A recent piece in The New York Times reports a study in the Journal of the American Medical Association that found an increase in spending on spinal treatments to $86 billion in 2005, 65% higher than it was in 1997, with no evidence of improvement in health status. It quotes one of the authors: “We are putting a lot of money into this problem, and it’s a big investment in health care expenditures, but we’re not seeing health status commensurate with those investments.” [See "Americans Spend More On Treating Their Backs," The New York Times, February 13, 2008]
This commentary by Merle C. Rabine examines two recent California Workers' Compensation Appeals Board panel decisions - Sepeda and Barrera - involving whether controversial and expensive spinal treatments, artificial disc replacement and manipulation under anesthesia, are reasonable and necessary to cure or relieve from applicants’ industrial injuries. The panels do not address the issue of cost. Instead, they focus on whether the proposed treatment is reasonable and necessary. The opinions taken together provide some guidance to practitioners about how to approach the issues.
To read Rabine's comments and practice points on this topic, see his expert commentary article.
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