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Advocates pressure Oregon to cover Fibromyalgia treatments

Monday 7 October 2013


From US news outlet the Portland Business Journal:


Woman - back pain
(Photo: Lea Kavcic)

Advocates pressure Oregon to cover fibromyalgia treatments

Staff reporter - Portland Business Journal
Oct 4, 2013, 2:10pm PDT
UPDATED: Oct 4, 2013, 2:39pm PDT

Oregon is the only state whose Medicaid program doesn’t cover treatment for fibromyalgia, which causes chronic muscle pain.

But patients, doctors and advocates are working to change that — and soon. Next Thursday, they will ask Oregon health policymakers to consider adding fibromyalgia onto the Prioritized List of 498 conditions covered by Oregon Medicaid reimbursement. They will testify before a subcommittee of the Health Evidence Review Commission.

One reason the condition is currently listed way down on line 634 is that it has a history of being misunderstood and dismissed as depression, especially in women.

“It was thought to be a psychological problem,” said Dr. Robert Bennett, a professor of medicine at Oregon Health & Science University, who has been researching the disorder for the past 35 years. “It’s gradually emerged as a significant problem.”

Bennett said much has changed in recent years. Fibromyalgia is now recognized by the World Health Organization and will be included next year on the International Classification of Diseases coding. This is the official system for diagnoses and procedures associated with medical reimbursement in the U.S.

Bennett said private insurance generally covers treatment. It is also recognized by the Social Security Administration as grounds for disability.

Bennett said fibromyalgia is the third most common pain condition, affecting 5 percent of women and 1 percent of men. The National Fibromyalgia & Chronic Pain Association estimates 117,000 Oregonians suffer from the disorder.

The condition is caused by an abnormality in the nervous system at the molecular level. It causes widespread pain and tenderness, fatigue, sleep disturbances, cognitive difficulties and stiffness, as well as depression, anxiety and migraines.

There are three drugs approved to treat it that work at specified sites in the nervous system. It can also be treated with special exercises, physical therapy and cognitive behavioral therapy.

“A whole lot of things can be done to help these patients now,” Bennett said. "I think most doctors are aware of it and don’t dismiss it as they have in the past.”

When symptoms go untreated, they can increase over time, said Jan Favero Chambers, founder and president of the fibromyalgia association. She said coverage is important because it will mean earlier diagnoses, better symptom management and fewer people on disability.

Dr. Ginevra Liptan with Legacy Medical Group-Good Samaritan said her clinic's patients are 40 percent Medicaid. When one is diagnosed with fibromyalgia, she is limited to treating them with opiates, which don't work well and are dangerous. Or she can refer them to physical therapy, but Medicaid won't cover that treatment if the pain is associated with fibromyalgia.

"It ends up being really frustrating to patients and doctors because we're limited in the tools we can utilize," Liptan said. "It keeps it a second-class diagnosis."

Elizabeth Hayes covers health care for the Business Journal.


The above, with comments, originally appeared here.


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