Healthcare practice, including pain management, is governed at the state level and not by federal laws. Numerous barriers continue to affect the provision of pain care. A prevalent barrier is the presence of state policies that create undue restrictions or practice ambiguities. Healthcare professionals need to understand the state statutes and regulatory policies that govern practice in their state so that they remain in compliance with, and thoroughly conform to, legal standards.

The University of Wisconsin Pain and Policy Studies Group (PPSG) has created the Progress Report Card to evaluate the ability of state policies to support pain management and palliative care by looking at the language in laws and regulations and assigning a letter grade from A to F. The PPSG examined these policies and laws for language that would impede or enhance practices in healthcare to help alleviate pain in patients. Over the last 12 years, PPSG has published six Progress Report Cards and has found significant improvement in states’ policies over time.

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