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American Society of Interventional Pain Physicians News  | April 16, 2014




  1. A Reprieve from Draconian Cuts for 2015; but Devastating Cuts in 2014 Not Yet Reversed: The Struggle for IPM Continues
  2. Dr. Kenneth Candido Named RUC Rep for ASIPP
  3. Help Us Keep the ASIPP Seat on the AMA HOD: Join or Renew Your AMA Membership Today!
  4. Register Today: Spinal & NonSpinal Interventional Techniques Offered Just One Time This Year: June 20-21
  5. Save the Date: ASIPP to Hold Practice Management Webinar May 13
  6. How Being a Doctor Became the Most Miserable Profession 
  7. Surge in Narcotic Prescriptions for Pregnant Women
  8. How Morcellators Simplified the Hysterectomy but Posed a Hidden Cancer Risk
  9. ACP keynote: Physicians must engage on healthcare costs to strengthen relationships with patients
  10. New state laws aim to clear up patient confusion
  11. New state law requires AMA grace period notification
  12. DIY Opioid Antidote Gets Fast FDA Approval
  13. Meaningful use exemption added as EHR program moves forward
  14. Free HIPAA risk assessment tool can help ensure compliance
  15. Creating a better health care system: Experts explore options
  16. Sebelius announces resignation amidst ACA, ICD-10 and SGR challenges
  17. Who Is Sylvia Burwell, HHS Secretary Sebelius's Expected Replacement?
  18. Labor Split Boosts Ohio Governor
  19. Two New Studies Raise Red Flags on Obamacare
  20. Doctor-Pay Trove Shows Limits of Medicare Billing Data
  21. Poll: Health law's campaign clout bad news for Democrats
  22. AMA: Docs Add $1.6 Trillion to Economy
  23. State Society News
  24. Physician Wanted

dracoA Reprieve from Draconian Cuts for 2015; but Devastating Cuts in 2014 Not Yet Reversed: The Struggle for IPM Continues


One step forward and two steps back. That seems to be the pattern as ASIPP continues to fight epidural cuts. We are making progress as we enter Phase 3 of our battle, but challenges still remain.


Draconian epidural cuts will be fixed for 2015, most likely in the physician payment proposed rule that will be published in June 2014. However, the cuts are in place for now and will remain in place for the rest of this year. CMS Administrator Marilyn Tavenner has stated that she will personally oversee that the fix is made for 2015. According to Ms. Tavenner, her staff approved the cuts without first getting AMA's recommendations. She plans on changing their internal processes so that does not happen again. Exact details are forthcoming, but it is likely that AMA's RUC recommendation will be followed.


Reversing these cuts in 2015 is a prime example of how advocacy and action can make things happen. Ms. Tavenner has emphasized that she was contacted on this issue by numerous individuals. In addition, there were 11,000 letters sent to CMS, 65,000 letters sent to Congress, and 40 letters from members of Congress to CMS on this issue. As an organization we need to remember that we can effect change if we speak with one voice and if that voice is loud enough to be heard.


ASIPP Board Member John Swicegood, MD and his wife Cindy deserve credit for getting the Arkansas congressional delegation involved. A special thank you is in order to Representative Ed Whitfield (R-KY) for working with this Arkansas delegation, including the state's two US senators and four US House members.


 That still leaves the problem of epidural cuts for this year. Having them reversed is our next goal. Numerous meetings have been held with staff members of the House Energy and Commerce Committee. We are happy to announce that House Majority Leader Eric Cantor (R-VA) is becoming involved with resolving this issue. At the recent ASIPP Annual Meeting, Leader Cantor met with ASIPP representatives where we outlined our concerns to him. You may see the presentation we provided to CMS and congressional members at this link.  (See CMS Presentation)


Victories like this cost money. If we hope to continue this fight over epidural cuts we will need your help. Please make sure your dues are up to date. Also, please consider making an additional contribution here. Together we can help our patients, save our specialty, and ensure our livelihood.

rucDr. Kenneth Candido Named RUC Rep for ASIPP



Dr. Kenneth Candido has been named the ASIPP representative on the Relative Value Unit Committee (RUC). Candido practices interventional pain management at the Advocate Illinois Masonic Medical Center in Chicago, IL. He is a long-time member of ASIPP, as well as a faculty member for ASIPP workshops and meetings.


juneRegister Today: Spinal & NonSpinal Interventional Techniques Offered Just One Time This Year: June 20-21




This 2-day comprehensive review course and cadaver workshop on spinal interventional techniques (basic and intermediate levels) and non-spinal interventional techniques. Participants experience a comprehensive and intense learning opportunity, focusing on interventional pain management techniques.



This intensive review course in spinal and non-spinal interventional techniques is planned as a CME activity for interventional pain physicians-for review, skills improvement or to fullfil state board requirements for CME hours.



After this course, participants should be able to:

- Describe the delivery of multiple aspects of interventional pain management.

- Review multiple areas of interventional pain management including spinal and non-spinal techniques.

- Demonstrate skills through interactive hands-on cadaver workshop.



Physicians should be able to integrate multiple aspects of spinal and non-spinal techniques in interventional pain management in treating their patients so that patients have better outcomes and reduced side effects.






212 N. Kingshighway, St. Louis, MO 63108 - (877) 587-2427

Each tastefully decorated space welcomes you with a comforting array of amenities and personal touches, including fine cotton sheets, generously sized towels and pre­mium toiletries.The discounted nightly rate of $160 is available through May 30, 2014 or until sold out which ever occurs first. Ask for the ASIPP room block when registering.


CLICK HERE for Brochure


CLICK HERE to Register

webinarSave the Date: ASIPP to Hold Practice Management Webinar May 13



May 13, 2014 | 11:00am CST

Mark your calendar

This 90 minute webinar will be presented by Gary M. Janko, Executive Vice President & COO

Pain Solutions Management Group, LLC

His experience includes leadership positions in both the provider and payer sectors of the health care system. He is a regular contributor to practice management journals, and lectures on critical business issues affecting medical practices. He is a regular faculty member for ASIPP meetings.

(Complete information to be announced soon)

amaHelp Us Keep the ASIPP Seat on the AMA HOD: Join or Renew Your AMA Membership Today!

In order for ASIPP to maintain its seat on the American Medical Association (AMA) House of Delegates (HOD), we must submit our membership data to the AMA for a 5-year review to determine that we still meet the 35% membership AMA/ASIPP match requirement needed to maintain our HOD seat. We would urge you to check your membership status by April 11, 2014. If you are not current on your AMA dues, please renew them this week. If you are not already a member, we urge you to join the AMA. You can check your membership status by clicking on the following link: https://commerce.ama-assn.org/membership/

Joining the AMA will further strengthen our specialty's representation at the national level through the AMA HOD, the AMA's policymaking body, and strengthen our ability to meet the challenges in interventional pain management today with thoughtful, well-organized responses, specifically in the areas of coding (CPT) and reimbursement (RUC).

As a member of the AMA, you will get access to a broad range of practice management resources and publications such as the Journal of the American Medical Association, AMNews, AMA Morning Rounds and the Archives journals. So this is a win-win request.

Please take this opportunity to support the critical activities of ASIPP by joining the AMA today. To join the AMA, visit https://commerce.ama-assn.org/membership/ or call (800) 262-3211.


Thank you in advance for doing your part in maintaining AMA representation for ASIPP and IPM

miserableHow Being a Doctor Became the Most Miserable Profession


Nine of 10 doctors discourage others from joining the profession, and 300 physicians commit suicide every year. When did it get this bad?


By the end of this year, it's estimated that 300 physicians will commit suicide. While depression amongst physicians is not new-a few years back, it was named the second-most suicidal occupation-the level of sheer unhappiness amongst physicians is on the rise.


Simply put, being a doctor has become a miserable and humiliating undertaking. Indeed, many doctors feel that America has declared war on physicians-and both physicians and patients are the losers.


Not surprisingly, many doctors want out. Medical students opt for high-paying specialties so they can retire as quickly as possible. Physician MBA programs-that promise doctors a way into management-are flourishing. The website known as the Drop-Out-Club-which hooks doctors up with jobs at hedge funds and venture capital firms-has a solid following. In fact, physicians are so bummed out that 9 out of 10 doctors would discourage anyone from entering the profession.


The Daily Beast


surgeSurge in Narcotic Prescriptions for Pregnant Women


Doctors are prescribing opioid painkillers to pregnant women in astonishing numbers, new research shows, even though risks to the developing fetus are largely unknown.


Of 1.1 million pregnant women enrolled in Medicaid nationally, nearly 23 percent filled an opioid prescription in 2007, up from 18.5 percent in 2000, according to a study published last week in the journal Obstetrics & Gynecology. That percentage is the largest to date of opioid prescriptions among pregnant women. Medicaid covers the medical expenses for 45 percent of births in the United States.


New York Times

hysterHow Morcellators Simplified the Hysterectomy but Posed a Hidden Cancer Risk


Nancy Lincoln Davies, with her husband Glenn Davies in 2012, died last year after her cancer spread. Glenn Davies

The women's health-care community got a shock to the system in December, when leading U.S. hospitals abruptly began acknowledging that a commonly used surgical tool risked killing some women.


The tool, used since the 1990s in many hysterectomies, can stir up aggressive cancers, they said. Brigham and Women's Hospital, Temple University Hospital and others quickly altered their procedures for the tool's use. The Food and Drug Administration has begun a probe of its risks.


Wall Street Journal


Access to this article may be limited.

keynoteACP keynote: Physicians must engage on healthcare costs to strengthen relationships with patients


The United States spends more on healthcare, and puts greater financial burden on its patients, than anywhere else in the developed world.


That dynamic is harming the relationship between physicians and their patients, and it's up to physicians to lead the counterattack, said Elisabeth Rosenthal, MD, a healthcare reporter at the New York Times who delivered the keynote address Thursday at American College of Physicians (ACP) Internal Medicine 2014 conference in Orlando, Florida.

Rosenthal's recent series, "Paying Till It Hurts," highlighted the rising cost of healthcare in the United States and the increasing burden being shouldered by patients. Her coverage focused on the cost of common procedures and treatments, including child birth, colonoscopies, asthma medication, joint replacements, and stitches.


Medical Economics


confuseNew state laws aim to clear up patient confusion


Two states last month passed legislation that should provide increased clarity and transparency for patients trying to discern the qualifications of their health care professionals, bringing the total number of states with similar laws to 18.


West Virginia and Utah passed bills requiring clinicians to wear name tags that identify the clinician's name and license type during direct patient encounters. Both laws, and the 17 others previously passed in other states, were based on AMA model state legislation, part of the AMA's Truth in Advertising campaign (AMA login required) launched in 2009.


Utah's bill also prohibits deceptive or misleading representations by a health care professional, and makes it unlawful conduct for someone to wear a misleading ID during a patient encounter.

American Medical Association


graceNew state law requires AMA grace period notification


Washington has become the first state to enact legislation that requires health insurers to notify physicians when patients enrolled in exchanges under the Affordable Care Act (ACA) enter the grace period, and other states may not be far behind.


Legislation passed last month will require a health plan, upon request by a physician, to provide information regarding an exchange enrollee's eligibility status "in real-time." The law also requires that health plans in the exchange notify physicians and other health care providers that "an enrollee is in the grace period within three business days after submittal of a claim or status request for services provided."


American Medical Association


diyDIY Opioid Antidote Gets Fast FDA Approval


Drug overdoses have become the leading cause of injury in the United States. More people between the ages of 25 and 64 now die from overdose than in car crashes-and prescription drugs are largely to blame. Opioids are particularly dangerous, killing more than 16,000 people in 2010. Prescription opioid overdoses now claim more lives each year than heroin and cocaine combined.


When an opioid overdose happens, a quicker response time often means the difference between life and death. Today the Food and Drug Administration approved a long-awaited emergency drug-overdose treatment that family or community members can easily use to treat someone who has overdosed. The device, called Evzio, is a pocket-size auto-injector filled with the opioid antidote naloxone. Its approval is a boon for drug advocates who have long sought faster response options for drug overdoses. It is also a rare example of a fast action from FDA; many medications take years to pass regulatory hurdles, but Evzio passed after just 15 weeks of review.



Scientific American

meaningfulMeaningful use exemption added as EHR program moves forward


The Centers for Medicare & Medicaid Services (CMS) recently announced an addition to its hardship exemptions available to physicians who are unable to demonstrate meaningful use of electronic health records (EHR). The announcement came the same month that the AMA addressed Stage 3 meaningful use recommendations during a Health IT Policy Committee meeting.


A few grounds for hardship exemptions now are available, including:


*  The physician's software vendor is unable to achieve 2014 Edition certification, the most recently added hardship exemption

*  The physician can't get sufficient Internet access or faces other infrastructure barriers

*  The physician is newly practicing and has not had enough time to establish meaningful use, in which case the physician can apply for a two-year exception

*  The physician is practicing at multiple locations and has no control over the availability of certified EHR technology for more than one-half of patient encounters

*  A natural disaster or other unforeseeable circumstance occurs

*  A physician hasn't had enough patient interactions to meet the threshold requirements


American Medical Association

hipaaFree HIPAA risk assessment tool can help ensure compliance


Physicians in small to mid-sized practices can conduct their own risk assessments using a free tool newly available from the U.S. Department of Health and Human Services.


The security risk assessment (SRA) tool is designed to help practices conduct and document a risk assessment to evaluate potential security risks in their organizations under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. Conducting an SRA also is a core requirement for physicians seeking payment through the federal meaningful use program for electronic health records.


Physicians can watch a tutorial and other videos about risk analysis and contingency planning to provide further context. The assessment tool is available through the Apple App Store (search for "HHS SRA tool") for use on iPads, and can be downloaded onto computers running Windows operating systems.


American Medical Association


exploreCreating a better health care system: Experts explore options


If you could scrap the current health care system and start from scratch, what would it look like? The AMA's work in its three strategic focus areas are building blocks toward a better health care system, said AMA CEO and Executive Vice President James L. Madara, MD, March 27 during a capstone panel hosted by The Atlantic.



Dr. Madara joined Sam Nussbaum, MD, chief medical officer for WellPoint, and Kavita Patel, MD, managing director for the Brookings Institution Engelberg Center for Health Care Reform, to discuss the changing health care system during The Atlantic's Health Care Forum in Washington, D.C. The three panelists discussed health insurance, electronic health records (EHR) and other challenges that may be keeping physicians from providing high-quality patient care.


American Medical Association

sebeliusSebelius announces resignation amidst ACA, ICD-10 and SGR challenges


Shortly after announcing the enrollment of 7.5 million people in the Affordable Care Act (ACA) health insurance exchanges, Kathleen Sebelius resigned as secretary of the of the U.S. Department of Health and Human Services (HHS). Her departure leaves many unanswered questions for the Obama administration and about the future of the ACA and other healthcare challenges.


"I knew it wouldn't be easy," Sebelius said about the rollout of ACA at a press conference Friday announcing her resignation. "The Affordable Care Act is the most significant social change this country has seen in 50 years."

Sebelius, 65, served President Barack Obama's administration for five years, and led the rollout the ACA exchanges in October 2013. The website hosting the healthcare exchanges, Healthcare.gov, faced troubles from the beginning. It was virtually unworkable for weeks, after being flooded with people attempting to sign up for coverage.


Medical Economics


whoWho Is Sylvia Burwell, HHS Secretary Sebelius's Expected Replacement?


Sylvia Mathews Burwell, President Barack Obama's expected choice to run the Department of Health and Human Services, has spent months as budget director trying to slowly repair frayed relations between the White House and congressional Republicans on tax and spending policy.


Her efforts will be now put to the test as she tries to win Senate confirmation and continue the White House's implementation of the Affordable Care Act.


Ms. Burwell, a veteran of the Clinton White House and Treasury Department who has held senior roles at the Bill & Melinda Gates Foundation and the Walmart Foundation, will face close scrutiny because the agency she has been tapped to run oversees some of the most polarizing and expensive parts of the federal budget.



Wall Street Journal


Access to this article may be limited.

laborLabor Split Boosts Ohio Governor


TOLEDO, Ohio-Gov. John Kasich has earned such ire among unions that he is on a list of six Republican governors the AFL-CIO has said it hopes to topple this fall.


But a group of laborers within the AFL-CIO's own ranks are considering backing Mr. Kasich's re-election bid, emblematic of a larger split in the labor federation over issues ranging from the Keystone XL pipeline to the Affordable Care Act.


Members of building trades unions-including carpenters, laborers, electricians and iron workers-tend to be more conservative politically than most other union members. They often side with business over environmental groups and find common ground with Republicans on infrastructure projects.



Wall Street Journal


Access to this article may be limited.

redTwo New Studies Raise Red Flags on Obamacare


Barack Obama wasted little time last week declaring victory as the deadline for enrollment in Affordable Care Act exchanges expired - well, more or less, anyway. The White House celebrated as it announced that 7.1 million consumers had signed up for health insurance through the federal and state exchanges, slightly exceeding their original goals and significantly outpacing expectations after the disastrous rollout of Obamacare last October. "The debate over repealing this law is over," President Obama told the press on April 1. "The Affordable Care Act is here to stay."


Yahoo Finance



troveDoctor-Pay Trove Shows Limits of Medicare Billing Data


The trove of Medicare data released Wednesday  shows a wide cast of characters in the top ranks of the highest-reimbursed doctors, and reveals as much about the limits of the newly public billing records as it does about medical practice.


Among the highest-reimbursed doctors in their fields were a Michigan oncologist with $10 million in 2012 payments and a Rhode Island anesthesiologist at $3.5 million, both of whom have been indicted for fraud in federal courts. Also among the highest reimbursed was Jean Malouin, a family-medicine doctor in Michigan, but that is because she reimburses other doctors in a special demonstration program backed by the agency that oversees Medicare. The Michigan oncologist has pleaded not guilty. An attorney for the anesthesiologist says his client is innocent.

That diversity underscores crucial gaps in the new data. Medical groups and policy makers have asserted that the figures lack context needed to show which doctors may be abusing the system and which are simply hard workers and overseers of complicated medical practices, or those whose specialties involve high overhead costs, such as radiation oncology, that lead to bigger bills.



Wall Street Journal


Access to this article may be limited.

pollPoll: Health law's campaign clout bad news for Democrats


WASHINGTON - The Affordable Care Act looms as a powerful issue in this year's congressional elections, a USA TODAY/Pew Research Center Poll finds, and one that is reverberating in ways likely to boost the GOP.


In the survey, taken after President Obama announced a surprising 7.1 million Americans had signed up for health care through the law's exchanges, more than eight in 10 registered voters say a candidate's stance on the law will be an important factor in determining their vote. A 54% majority call it very important.


By 2-1, those who rate the issue as very important disapprove of the law.



USA Today


trillionAMA: Docs Add $1.6 Trillion to Economy


U.S. physicians produced $1.6 trillion in direct and indirect economic activity in 2012 and supported an average of more than 13 jobs apiece, according to an economic impact analysis released Wednesday by the American Medical Association.


But some outside observers say the AMA's analysis -- meant to put a dollar figure on doctors' real-world impact -- may be making unrealistic assumptions and be based on unreliable information.


MedPage Today

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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


FSIPP Annual Meeting set for May 16-18, 2014


The Florida  Soceity of Interventional Pain Physicians will hold its annual meeting May 16-18 at the Hilton Bonnet Creek, Orlando, Florida--

On the Disney Property.


Don't miss this year's FSIPP Annual Meeting. It is expected to supersede all other meetings and includes an additional full-day Friday Schedule with concomitant sessions, Session A, Prescribing Controlled Substances and Session B, Practice Management. Our full-day Practice Management Session is a new edition to our meeting and will include: ICD-10, PQRS, HIPPA and cyber situations, audits, efficiency, solvency and much more. Our Controlled Substance Workshop will provide full updates on the pill mill crisis in Florida, a review of current statistics, trends in prescribing practices and addiction. The Friday Night Dinner for you and your family will feature Spanish Guitar Music, Flamenco Dancers, Sketch Artists and a Banquet Dinner. Discounted packages for the Spectacular Disney World Kingdoms are available to all. Lectures on Saturday and Sunday will be presented by nationally recognized speakers on cutting edge issues in pain management.


Go to FSIPP's homepage, http://fsipp.org, for information on reserving your hotel room. The Conference Brochure with registration materials will also be available soon and you will be notified.


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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