A proposal by the Centers for Medicare & Medicaid Services to remove pain management questions from hospitals’ value-based purchasing scores drew the ire of some clinical advocates, who say the change would hurt patients.

CMS said their plan would help decrease the number of opioid prescriptions given by clinicians, and would address opioid overuse. Many physicians have told CMS they are pressured by patients to prescribe pain-relieving medications based on the questions they ask. Negative feedback from the questions results in lower scores, which in turn led to less revenue.

In response to the proposal, a coalition of pain medicine societies sent a letter to the CMS lobbying that the questions be retained until better ones could be written to replace them. The letter argued that there was no evidence linking the questions to overprescription of opioids and warned it would revert care back to a time where pain was not adequately treated. It added that eliminating the questions would “send the wrong message to clinicians and patients” and impact data used to improve pain management.

The coalition consisted of the American Pain Society, the American Academy of Pain Medicine, and the American Academy of Hospice and Palliative Medicine.