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  • CMS Retains Clinical Study Requirement in Final TENS Decision Memo

    Despite APTA's urging for continued Medicare coverage of TENS for chronic low back pain (CLBP) and additional research regarding the circumstances when the use of TENS for CLBP is effective, the Centers for Medicare and Medicaid Services (CMS) finalized the requirement of enrollment in an approved clinical study to receive coverage for TENS for CLBP.

    In its final decision memo, CMS said that the clinical study requirement is to support additional research on the use of TENS for CLBP, and this requirement will expire in 3 years. CMS says in the memo that based on its review of the evidence, "… we have determined that TENS is not reasonable and necessary for CLBP under 1862(a)(1)(A) of the Act. Neither the comments we received, nor the discussions that we have had with industry and investigators, have provided us with the persuasive scientific evidence to reach a different conclusion." Thus, at the expiration of the 3-year clinical study requirement, TENS for CLBP will not be covered, as it will be considered not reasonable and necessary.

    Links to APTA's comments and summary on the National Coverage Analysis Tracking Sheet for TENS for Chronic Low Back Pain can be found on APTA's Medicare Coverage Issues webpage.

    APTA members commented extensively on CMS's proposal memo in News Now coverage posted March 14 and April 3.

    Physical and Cognitive Rest Associated With Reduced Concussion Symptoms

    A week of cognitive and physical rest—which included taking time off from school or work and avoiding talking on the phone, exercising, watching TV, socializing, or working at a computer—alleviated symptoms of concussion in 49 high school and college athletes, according to a Reuters Health article based on a study in The Journal of Pediatrics.

    To measure the effect of "an intensive bout of rest" after a concussion, researchers evaluated the athletes between April 2010 and September 2011 and assigned them to groups based on the time elapsed between sustaining a concussion and the onset of rest. Fourteen of the patients started the rest within a week of their injuries. Another 22 patients began resting within a month of the concussion, and 13 patients began the week of rest between 1 and 7 months after the concussion.

    At the beginning of the study, all of the patients had symptoms related to the injury, such as headaches and trouble concentrating.

    After the week of rest, all groups saw their symptoms improve regardless of the time between concussion and onset of rest. Among the athletes who started the rest within a week of their concussion, their symptoms improved from a score of 22 on a 132-point scale down to 7, says the article.