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American Society of Interventional Pain Physicians News  | April 23, 2014




  1. Sen. John Boozman Suffers aortic aneurysm
  2. Casual marijuana use linked to brain abnormalities
  3. Spinal & NonSpinal Interventional Techniques Offered Just One Time This Year: June 20-21
  4. Register Today for ASIPP Practice Management Webinar May 13
  5. Obamacare Observations From the Marketplace
  6. FDA Panel Snubs Morphine-Oxycodone Combo
  7. When Spine Implants Cause Paralysis, Who Is to Blame?
  8. New Painkiller Rekindles Addiction Concerns
  9. Warding off fraud suits after CMS physician payment revelations
  10. FDA proposes program to speed approval of medical devices
  11. State Society News
  12. Physician Wanted

boozmanSen. John Boozman suffers aortic aneurysm


  Yesterday we received the sad news that Sen. John Boozman (R-Ark.) suffered an aortic aneurysm. He remains in an Arkansas hospital where he is recovering from emergency heart surgery.


As you know, Sen. Boozman is a great friend of ASIPP and has worked with ASIPP on multiple issues. He serves on the Senate Health Appropriations Committee. We wish him a full and swift recovery.


Please keep Sen. Boozman and his family in your thoughts and prayers.


Washington Post

casualCasual marijuana use linked to brain abnormalities


 Apr. 16, 2014 - 4:53 - Devi E. Nampiaparampil, MD "Dr. Devi" recently was interviewed regarding a new study on impact on adults who smoke just once or twice a week.


Here's the link to Dr. Devi's interview:




Here is the abstract and link to the original study:


Marijuana is the most commonly used illicit drug in the United States, but little is known about its effects on thehumanbrain, particularly on reward/aversion regions implicated in addiction, such as the nucleus accumbens and amygdala. Animal studies show structural changes in brain regions such as the nucleus accumbens after exposure to_9-tetrahydrocannabinol, but less isknownabout cannabis use and brain morphometry in these regions in humans.Wecollected high-resolutionMRIscans on young adult recreational marijuana users and nonusing controls and conducted three independent analyses of morphometry in these structures: (1) gray matter density using voxel-based morphometry, (2) volume (total brain and regional volumes), and (3) shape (surface morphometry). Gray matter density analyses revealed greater gray matter density in marijuana users than in control participants in the left nucleus accumbens extending to subcallosal cortex, hypothalamus, sublenticular extended amygdala, and left amygdala, even after controlling for age, sex, alcohol use,

and cigarette smoking. Trend-level effects were observed for a volume increase in the left nucleus accumbens only. Significant shape differences were detected in the left nucleus accumbens and right amygdala. The left nucleus accumbens showed salient exposuredependent alterations across all three measures and an altered multimodal relationship across measures in the marijuana group. These data suggest that marijuana exposure, even in young recreational users, is associated with exposure-dependent alterations of the neural matrix of core reward structures and is consistent with animal studies of changes in dendritic arborization.



Journal of Neuroscience and Fox News 



juneSpinal & 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

webinarRegister Today for ASIPP Practice Management Webinar May 13




WEB INAR DATE: May 13, 2014

TIME: 11:00am CST


LENGTH: 90 Minutes

SPEAKER: Gary M. Janko, MPA

Gary M. Janko, MPA

PSMG, Executive Vice President and Chief Operating Officer




The purpose of this webinar is to detail the major elements of the revenue cycle; identify meaningful benchmarks; define critical operating workflows and their impact on clinical efficiency; develop optimal report sets; and establish a budget to measure administrative and clinical performance against established goals. The webinar content is designed for both physicians, mid-level providers, and key administrative staff.


Upon conclusion, the attendee will gain an understanding of the need for establishing practice benchmarks and performance goals; the budgeting process; the inter-relationship between clinical workflow and the revenue cycle; develop report sets and methodology; presentation of financial results; and how to interpret operating trends and results.


The presentation will include detailed discussion of key workflows, examples of management and production reports, budget components, and financial statement presentation. Requirements for internal controls and segregation of duties to protect Practice assets will also be addressed.



Registration and other information can be found at:






observationObamacare Observations From the Marketplace

A few observations from my travels and conversations in the marketplace:

About half of the enrollments are coming from people who were previously insured and half are not. When I try to gauge this, I go to carriers who had high market share before Obamacare and have maintained that through the first open enrollment. Some carriers have said only a small percentage of their enrollments had coverage before but health plans only would know who they insured before. By sticking to the high market share carriers who have maintained a stable market share and knowing how many of their customers are repeat buyers, it's possible to get a better sense for the overall market. Other conventional polls have suggested the repeat buyers are closer to two-thirds of the exchange enrollees.


Health Policy and Market

fdaFDA Panel Snubs Morphine-Oxycodone Combo


  An FDA advisory committee has voted unanimously against approval of an oral combination of morphine and oxycodone (Moxduo) for acute pain.


In the 14-0 vote, panelists concluded there wasn't sufficient evidence to support that the combined drug is safer than either morphine or oxycodone alone for moderate to severe acute pain. The FDA is not obliged to go along with its advisory committees' recommendations but it usually does.



MedPage Today

blameWhen Spine Implants Cause Paralysis, Who Is to Blame?


Rick Greenwood checked in for an overnight stay at a Dallas hospital two years ago to have a spinal-cord stimulator implanted in his back. The surgery was meant to relieve the back pain that had troubled him for more than 40 years, but when he left the hospital one month later, he was pushed out in a wheelchair, paralyzed from the waist down.

Mr. Greenwood, 66 years old, is among more than 100 patients who have experienced partial or permanent paralysis in recent years after having spinal-cord stimulators inserted in their backs, according to a Wall Street Journal analysis of adverse-event reports submitted to the U.S. Food and Drug Administration, and a review of medical malpractice lawsuits. In many cases, the injuries occurred after patients' spinal cords were punctured or compressed by the stimulator electrodes, which are implanted in a narrow cavity of the spine called the epidural space, according to experts who reviewed the reports.


In all, the FDA's database contains 58 unique reports of paralysis with report or event dates from 2013, compared with 48 in the prior year. The paralyzed patients received spinal stimulators made by a variety of companies, including the three biggest: Medtronic Inc., and Boston Scientific Corp.


Wall Street Journal


Access to this article may be limited.

addictionNew Painkiller Rekindles Addiction Concerns


The abuse of prescription painkillers has reached epidemic proportions in America.


Nearly half of the nation's 38,329 drug overdose deaths in 2010 involved painkillers like hydrocodone and oxycodone, according to the Centers for Disease Control and Prevention. These narcotics now kill more adults than heroin and cocaine combined, sending 420,000 Americans to emergency rooms each year.


So many state health officials and advocacy groups were incredulous last fall when the Food and Drug Administration approved an even more powerful prescription painkiller - against the advice of its own expert advisory committee.



New York Times


cmsWarding off fraud suits after CMS physician payment revelations


The release of Medicare's payments to doctors could impact medical practices and health systems in a lot of ways, including being fodder for fraud accusations - a problem that's worth getting ahead of from the get-go.


Amid seemingly increasing healthcare fraud lawsuits and whistle-blower allegations, expect many lawyers, employees or former employees to go through the Medicare payment data looking for hints of aberrant billing trends.

But don't expect that to be the sole source of evidence they can use, said Michael Matthews, a partner with the law firm Foley & Lardner who has represented health organizations on the receiving end of False Claims Act suits.



Healthcare Finance News

speedFDA proposes program to speed approval of medical devices


The U.S. Food and Drug Administration on Tuesday proposed speeding up medical device approvals for patients who have no other treatment options through a new program focused on earlier and more frequent interactions between companies and FDA staff.


The Expedited Access Premarket Approval Application program is a response to criticisms by policymakers, patient groups and industry that the FDA process for approving medical devices is inefficient and slow, delaying patients' access to new, helpful products.


The program is not a new pathway to market, the agency said, but rather a change in approach aimed at reducing the time it takes to develop a product and get it to market.





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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


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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