Pain Matters Podcast Network · AAPM - American Academy of Pain Medicine

History in the Making: The Battle for SCS Coverage in Washington State

·1 hr 3 min·4 clips

The report gave its highest weight to one Norway study and excluded the newer SCS comparator trials.

The Pain Matters Podcast looks at Washington State’s spinal cord stimulation coverage fight, where policy, evidence review, and patient access run into each other. Before November 17, 2023, Washington was the only state in the U.S. not extending SCS benefits to state employees, state-sponsored health plans, and injured workers under Washington Labor and Industries. That made the hearing matter. Doctors, medical societies, industry leaders, patients, and state senators all press for change. The Washington State Physicians Spinal Cord Stimulation Workgroup leads the challenge and goes after the HTCC report directly. Their complaint is simple: the evidence was inaccurate, outdated, and not clinically informed. The episode spends time on why comparator choice matters so much. In this field, it can decide what looks convincing and what gets ignored. It also gets into the practical problem that many large modern studies use standard comparator designs rather than sham controls. Those studies include newer waveforms and stimulation approaches, and the episode argues that leaving them out means leaving out some of the best available data. The gap between ideal evidence and usable evidence keeps coming up. That gap shapes how clinicians think about real patients, and it shapes what policymakers are willing to cover. The Washington State Healthcare Authority, which serves over two and a half million people, preliminarily voted to cover SCS. The HCA will reconvene later this month to define the stipulations. The episode keeps its focus on how that shift happened, not on calling it a finished win. It treats the hearing as a case study in contested coverage decisions and in how local pain experts can organize when a review process misses the clinical context. The result is a clear account of advocacy, method, and institutional change. The show frames the outcome as a move toward more inclusive care, not the end of the story.

As heard by us

A focused look at how Washington's spinal cord stimulation coverage fight moved from evidence debate to a preliminary vote.

Washington State's fight over spinal cord stimulation coverage comes through as a tightly argued policy story, anchored in clinical disagreement over what evidence counted and what got left out.

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Why you'd press play

Hear how Washington's SCS coverage fight moved from denial into a preliminary path to coverage.

Read the full recommendation in PlayNext →

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