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American Society of Interventional Pain Physicians News  | June 25, 2014


iomASIPP Receives Vindication with Painful Disclosures Concerning Conflicts of Interest of Institute of Medicine


For the last 2 years we have been saying that that the chronic pain statistics from IOM were overblown, along with associated expenses. Now a story from Medpage today from John Fauber confirms the conflicts of interest at the Institute of Medicine and the authors of this report. (see Tables)  


The FDA and other agencies like CMS and even the Government Accountability Office (GAO) have used this inaccurate chronic pain data from an IOM report which was essentially based on a study by Gaskin and Richard. This report showed the total incremental medical expenditures for selected pain conditions exceeded $650 billion and the dramatic number of people suffering with chronic pain to be 100 million (Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain 2012; 13:715-724). Unfortunately, the data were utilized in a flawed manner. This study from Johns Hopkins defined persons with pain as follows:


   Persons who reported that they experience pain that limited their ability to work, which is appropriate and includes 43.9 million of the total 100 million being estimated and discussed here, with 21.3 million suffering with moderate pain and 22.6 million suffering with severe pain.

  However, the number 2 category is persons who were diagnosed with joint pain or arthritis, which is estimated to be 123.7 million.

  Finally, they also included 24.7 million persons who had a disability that limited their ability to work that had nothing to do with pain.


Thus, multiple conditions were not only repeatedly counted, but also include very expensive arthritis and functional disability which are not related to chronic non-cancer pain. A liberal estimate would be approximately 30 million requiring therapy for chronic non-cancer pain, either with interventional procedures, physical therapy, surgical interventions, or chronic opioid therapy.


This is the report from John Fauber published in Milwaukee Journal Sentinal / MedPage Today 


vegasASIPP plans cadaver workshop with basic and intermediate techniques, along with percutaneous disc decompression and vertebral augmentation and ultrasound for nonspinal interventions in Vegas


ASIPP has scheduled a Cadaver Workshop for Basic, Intermediate and Advanced (Disc Interventions) and an Ultrasound for Non-Spinal Injections Course. to be held Aug. 22-24 in Las Vegas.



This 2 day review course and cadaver workshop includes interventional techniques (basic, intermediate, and advanced), Ultrasound for non-spinal

injections, and Disc Interventions (advanced). Participants experience a comprehensive and intense learning opportunity, focusing on interventional pain management techniques


Ob jectives

After this course, participants should be able to:

- Describe the delivery of multiple aspects of interventional pain


- Review multiple areas of interventional pain management including

fluoroscopic interpretation and radiation safety

- Demonstrate skills through interactive review of images






Planet Hollywood

3667 Las Vegas Boulevard South, Las Vegas, NV 89109









workingObamacare: What About the Working Class and the Middle Class?


The administration issued a report yesterday that says individuals who selected plans in the federal health insurance exchanges have a post-credit premium that is on average 76% less than the full premium for the plans they selected. And, 69% are paying less than $100 after the subsidies--46% are paying $50 or less.

The administration also pointed out that 65% of individuals selecting the Silver Plan in the federal exchange chose the lowest or second-lowest cost Silver Plan.

As I have said before, only about one-in-three subsidy eligible people bought and paid for coverage during Obamacare's first open-enrollment.


Health Policy and Market Blog

kaiserKaiser Family Foundation Survey Finds Most People Who Bought Health Insurance on the Exchanges Are Happy With It and That 57% Were Previously Insured--No One Should Be Surprised On Either Count


Let's take a look at both of these headlines:

Most People Are Happy
But Kaiser only asked the people who bought health insurance on the exchanges if they were happy with what Obamacare offered them.

As I have said before on this blog, two out of three subsidy eligible people did not buy a health insurance plan in the first open-enrollment.

This week the administration also reported that 76% of those who received a subsidy paid less than the full premium for the plans they selected. And, 69% are paying less than $100 after the subsidies--46% are paying $50 or less.

Health Policy and Market

udtUrine Drug Screen Testing Webinar Set for July 15


FEE:  $175 

DATE: July 15, 2014

TIME:  11:00am-12:30am CST

LENGTH: 90 Minutes

SPEAKER: Marvel Hammer, RN, CPC



 Marvel J. Hammer, RN, CPC

MJH Consulting, Denver, Colorado


Marvel J. Hammer RN BS CPC CCS-P ASC-PM CPCO, is a registered nurse with over twenty-five years' experience in a multitude of specialties.  


Overview: Are you confused about how you should bill for the urine drug screen testing in your Interventional Pain Management Practice? Get the facts straight: steps to Urine Drug Screen Testing Compliance in your physician office


Are you performing point-of-care (POC) urine drug screen (UDS) testing in your interventional pain management practice? Does your office have the correct CLIA certification?  Is the test you are using the correct test for your CLIA certification?  Are you coding for your POC UDS compliantly?  When should you report one of the HCPCS "G" codes for your POC UDS testing?  Which of the HCPCS "G" codes should you report for your Medicare beneficiaries UDS testing?  Are you reporting the correct units of service for the specific UDS test that you are using?  Why is medical necessity important in POC UDS testing?  Which ICD-9 code should you report?  Is your UDS documentation up to snuff for a payer review? 


Get the answers to these questions and much more in this 90 minute webinar.


Click here to register.


politicsThe Politics of Pain: Running a Tab in Congress 


The Institute of Medicine's report on pain was ordered by Congress. It grew out of 2008 and 2009 Senate and House bills that called on the institute to examine pain issues.


The House bill was introduced by U.S. Reps. Mike Rogers (R-Mich.) and Lois Capps (D-Calif.).


According to the Center for Responsive Politics, from 2009 through 2014, Rogers received more than $300,000 from individuals and PACs of companies that make and market pain treatments, including more than $55,000 from Abbott Laboratories, which was marketing Vicodin in 2011. Capps received less than $26,000.


MedPage Today
tomTom Coburn report details VA problems 


Delinquent doctors and nurses and lagging medical treatment at the Department of Veterans Affairs may have caused the deaths of more than 1,000 veterans and cost the U.S. $845 million in medical malpractice suits, Sen. Tom Coburn charged in a report released on Tuesday.


The deaths, which occurred over a 10-year period, resulted from VA officials prescribing unneeded and unmonitored painkillers to veterans, delayed treatment that caused cancer to go undetected and veterans waiting at times for months for procedures, the report found.



sickSick Drawn to New Coverage in Health-Law Plans


People enrolled in new plans under the health law are showing higher rates of serious health conditions than other insurance customers, according to an early analysis of medical claims, putting pressure on insurers around the country as they prepare to propose rates for next year.


Among those health-law marketplace enrollees who have seen a doctor or other health-care provider in the first quarter of this year, around 27% have significant health issues such as diabetes, psychiatric conditions, asthma, heart problems or cancer, the data show. That is sharply higher than the rate of 16% for last year's individual-consumer market over the same time frame, according to the data, which was supplied by Inovalon Inc., a health-technology firm that receives medical claims directly from nearly 200 insurers that are its clients.


It is also more than double the rate among people who held on to their existing individual policies; among those enrollees, the rate was 12%. Those consumers, who kept so-called grandfathered individual plans, are showing by far the lowest rates of use for health-care services such as emergency-room visits, hospital stays and prescriptions.


Wall Street Journal

Access to this article may be limited.



chemicalEasier Cleaning Without Chemicals


OXO and other manufacturers of micro-fiber cleaning clothes are trying to convince consumers that warm water is enough. WSJ reporter Ellen Byron explains "the new clean" on Lunch Break with Tanya Rivero. Photo: F. Martin Ramin for The Wall Street Journal


Cleaning products tout a litany of powers: fast action, germ fighting and pleasant fragrance. How could the house get as clean with just water?


Makers of microfiber cloths, fancy sponges and high-tech brushes claim their tools can do just that. Spritzing some water-and splurging on a $113 mop or a $27 dusting cloth-can achieve a sparkling home, these companies say.


  Wall Street Journal


Access to this article may be limited.

sittingHow Bad Sitting Posture at Work Leads to Bad Standing Posture All the Time 


There's a growing evidence for the health benefits of good posture, from reducing back and joint pain to boosting mood. WSJ's Jeanne Whalen and NY-Presbyterian/Columbia University Medical Center's Dr. Evan Johnson discuss on Lunch Break with Tanya Rivero. Photo: Cassandra Giraldo for The Wall Street Journal. Photo: Cassandra Giraldo for The Wall Street Journal.


Looks like your mother was right when she told you to sit up straight.


There's growing evidence that good posture contributes to a range of health benefits, from reducing back and joint pain to boosting mood. Health-care practitioners from physical therapists to surgeons to psychologists increasingly take posture into account when evaluating patients, and offer tips and tools for improvement.


Wall Street Journal

Access to this article may be limited.

allergySeasonal Allergy Symptoms Can Significantly Impair Driving Ability 


Common seasonal allergy symptoms, such as watery eyes, sneezing and fatigue, can significantly impair driving ability, says a study in the July issue of Allergy. Allergy symptoms' effect on driving was comparable to having a blood-alcohol concentration nearing impaired levels, according to the researchers. Allergy medications weren't wholly effective at reducing the symptoms' effects.


Allergic rhinitis, or hay fever, has been linked to car accidents but the effects on a driver's performance weren't known, researchers said.


The study, in the Netherlands, involved 19 people in their early 30s with grass- and tree-pollen allergies. During the off-season, when they were free of symptoms, subjects were each treated in turn with an antihistamine, steroid nasal spray or a placebo pill or spray in four testing sessions on separate days. After each treatment, they were given grass and tree allergens or a placebo through a nasal spray to provoke allergy symptoms.


  Wall Street Journal


Access to this article may be limited.

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stateState Society News


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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