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American Society of Interventional Pain Physicians News  | June 11, 2014





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deviNEJM: Adverse Health Effects of Marijuana Use


Article Conclusion: 

Marijuana use has been associated with substantial adverse effects, some of which have been determined with a high level of confidence. Marijuana, like other drugs of abuse, can result in addiction. During intoxication, marijuana can interfere with cognitive function (e.g., memory and perception of time) and motor function (e.g., coordination), and these effects can have detrimental consequences (e.g., motor-vehicle accidents). Repeated marijuana use during adolescence may result in long-lasting changes in brain function that can jeopardize educational, professional, and social achievements. However, the effects of a drug (legal or illegal) on individual health are determined not only by its pharmacologic properties but also by its availability and social acceptability. In this respect, legal drugs (alcohol and tobacco) offer a sobering perspective, accounting for the greatest burden of disease associated with drugsnot because they are more dangerous than illegal drugs but because their legal status allows for more widespread exposure. As policy shifts toward legalization of marijuana, it is reasonable and probably prudent to hypothesize that its use will increase and that, by extension, so will the number of persons for whom there will be negative health consequences.





Potential Dangers of Marijuana Use


While marijuana is becoming legal in some parts of the country, new research points out dangers, including just how addictive it can be for teens, and why it's more potent than ever before.

This study will not end the debate about whether it's safe or not, but it's in a major medical journal and as the push to legalize marijuana continues, the study will come up again.

This time researchers analyzed the studies that are out there, looking at marijuana and whether it's harmful or not. Their findings were just published in the New England Journal of Medicine.


ABC News









burwellBurwell Confirmed as HHS Secretary


WASHINGTON -- The Senate confirmation of Sylvia Mathews Burwell as Secretary of Health and Human Services was the big healthcare focus in the nation's capital this week.


Senate Confirms Burwell as HHS Secretary

By a vote of 78-17, the Senate on Thursday confirmed Sylvia Mathews Burwell as the new Secretary of Health and Human Services.


Burwell, who currently heads the Office of Management and Budget (OMB), replaces Kathleen Sebelius, who tendered her resignation in April (but is continuing in office until her replacement becomes official). The latter's resignation came just a few weeks after the end of the first open enrollment period for the Affordable Care Act's health insurance exchanges, under which more than 7 million people have signed up for health insurance, exceeding government projections. Despite that final success, Sebelius was criticized for the federal exchange's rocky launch.


MedPage Today


sunshineRegistration Begins for Physicians to Review Sunshine Act Data

As of June 1, physicians can register to review their Physician Payment Sunshine Act data and correct any errors reported by pharmaceutical and drug manufacturers.


Registration for physicians is available under the Centers for Medicare and Medicaid Services (CMS) Enterprise Portal. The second step of the registration process will begin in July, when physicians can register in the CMS Open Payments system.


Under the Sunshine Act, CMS will publish payments providers received from drug and device manufacturers on September 30, 2014. However, physicians who have registered will have 45 days to review and correct the information before it's made public.


Medical Economics 

medicareMedicare gives primary care permission to increase hepatitis C testing

The Centers for Medicare and Medicaid Services (CMS) has announced that Medicare will cover hepatitis C virus (HCV) testing for adults, in a statement released June 2.


The testing will include a single screening for adults born between 1945 and 1965, and repeat screenings for adults considered high risk due to drug use or a blood transfusion prior to 1992. Disabled adults with Medicare under the age of 65 are eligible for the testing. The ruling specifies that covered testing must be ordered by a primary care provider.


"As preventive services gain recognition of their potential to improve the health status of the individual, we believe the primary care provider is in the unique position to provide a comprehensive and coordinated approach to Medicare beneficiaries' health care and this coordinated approach will help ensure the best outcomes for these services," CMS said in a response to commenters who questioned whether testing should be expanded to other practitioners and medical settings. "Other provider specialties may provide patient care in other settings but do not offer care in the context of being the coordinator of the patient's healthcare needs, not limited by problem origin or diagnosis."


Medical Economics



appleApple's HealthKit: What physicians need to know 

Technology giant Apple unveiled its new operating system, iOS 8, on June 2, and a new platform called HealthKit has the healthcare IT industry abuzz with its possibilities.


HealthKit will serve as a hub that enables health and fitness apps to communicate with one another. For example, an app that monitors heart rate or blood pressure can send information to a hospital app. Mayo Clinic will be syncing its app with HealthKit starting in September, and its patients will be able to send several types of health data directly to physicians.


"We believe Apple's HealthKit will revolutionize how the health industry interacts with people," John Noseworthy, M.D., Mayo Clinic president and chief executive officer said in a statement. "We are proud to be at the forefront of this innovative technology with the Mayo Clinic app."


Medical Economics


flock More patients flocking to ERs under Obamacare

LOUISVILLE, Ky. -- It wasn't supposed to work this way, but since the Affordable Care Act took effect in January, Norton Hospital has seen its packed emergency room become even more crowded, with about 100 more patients a month.


That 12 percent spike in the number of patients - many of whom aren't actually facing true emergencies - is spurring the Louisville hospital to convert a waiting room into more exam rooms.


"We're seeing patients who probably should be seen at our (immediate-care centers)," said Lewis Perkins, the hospital's vice president of patient care and chief nursing officer. "And we're seeing this across the system."


USA Today 



errorsSignificant Medicare coding errors signal need for physician education, OIG says


Nearly 42% of Medicare claims for evaluation and management (E/M) services are incorrectly coded, according to a recent study from the U.S. Department of Health and Human Services' Office of the Inspector General (OIG).

In its medical records review from 2010, the OIG report shows that Medicare inappropriately paid some $6.7 billion for incorrectly coded claims and those lacking proper documentation. That represents 21% of Medicare payments for E/M services in 2010.


The study found that incorrect coding included both upcoding and downcoding, and 19% of claims were lacking proper documentation. Claims for high-coding physicians were more likely to be incorrectly coded or insufficiently documented than claims from other physicians, the report says.


Medical Economics

icd-10ICD-10 may financially disrupt primary care, pediatric practices, study finds 

While the Centers for Medicare and Medicaid Services (CMS) is boasting of a successful ICD-10 testing week, a recent study shows that the switch to the new code set could be a significant financial disruption for narrow-margin primary care practices, especially those in pediatrics.


The study from researchers at the University of Illinois at Chicago (UIC), published in Pediatrics, the journal of the American Academy of Pediatrics, analyzed the impact of the transition to the International Classification of Diseases - 10th revision (ICD-10) on pediatric practices that operate on a low margin.


The researchers identified 2,708 ICD-9 codes used by pediatricians in Illinois and compared them to 174,500 patient encounters at the University of Illinois Hospital and Health Sciences System. They mapped those codes from ICD-9 to ICD-10 and rated the transition from easy to complex or convoluted.


Medical Economics

pricesHospitals' Prices for Common Services on the Rise 

WASHINGTON-Federal data released Monday show an increase in the average price hospitals charge to treat common conditions, with vascular procedures and chest-pain treatment showing some of biggest upticks.


The numbers from the Centers for Medicare and Medicaid Services include 2012 prices at 3,376 hospitals for the 100 most common inpatient stays by Medicare patients. It is the second year the agency has released such data, and it reflects $57 billion in payments from Medicare, the federal insurance program for the elderly and disabled.


The data show what each hospital charges on average for individual services alongside the typically much lower rates Medicare actually pays, based on a set schedule of fees. Private insurers also negotiate their own reduced amount.


Wall Street Journal


Access to this article may be limited.


treatmentDrug Treatment Swept Up in Push for Medical-Records Sharing


Federal officials are proposing to ease 40-year-old restrictions on the release of information about patients' drug- and alcohol-abuse treatment, so their electronic medical records can be more easily used and shared.


Federal law has long protected substance-abuse-treatment records from being disclosed to anyone without a patient's explicit consent, so that fear of stigma or discrimination wouldn't deter those in need from seeking help. If a patient agrees to share substance-abuse records with, say, a doctor or hospital, those records can't be sent anywhere else unless the patient consents again.



Wall Street Journal


Access to this article may be limited.
taxpayersTaxpayers Face Big Medicare Tab for Unusual Doctor Billings 

Ronald S. Weaver isn't a cardiologist. Yet 98% of the $2.3 million that the Los Angeles doctor's practice received from Medicare in 2012 was for a cardiac procedure, according to recently released government data.

The procedure is rarely used by the nation's heart doctors. Patients are strapped to a bed with three large cuffs that inflate and deflate rhythmically to increase blood flow through the arteries-a last resort to treat severe chest pain in people who can't have surgery.


The government data show that out of the thousands of cardiology providers who treated Medicare patients in 2012, just 239 billed for the procedure, and they used it on fewer than 5% of their patients on average. The 141 cardiologists at the Cleveland Clinic, renowned for heart care, performed it on just six patients last year. Dr. Weaver's clinic administered it to 99.5% of his Medicare patients-615 in all-billing the federal health-insurance program for the elderly and disabled 16,619 times, according to the data.


Wall Street Journal


Access to this article may be limited.
amaAMA Asks Obama to Cover Vets Outside VA


CHICAGO -- The AMA wants President Obama to expand health coverage for veterans by allowing physicians practicing outside the Veterans Affairs system to bridge the gap for veterans unable to access VA care.

The move by the AMA came after its House of Delegates unanimously approved the move, which was promoted in a pair of resolutions -- one from the Organized Medical Staff Section, and the other from the Florida Medical Association.


"When we looked at what was going on with the Veterans Administration, it became clear that the AMA really needed to take some leadership role in what we could do," Lee S. Perrin, MD, Boston, the delegate from the Organized Medical Staff Section (OMSS), said in the reference committee.



Med Page Today


ASIPPASIPP Now Offers Animations to Enhance Your Communication and Marketing Needs


ASIPP Marketing Services (AMS) is now a reseller of View Medica Pain Management procedure animations. Procedure animations can be used on ASIPP-TV24 in your waiting room, your web site, and/or hand held devices in consultations with your patients. These high-quality, low-cost animations can be purchased through ASIPP by contacting Ray Lane at rlane@asipp.org or 270-554-9412. ext. 220. 


vegasA Vegas Gamble: Doctor Builds a New Kind of Clinic in the Desert


LAS VEGAS -- On a Friday night in mid-May, part of Fremont Street in Las Vegas is shut down and converted into a skate park, with flanneled teens attempting tricks on ramps and rails. Alternative rock bandTaking Back Sunday is set to take a pop-up stage flanked by Zappos.com banners. Old industrial buildings converted into funky restaurants host tech geeks and startup CEOs. Street murals brighten drab concrete fences.


Here in the desert, there's a tech city vibe reminiscent of Seattle or Silicon Valley, although it's probably the last place anyone would expect such a thing. This party city of 2.5 million people has never had much of a cultural identity before, especially not in a downtown area that has long been considered a wasteland -- until Zappos CEO Tony Hsieh, known for his love of all things quirky, pumped $350 million into a revitalization project to turn it all around.



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CASIPP to Hold Annual Meeting on September 12-14 


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



Save the Date: NY/NJ Chapters Schedule Pain Medicine Symposium


The New York and New Jersey Societies of Interventional Pain Physicians' 2014 Pain Medicine Symposium will be held on November 6 - 9, 2014 at the Hyatt Regency Jersey City in New Jersey.


More information will be available soon.



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


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