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American Society of Interventional Pain Physicians News  | August 13, 2014


  1. What are You Waiting for? It's Time to Send your Comment Letters Today 

  2. ASIPP to Host October Controlled Substance and Cadaver Workshops in Orlando 

  3. WHO Ethics Panel Affirms Use of Experimental Ebola Drugs
  4. Feds' $10 Billion Search For Healthcare's Next Big Ideas
  5. EHRs may make patients leery about sharing information, study finds
  6. EHR template customization contributes to MU2 interoperability issues, vendors say 
  7. Many hospitals, clinics, not prepared for IT risks 
  8. Weak password and security guidelines put patient health records at risk 
  9. Ain't No Sunshine in This Act
  10. Special report: The dangers of painkillers
  11. Negotiating hospital contracts: What physicians need to know before signing
  12. How to survive in independent practice 
  13. Hospital facility fees: Why cost may give independent physicians an edge
  14. Restrictive covenants in physician agreements: What you need to know

What are you Waiting for? It's Time to Send your Comment Letters Today

 Comment Time is Ending Soon


Just a few days remain to submit your Comment Letters. We need to provide as many opinions and comments as possible regarding the addition of fluoroscopic component to the epidural codes and for reversal of the cuts this year, with retrospective reimbursement from January 2014. We gained substantially in principle in the change for office payments which also provides an opportunity for further negotiations with CMS. However, when fluoroscopy was removed as a separate reimbursement from facet joint injections and sacroiliac joint interventions, the corrective action resulted in an increase in reimbursement by adding part of the fluoroscopy reimbursement to procedure codes.


It is our hope that CMS will apply a similar methodology and philosophy to the epidural decision and correct the epidural reimbursement in the same manner. They used the same philosophy, with the Correct Coding Initiative claiming that they were component codes of the procedure and would not be reimbursable separately. We were able to reverse that decision several years ago. Click here to see impact.


In order for this to occur, we need each physician to send at least 100 letters from patients, colleagues, and staff. Our goal is to send at least 100,000 letters to CMS. This is not that hard to do - it only takes a bit of time each day.


Here is the link for the physician letter - Please place on your letterhead if mailed. To submit via Capwiz click on the follow Capwiz link for physician letters. 


For Patient Letters

  • Click on the link for Word version of the patient letter 
  • Print it off daily changing the date and ask your patients to sign as the check in.
  • Each day assign a member (or two) of your staff to enter the patient letters using the  Capwiz link for patient letters
  • Remember, your office must enter the letters otherwise the odds are they won't be submitted!


This is an easy way to make a huge impact! Please commit to joining us in this important letter writing campaign. We need the full support and action from our members. Meanwhile, we will continue to work aggressively through  Congress and the administration to reverse these unfortunate cuts. 


2015 Proposed Physician Fee Schedule - IPM Codes

octoberASIPP to Host October Controlled Substance and Cadaver Workshops in Orlando


The ASIPP Comprehensive Review Course and Competency Exam in Controlled Substance Management and Practice Management Competency Exam will be held in Orlando, Florida, on October 17-19, 2014.


The Controlled Substance Management intensive review course is designed to present interventional pain management specialists and other health care providers an in-depth review of multiple areas of interventional pain management-the areas we were never taught, yet are crucial for our survival.

The two-day comprehensive review courses are planned as a CME activity to prepare for competency certification or an in-depth review in areas of What You Need to Know in Controlled Substance Management in IPM. This review course is based on the American Board of Interventional Pain Physicians' specifications for competency certification examinations.


This course is intended to present interventional pain management specialists, nurses, and other healthcare providers an in-depth review of multiple areas of interventional pain management including Controlled Substance Management.

Educational Objectives for Controlled Substance Management:

* Review basic science and core concepts

* Discuss pharmacology

* Identify clinical use and effectiveness

* Identify substance abuse

* Discuss topics with documentation, regulatory issues,legal issues, and ethical issues

In addition to the review course, the American Board of Interventional Pain Physicians(for physicians) and the American Association of Allied Pain Management Professionals(for non-physicians) offers the opportunity for examination in order for physicians to obtain competency certification to and non-physicians to obtain associate certificates in Controlled Substance Management or Coding, Compliance, and Practice Management.


Controlled Substance Management (Oct. 17-18) and Competency Examination (Oct. 19)

Click HERE to register


Coding, Compliance, and Practice Management Competency Examination (Oct. 19)

Click HERE to register





Cadaver Workshop and Online Video Lectures -Basic, Intermediate, ABIPP Preparation


This 1-day workshop is designed for interventional pain physicians, for a review, skills improvement, or to assist in preparation for Comprehensive Interventional Pain Management Examination qualifications. ASIPP offers the most in-depth, comprehensive, and individualized programs available in interventional pain management, featuring maximum hands-on training with cadavers in a state-of-the-art facility and maximum ability to interact with other participants. 


Participants will experience a comprehensive and intense learning opportunity, focusing on interventional pain management techniques.

* Each cadaver station is limited to a maximum of 7 participants.

* Participants can choose the level of participation: basic, intermediate, or ABIPP Preparation

* C-arms and state-of-the-art equipment are utilized in this course. Participants are requested to dress in casual attire or scrubs. Leaded aprons and thyroid shields will be provided. However, participants are advised to bring their own protective eyewear.

* Participants will be provided with 7 video lectures relevant to the course material


Click HERE to register




ABIPP Part I Examination- Application 





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 Inform the agent that you are booking for American Society of Interventional Pain Physicians.

We have secured a group room rate of $129. Reserve rooms early-all unbooked rooms will be released after September 16, 2014.


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WHO Ethics Panel Affirms Use of Experimental Ebola Drugs


A World Health Organization (WHO) ethics panel has given a unanimous green light to use experimental medications in the West Africa Ebola outbreak.


But exactly how to use such medications -- and especially who gets them and in what circumstances -- remains up in the air.


The ethics panel said using medications that haven't been tested in humans must be done in a transparent fashion, including "informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity, and involvement of the community," according to Marie-Paule Kieny, PhD, an assistant director-general of the WHO.


MedPage Today



Dr. Devi Addresses Ebola Outbreak

Al Jazeera America



August 7: "Are We Safe From Ebola?"

Fox Business Network

"Opening Bell with Maria Bartiromo"


August 6: "Is ZMapp Really A Miracle Drug?"

Fox Business Network

"Varney & Co."


August 4: "Is the U.S. At Risk For an Ebola Outbreak?"

Fox Business Network

"Money with Melissa Francis"

August 1: "Ebola Patient To Be Treated in the U.S."


"Jose Diaz-Balart"


July 31: "What Can Be Done to Prevent Spread of Ebola in U.S.?"

Fox News Channel

"America's Newsroom"

Feds' $10 Billion Search For Healthcare's Next Big Ideas


The Affordable Care Act was supposed to mend what President Barack Obama called a broken healthcare system, but its best-known programs -- online insurance and expanded Medicaid for the poor -- affect a relatively small portion of Americans.


A federal office you've probably never heard of is supposed to fix healthcare for everybody else.

The law created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse.


Medpage Today


shareEHRs may make patients leery about sharing information, study finds


Some patients may be reluctant to divulge information when their physician uses an electronic health record (EHR) out of fear for their data's security, according to a study published in the Journal of the American Medical Informatics Association.


The study, "The double-edged sword of electronic health records: implications for patient disclosure," analyzed results from the 2012 Health Information National Trends Survey. It found that 13% of patients have withheld information from a physician for privacy/security reasons. A multivariable analysis of the results found a positive correlation between patients withholding information and their physician using an EHR during the patient encounter.


Related: EHR survey probes physician angst about adoption, use of technology



Medical Economics



EHR template customization contributes to MU2 interoperability issues, vendors say

Electronic health record (EHR) systems certified for Meaningful Use stage 2 (MU2) are often unable to exchange patient data between providers, despite this being one of the requirements for attestation, EHR vendors and physician advocates told a government committee.


During a meeting of the Health IT Standards Committee's implementation workgroup, technology vendors said that the templates, called the consolidated clinical document architecture (CCDA), are often coded improperly in EHR systems, preventing exchange of health data, reports Bloomberg BNA. While some data can be transmitted, it often requires providers manually entering the data into their system.


Emily Richmond, MPH, a senior product advisor for EHR vendor Practice Fusion, told the committee that while Practice Fusion is one of a small number of companies certified for MU2, fewer than 8% of the vendor's customers have sent clinical data to another provider, and only 1% have both sent and received patient data via CCDA.


Medical Economics


Many hospitals, clinics, not prepared for IT risks

Many healthcare organizations have little awareness of the risks associated with health information technology (IT), according to a report prepared by RAND Health in collaboration with the Office of the National Coordinator for Health IT (ONC).


"The research report finds that health IT safety often competes with other pressing priorities for limited resources within healthcare organizations," the ONC wrote in a blog post. "It also tells us that users of electronic health records (EHRs) see EHRs as a solution to patient safety problems, and may not understand new risks that may be introduced by EHRs."


RAND began its study with 14 different hospitals and clinics of various sizes, locations and patient loads, and found that many were unprepared to participate in an external health IT risk management assessment. Three of the organizations dropped out of the project. Of the 11 left, three became less active over the nine-month assessment. The study's authors found that the organizations with the most engagement had staff members experienced in organizational quality improvement and risk management.


Medical Economics



Weak password and security guidelines put patient health records at risk

Strong passwords are the first line of defense against computer hackers. But a government report warns that patients are at risk because the certification process for electronic health records (EHRs) doesn't require the use of a strong password.


An audit by the U.S. Department of Health and Human Services' Office of Inspector General (OIG) takes issue with the criteria used by the Office of the National Coordinator for Health Information Technology (ONC) to certify EHR vendors.


"Our audit revealed vulnerabilities with the Temporary EHR certification program," said the report.  "These vulnerabilities could allow hackers to penetrate EHR systems, thereby compromising the integrity, confidentiality, and availability of patient information stored in and transmitted by a certified EHR."


Medical Economics

aintAin't No Sunshine in This Act


Robert Harbaugh, MD, just wanted to do the right thing.


Toward the end of July, the Hershey, Pa., neurosurgeon and president of theAmerican Association of Neurological Surgeons sat down at his computer to register for the Physician Payments Sunshine Act database -- set for its public debut on Sept. 30 -- which will track payments made to providers by pharmaceutical and device companies. The database is aimed at shedding light on physician interactions with companies that make the medications and medical devices that doctors prescribe to patients.


It took Harbaugh several hours to input everything. "It's a several-step process and you need to put in ... a good deal of information," he told MedPage Today in a phone interview. "The last statement [from them] was that I'd get a [confirmatory] email from CMS within 24 hours."


MedPage Today

Special report: The dangers of painkillers
Every year, Percocet, Vicodin, and other opioids kill 17,000 Americans and acetaminophen sends 80,000 people to the ER


drugs America is in pain-and being killed by its painkillers.


It starts with drugs such as OxyContinPercocet, and Vicodin-prescription narcotics that can make days bearable if you are recovering from surgery or suffering from cancer. But they can be as addictive as heroin and are rife with deadly side effects.


Use of those and other opioids has skyrocketed in recent years. Prescriptions have climbed 300 percent in the past decade, and Vicodin and other drugs containing the narcotic hydrocodone are now the most commonly prescribed medications in the U.S. With that increased use have come increased deaths: 46 people per day, or almost 17,000 people per year, die from overdoses of the drugs. That's up more than 400 percent from 1999. And for every death, more than 30 people are admitted to the emergency room because of opioid complications.



Consumer Reports


Negotiating hospital contracts: What physicians need to know before signing


Physician employment contracts with hospitals or healthcare systems can be unpredictable. Mergers and layoffs are all often overlooked realities for employed physicians, especially during a time when so much emphasis is on reducing healthcare costs. If you are negotiating an employment contract, take a close look at the compensation arrangement, termination clauses, and non-compete agreements.


Because things may not work out as anticipated for either the physician or the employing hospital or health system, it is important to address at the outset some of the potential issues that may arise upon termination of the relationship. This article examines typical issues that should be addressed in a hospital employment contract and suggests post-termination matters that should be brought up before signing


Medical Economics

How to survive in independent practice


Despite a healthcare environment that's pushing physicians toward employment, many doctors still value their autonomy, and are exploring strategies-from banding together in physician independent associations or consortiums to enhancing their business strategies-to preserve their independence in the face of increasing burdens and financial difficulty.


Orthopedic surgeon Barbara Bergin, MD, is running out of options for keeping her private practice in Austin, Texas ahead of the economy. With her partners, she has expanded Texas Orthopedics Sports & Rehabilitation Associates from three to 25 physicians, making it more cost-effective to handle escalating medical records requirements. Meanwhile, the practice invested heavily in technology and staff to make paperwork more efficient.

Nonetheless, after 27 years in private practice, Bergin often faces a workday


Medical Economics



Hospital facility fees: Why cost may give independent physicians an edge


In this era of cost reduction, independent primary care practices have an edge: It's called value.

As calls from government and private payers intensify for hospitals to trim costs and become more transparent in their pricing, some experts believe the pendulum may swing to favor providers delivering quality care at the best price.



The notion flies contrary to the current trend of physicians selling their practices to hospitals, which is believed to increase an institution's bargaining power and allow the health system to deliver outpatient services and be reimbursed at a higher, outpatient rate.


Medical Economics

Restrictive covenants in physician agreements: What you need to know


A common issue in almost all physician employment agreements concerns restrictive and non-solicitation covenants. Some physicians and employers have the impression that such covenants are not enforceable, when the truth is more complex.


While courts may be reluctant to enforce such covenants and will try to limit their scope, properly drafted restrictive and non-solicitation covenants are valid. Enforceability hinges on whether the covenants are reasonably necessary to protect the interests of the medical practice or the hospital.


What's crucial are the specifics of the covenants: What items are covered, the length of time that the covenants will remain in place, and the geographic scope of the restrictive covenant.


Medical Economics


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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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