Medicare and Medicaid financing of pain management.

Many Americans who endure pain are beneficiaries of the Medicare and Medicaid programs; however, these programs have many gaps and deficiencies and fail to cover some vital pain management services. Moreover, Medicare and Medicaid provider certification requirements and payment provisions fail to attend to pain management issues, creating disincentives for the provision of adequate pain treatment. Finally, Medicare and Medicaid surveillance and enforcement programs might be deterring adequate provision of pain management. This article reviews these problem areas, and suggests reforms that would address them.