of the American Association of Neurological Surgeons (AANS), the Congress of Neurological
Surgeons (CNS), the AANS/CNS Joint Section on Pain and the AANS/CNS Joint Section on Disorders of
the Spine and Peripheral Nerves, we enthusiastically support S. 586, the Non-Opioids Prevent Addiction
in the Nation (NOPAIN) Act. Since neurosurgeons are on the cutting edge of innovative, non-opioid
treatments for chronic pain and acute postoperative pain, we commend you for leading this initiative.
Your legislation would appropriately require the Centers for Medicare & Medicaid Services to provide
separate Medicare payments for non-opioid treatments used to manage pain in both the hospital
outpatient department and the ambulatory surgery center (ASC) settings. Under the NOPAIN Act,
reimbursement for qualifying devices would be similar to the amount paid by a hospital or ASC for a
medical device under transitional “pass-through” status. This payment would be implemented by
creating new payment categories — Ambulatory Payment Classifications — for qualifying treatments.
Also, payment for qualifying drugs and biologics would be equivalent to the current Medicare Part B
payment amount for other separately paid drugs and biologics — which is based on a percentage of the
product’s Average Sales Price.
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