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American Society of Interventional Pain Physicians News  | February 26, 2014





  1. The Saga of Draconian Cuts Continues: Emergency RUC Survey Requested
  2. IPM in Perfect Storm: Experience Relief in Annual Meeting
  3. Documentation, Billing, and Coding Webinar Scheduled for March 13
  4. Health Law Already Has Impact on Bottom Lines
  5. CMS Report: 65% Of Small Business Will Pay Higher Premiums Due To ACA
  6. CMS Proposes 1.9% Cut in Medicare Advantage Pay
  7. Obamacare stats still hard to nail down
  8. Comparative Studies: No Informed Consent Needed?
  9. Drug Testing Company to Pay $5 Million Civil Money Penalty Settlement
  10. Killing Pain: Benzo 'Boost' Can Be Deadly
  11. Keep your patients informed and entertained with ASIPP-TV24 in your waiting room
  12. 2014 Work Plan Highlights for Physicians
  13. ICD-10 Follies: Sucked Into Jet Engine
  14. State Society News
  15. Physician Wanted

emergencyThe Saga of Draconian Cuts Continues: Emergency RUC Survey Requested 



It appears that while we continue our work in Phase 1, we are also entering Phase 2.

On 2/20/2014, the Honorable Congressman Ed Whitfield personally spoke with CMS Administrator Marilyn Tavenner, even though there were multiple staff contacts in the past from various Congressional offices. Following the conversation, we arrived, in no uncertain terms, at 2 conclusions.


1. Multiple personal phone calls from Members of Congress to Administrator Tavenner are required.


2. An emergency resurvey by the AMA-RUC of CPT codes 62310 through 62319 and 77003 to be completed by the April RUC meeting is necessary.


We are pursuing both avenues and we have seeking collaboration with the ASA, NASS, ISIS, and AAPM.


Also we have a meeting scheduled with CMS on March 27.

As you are well aware, we are facing multiple issues not only with these SGR cuts, continued sequestered cuts, PQRI, and electronic reporting cuts. Further, major expenses and cash crunches are expected with the implementation of ICD-10.

On behalf of interventional pain physicians, just from ASIPP alone, we have sent over 11,000 letters to CMS and over 65,000 letters to members of the congress. In addition, at least 40 Members of Congress have been involved with phone calls and letters.


Consequently, the only solution for these draconian cuts, and the resulting problems which are mounting on a daily basis, appears to be an emergency survey of these codes by the AMA-RUC. (SEE ASIPP Request Letter to the AMA RUC)


We are also working on getting as many Members of Congress as possible to make phone calls to Administrator Tavenner. (See Letter of Request to Sen. Pryor)


Once again, let us be calm, cool, and collected. As Lincoln stated, "A house divided against itself, cannot stand."


We will keep you posted with the developments. If you know a representative or a senator, please contact them and ask them to directly to speak to CMS. You can provide the points as in the attached letter.

annualIPM in Perfect Storm: Experience Relief in Annual Meeting






Pre-Registration New This Year!

For your convenience ASIPP will offer preregistration on Thursday, April 3 from 4pm-7pm. Take care of your registration early and enjoy some of the New Orleans night life.



There is no question that we are facing a perfect storm for interventional pain management. We are all quite certain that everyone has recognized this by this time. A perfect storm is, as described by supporters of the present administration, as a confluence of many factors or events - none of which alone is particularly devastating - creates a catastrophic force. Many of us think that such a confluence is devastating and rare, especially for a small evolving specialty such as interventional pain management.



This Annual Meeting is focusing on all the issues leading to the perfect storm and hopefully we will develop a strategy to get out of the storm. Some of the lifesaving topics will be:

  • Raj-Racz Distinguished Lecture -- Navigating Uncertainty in Health Care and Surviving as Individual Pain Physicians in the New Era by Honorable Benjamin Sasse, PhD
  • Manchikanti Distinguished Lecture - Interventional Pain Management and the Media in the New Era by Devi E. Nampiaparampil, MD
  • Onerous Regulations and Draconian Cuts: Optimizing Practice Patterns for Future Survival by Laxmaiah Manchikanti, MD
  • Independent Practice of IPM: Is It Feasible? by Debra Beaulieu and many others.


Exhibitor Reception In Exhibit Hall


Your invited to a special Exhibitor Reception for Meeting attendees on Friday, April 4th from 6pm-7pm in the Exhibit Hall. Complimentary food and drinks will be served while attendees have an opportunity to mix and mingle with over 50 vendors. Exbitibors will be available to demonstrate products,discuss services, answer questions, and develop mutually beneficial relationships. You may find new ways to offer better services, at better prices through new vendor contacts. Click here to view exhibitor floor plan.  




If you are unable to book a room at the Hilton New Orleans Riverside, rooms are available at several nearby hotels.

  • Harrah's New Orleans - 228 Poydras Street - 800-427-7247
  • Hyatt Place New Orleans Convention Center - 881 Convention Center Blvd. - 504-524-1881
  • Lafayette Hotel - 600 Saint Charles Avenue - 866-460-7454
  • Courtyard by Marriott New Orleans Downtown/Convention Center - 300 Julia - 504-598-9898
  • St. James Hotel, an Ascend Hotel Collection Member - 330 Magazine Street - 866-599-6674

 Visit the 2014 ASIPP Annual Meeting Website for more details


 Exhibitor Reception In Exhibit Hall


Your invited to a special Exhibitor Reception for Meeting attendees on Friday, April 4th from 6pm-7pm in the Exhibit Hall. Complimentary food and drinks will be served while attendees have an opportunity to mix and mingle with over 50 vendors. Exbitibors will be available to demonstrate products,discuss services, answer questions, and develop mutually beneficial relationships. You may find new ways to offer better services, at better prices through new vendor contacts.


Join ASIPP's Annual Meeting as an exhibitor and meet with hundreds of Interventional Pain Physicians. It's a great opportunity to build Physician relationships. Click here to view exhibitor floor plan. 


Visit the 2014 ASIPP Annual Meeting Website for more detail




webinarDocumentation, Billing, and Coding Webinar Set for March 13
Dr. Laxmaiah Manchikanti will present this webinar from 6 to 730 pm March 13,2014


Cost for the webinar is $175. Participants may receive 1.5 Credit Hours.
The incorporation of documentation measures into a physician practice should not be at the expense of patient care, but instead should augment the ability of the physician practice to provide quality patient care.
A well-designed documentation program can:
* Speed and optimize proper payment of claims.
* Minimize billing mistakes.
* Reduce the chances that an audit will be conducted by HCFA or the OIG.
* Avoid conflicts with the self-referral and anti-kickback statutes.
* Avoid submitting claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

Recently documentation in IPM has been under attack from all carriers as well as recovery contractors, OIG, and others. OIG may seek civil monetary penalties and sometimes exclusion for a wide variety of conduct and is authorized to seek different amounts of penalties and assessments based on the type of violation at issue. Penalties range from $10,000 to $50,000 per violation.

In this innovative and interactive webinar, we will evaluate the rules and regulations of documentation, billing, and coding, along with practical examples and case presentations.
This webinar is intended for interventional pain management specialist, nurses, staff, and other healthcare providers.
Click HERE to register


impactHealth Law Already Has Impact on Bottom Lines


The Affordable Care Act's impact on the bottom line is starting to ripple across corporate America.

More than 80 public companies told investors the new health-care rules were, or could be, a financial boost or drag on their quarterly earnings, though they were often uncertain of the magnitude, according to a Wall Street Journal search of earnings-call transcripts for the most recent quarter provided by FactSet.


The Congressional Budget Office's most recent estimate of the ACA's budgetary impact is $1.36 trillion between 2014 and 2023. The financial effects on businesses are evolving as changes are made to the legislation, including a decision this month to again delay when many smaller companies will face a fine if they fail to offer health insurance.


Wall Street Journal

Access to this article may be limited.

cmsCMS Report: 65% Of Small Business Will Pay Higher Premiums Due To ACA


According to the Wall Street Journal, a new CMS report concludes that as a result of the passage of the Affordable Care Act, 65% of small business will have to pay higher health insurance premiums. The Journal notes that the report did not provide an estimate of what the average increase is. The Journal notes that Speaker John Boehner said, "The Obama administration has finally been forced to disclose what we've long feared: the president's health-care law means higher premiums for millions of American workers."


On its website, CNN reports that while Republicans "are seizing on a new report," Democrats "point out that Republicans designed and ordered the report, which they say ignores billions of dollars in subsidies that will decrease those premiums." CNN also notes that CMS "released the report on Friday with little fanfare," and "neither the HHS website nor the CMS website shows a news release...about the report."


Wall Street Journal




Access to this article may be limited.

proposesCMS Proposes 1.9% Cut in Medicare Advantage Pay


CMS logo An Obama administration announcement about payment rates for Medicare Advantage plans in 2015 has set off a dispute about how large -- or small -- the changes really are.


Late Friday, the Centers for Medicare and Medicaid Services (CMS) announced proposed rates that officials said could mean payment reductions of 1.9% for the private plans in the program.


But insurers, who have led a fierce lobbying campaign against payment reductions, say the Medicare Advantage plans would sustain a far deeper cut. That's because the lower payment rates will be combined with new health law fees on health plans, a phase-out of the "star rating" system that helped buffer the reductions for Medicare Advantage plans in prior years, and Medicare cuts in the automatic federal spending cuts known as "sequestration."



MedPage Today

statsObamacare stats still hard to nail down


When you go to all this trouble to cover the uninsured, is it really that unreasonable to ask how many uninsured people Obamacare has covered so far?


The answer, apparently, is: Yes. It's unreasonable.


The truth is, nobody has a good, real-time fix on how successful the Affordable Care Act has been in reducing the ranks of the uninsured. The Obama administration hasn't been able to say how many of the 3.3 million people who have signed up for private health insurance coverage, or of the 6.3 million who have been determined eligible for Medicaid, were actually uninsured before - and health care experts aren't sure yet, either.



studiesComparative Studies: No Informed Consent Needed?


Randomized comparative effectiveness trials could be done in routine clinical practice without informed consent in some circumstances, one group argued.


The key requirement is that patients know that they're getting care at an institution that integrates such research into clinical care -- what's termed a learning healthcare system, Ruth Faden, PhD, MPH, of Johns Hopkins University in Baltimore, and colleagues explained in an article outlining the ethical basis for skipping or streamlining informed consent.



MedPage Today

drugDrug Testing Company to Pay $5 Million Civil Money Penalty Settlement



Washington, DC -- Medicus Laboratories, LLC (Medicus) has agreed to pay $5 million and enter into a 5-year Corporate Integrity Agreement with the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). The settlement reflects OIG's ongoing efforts to combat fraud in the urine drug testing industry through a unique combination of audits, investigations, and legal remedies.


The settlement resolves OIG's allegations that Dallas-based Medicus violated the Civil Monetary Penalties Law by submitting false or fraudulent claims to Medicare. Specifically, OIG contended that Medicus knowingly presented multiple, prohibited claims to Medicare for a single patient encounter and submitted claims for other laboratory tests not covered by Medicare.


"OIG uses a multidisciplinary approach to protect HHS programs," said Gregory E. Demske, Chief Counsel to the Inspector General. "This matter, begun through OIG data-mining by OIG auditors, shows that once we uncover fraudulent billing, OIG will quickly shift gears and impose civil money penalties to recover taxpayer dollars and ensure that Medicare providers abide by the rules."


"As the largest payer of clinical laboratory services, Medicare is vulnerable to fraud, waste, and abuse. This case serves as an example of our continued efforts to protect the integrity of Medicare payments for clinical lab services," said Brian P. Ritchie, Assistant Inspector General for OIG's Centers for Medicare & Medicaid audits.

In resolving this matter through settlement Medicus has denied any liability. No judgment or finding of liability has been made against Medicus.




benzoKilling Pain: Benzo 'Boost' Can Be Deadly


Only Michael Moore knew the combination to the safe in his bedroom closet. He had locked up his prescriptions for chronic pain and insomnia so his two young children could not get into them.

As it turned out, it was Moore, 49, who needed the protection.


On Nov. 3, 2012, Moore, a computer analyst from Milwaukee who had suffered a serious knee injury years earlier, died of an accidental overdose. When police opened the safe they found hundreds of two types of prescription pills: opioids and benzodiazepines.



MedPage Today


keepKeep your patients informed and entertained with ASIPP-TV24 in your waiting room

With ASIPP-TV24 our patients will view TV programming about Interventional Pain Management furnished by the American Society of Interventional Pain Physicians (ASIPP) and video of your practice if you choose. Your waiting room patients will increase their awareness of pain management issues and procedures by watching ASIPP-TV24.


And this relevant and appealing programming will also lessen the perceived wait time for patients and caregivers. ASIPP-TV24 is easy to setup and run. A media player and all of the content, administration, and technical support is handled by ASIPP and it's partner Tanager Productions. Fresh content is downloaded to your office on a regular basis. All of this for a subscription fee as low as $35 per month.

For more information Click Here.

workplan2014 Work Plan Highlights for Physicians


On January 31, 2014, the Office of Inspector General ("OIG") finally released its Work Plan for fiscal year 2014. The Work Plan is a dense summary of the OIG's various enforcement priorities for the year. This overview is specifically for physicians, hospitals, and other health care providers. Some of this year's plan's significant focus areas are discussed below.


Place-of-service coding errors


Federal reimbursement regulations, including Medicare regulations, provide different levels of payment depending on the setting of the performed services. Non-facility or physician clinic payments are higher than many hospital-based payments. Specifically, OIG will be looking at the services provided in ambulatory surgical centers and hospital outpatient departments to see whether miscoding with respect to the site of services is a source of Medicare overpayment and as such can be recovered from providers.



Law Review


folliesICD-10 Follies: Sucked Into Jet Engine


It is 217 days before the move to ICD-10 becomes a must-do. Lest the deadline slip your mind, MedPage Today is spotlighting some of those thousands of new codes that might just be getting a bit too granular.


Today's code:

V97.33XD: Sucked into jet engine, subsequent encounter


Other "Follies"

W61.92: Struck by other birds

Z63.1: Problems in relationship with in-laws

W45.8XXA: Other foreign body or object entering through skin, initial encounter

V52.2XXA: Person on outside of pick-up truck or van injured in collision with two- or three-wheeled motor vehicle in nontraffic accident, initial encounter

V00.32: Snow-ski accident

X92.0: Assault by drowning and submersion while in bathtub

W00.1: Fall from stairs and steps due to ice and snow


MedPage Today

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stateState Society News




Georgia Society Chapter Plans Meeting



The Georgia Society of Interventional Pain Physicians (GSIPP) will have its 10th Annual Pain Summit April 25 - 27, 2014 at The Ritz Carlton Lodge Reynolds Plantation in Greensboro, GA.




For more information and registration, visit www.gsipp.com


CASIPP Sets Date for Annual Meeting


The California Society of Interventional Pain Physicians will hold its 2014 annual meeting September 12-14 at the Terranea Resort (www.terranea.com) in Rancho Palos Verdes, CA.


For more information, go to www.casipp.com




* Please send in your State Society meeting news to:
 Holly Long at hlong@asipp.org








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