The health care industry is moving at a fast pace where health care providers and their patients continue to strive for guidance and additional support from specialty societies. Current NASS practice has been reactively responding to requests from various insurance companies by sharing our expert opinions in reviewing coverage policies. However, in June 2012, to meet the complexity of the health delivery system and ongoing demands of NASS members and their patients, the NASS Board of Directors approved the formation of a multi-specialty team to proactively develop credible and reasonable coverage recommendations for NASS to share with payors, patients and spine care providers. The group determined the topics, from therapeutic to diagnostic procedures including non-operative, interventional, and surgical procedures. NASS reviewed and selected topics that represent a wide variety of frequently-used care tools.
In May 2014, after more than a year of rigorous scientific literature review, drafting and editing, NASS approved its first set of coverage recommendations. NASS has recently published these 13 coverage recommendations (https://www.spine.org/Pages/PolicyPractice/Coverage/CoverageRecommendations.aspx) with a plan to publish more in coming months.
These coverage recommendations use an evidence-based approach to spinal care where possible. In the absence of high-level data, policies reflect the multi-disciplinary experience and expertise of the committee members in order to present reasonable standard practice indications in the United States.
It is our strong intent and vision that insurance providers and their patients will utilize these coverage recommendations as a reference to guide appropriate coverage decisions and to guard against inappropriate denial of quality spinal care.
NASS coverage recommendations will be revised periodically based on the availability of new evidence-based literature and the feedback we receive from interested parties. For more information on NASS’ coverage activities, please contact us at firstname.lastname@example.org.