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American Society of Interventional Pain Physicians News  | November 5, 2014


  1. GOP Senate Win Opens Door to Deals
  2. 2014 Midterm Elections: Overview of Results and Potential Legislative Action 
  3. CMS Releases Physicians Fee Schedule for all Services
  4. Pain Specialists Show Increasing Rates of Burnout
  5. Take a Moment to Participate in Physician Survey on Epidural Steroid Injections
  6. U.S. Physician Leaders Suffer Loss of Public Trust
  7. Sustainable Growth Rate: Reduction in Physician Reimbursement Rate
  8. Physicians Reveal Best and Worst Insurance Companies to do Business With 
  9. ASIPP Resident/Fellow Governing Counseling Seeking Officer Nominations 
  10. FDA Hearing Yields Little Consensus on Abuse-Deterrent Opioids 
  11. Busted: 6 physicians facing jail time 
  12. 76% of Physicians Don't Like CMS Quality Reporting Programs 
  13. Health Insurers "Expect at Least 20% Growth" From 2015 Enrollment  
  14. Prescription Opioids Involved in Most Overdoses Seen in Emergency Departments 
  15. New technique to switch off pain at source 
  16. Call for Abstracts! Make Plans Today to Participate in 17th Annual Meeting Abstract Session 
gopGOP Senate Win Opens Door to Deals


Republicans prepared to take control of the Senate in January for the first time in eight years-a power shift that almost certainly will put the chamber's gavel in the hands of Sen. Mitch McConnell and opens up new possibilities for deal-making after years of partisan gridlock.


While government will be divided-with Republicans in charge of both chambers and Democrats controlling the White House-President Barack Obama may find a new path for compromise in his final two years in office.



Wall Street Journal

2014 Midterm Elections: Overview of Results and Potential Legislative Action

The Greenberg Traurig Group, an advocacy group utilized by ASIPP,  has provided the following election analysis.


The Republican Party gained control of both chambers of Congress in yesterday's midterm elections, with the Republican Party gaining a majority in the Senate and retaining its majority in the House.

In the Senate, Republicans appear to have gained at least 8 seats, with the Louisiana race slated for a runoff on Dec. 6. Republicans will hold a 53 to 47 or 54 to 46 majority, depending on the outcome of that race. The GOP could also gain one more seat in the Senate if Sen. Angus King, an Independent from Maine, chooses to caucus with the Republicans in the 114th Congress.

In the U.S. House, Republicans will have their largest majority (and Democrats will have their smallest minority) since 1929. Republicans appear to have won 13 to 16 House seats, which will give them 247 to 250 total seats (to the Democrats' total of 183 to 186 seats). 


Click HERE to read the full report.




CMS releases Physician Fee Schedule for all Services


CMS has reversed the proposed rule's payment cuts for epidural injections, but at the same time, they bundled fluoroscopy into epidural injections and considered them as misvalued codes.


CMS reduced payment for these services in 2014 under the misvalued code initiative. In response to concerns from pain physicians regarding the accuracy of the valuation, CMS proposed to raise the values in 2015 based on their prior resource inputs before adopting further changes after considering RUC recommendations. However, because the inputs for these services included those related to image guidance, we proposed to prohibit separate billing for image guidance for CY 2015. CMS finalized the policy as proposed to avoid duplicate payment for image guidance. The agency has asked the RUC to further review this issue and make recommendations to us on how to value epidural pain injections."


Below are the fee schedules for IPM codes for physicians, ASCs, and hospital outpatient departments.


Physicians Payments Rates - Click here


ASC Payment Rates - Click here


HOPD Payment Rates - Click here


Pain Specialists Show Increasing Rates of Burnout


The high rate of burnout among pain specialists found in a recent study may be a wake-up call to the speciality, as it places these physicians at risk for substance abuse, interpersonal difficulties and suicidal tendencies, and also increases the risk for medical errors. The investigators called for preemptive measures to help pain specialists before burnout sets in.


Pain Medicine



Take a Moment to Participate in Physician Survey on Epidural Steroid Injections


A survey is being conducted to support a study on the technical performance of epidural steroid injections.


The benefit of completing this survey will be a peer-reviewed publication of the group data that informs the clinical community of the current practices that relate to performance of epidural steroid injections. 


Click on the following link to take the survey: https://www.surveymonkey.com/r/STATEOFESI


The survey takes about 5-10 minutes to complete. 


The study has been approved by the Institutional Review Board of NYU School of Medicine. 


U.S. Physician Leaders Suffer Loss of Public Trust


Physicians in the U.S. enjoy a lower level of public trust than physicians in any of the countries that the U.S. healthcare system is normally compared against.


Only 58% of U.S. adults agree with the statement, "All things considered, doctors in [your country] can be trusted." That puts the U.S. at 24th among the 29 industrialized countries where this survey was carried out, above only Chile, Bulgaria, Russia, and Poland, and tied with Croatia.


In other countries -- Turkey, France, Finland, Britain, the Netherlands, Denmark and Switzerland -- more than 75% of adults agreed that doctors could be trusted.


MedPage Today



Sustainable Growth Rate: Reduction in Physician Reimbursement Rate

As we have discussed over the past years, the physicians are again confronted with the potential of a crippling reduction in reimbursement under the Medicare program, pursuant to the Sustainable Growth Rate (SGR).  Congress has traditionally kicked this can down the road one year or a little bit longer.  The clock is again running for the year 2015.  The policy adopted on October 31, 2014, by the Center for Medicare and Medicaid Services has reduced the Medicare reimbursement by 21.2%, starting in the Spring of 2015.


The question now is whether or not the lame duck Congress will be able to permanently fix the SGR, just kick the can for a year or to the new Congress, and then it will be up to the new Congress either to permanently correct the SGR, kick the can down the road for a year, as Congress has done on an annual basis, or fail to do anything and have the SGR implemented, which will have a major impact not only on the reimbursement to the physicians but on the entire Medicare beneficiary population.


National Law Review




Physicians Reveal Best and Worst Insurance Companies to do Business With


Insurers play a huge role in the financial lives of most physicians, and they also create some frustration. More than 6300 physicians across 25 specialties took part in an online survey from July 9 through September 21, 2014, and told us how they feel about the leading insurers.







FDA Hearing Yields Little Consensus on Abuse-Deterrent Opioids


After 2 days of public hearings addressing ways to make it more difficult to abuse opioids, no clear consensus emerged.

Researchers, regulators, industry, and patients agree that opioids are a magnet for drug abusers, but there is also widespread agreement that these drugs do what they were designed to do: kill pain. And pain is big business in the U.S.


So far, only three drugs -- the combination product oxycodone hydrochloride plus naloxone marketed as Targiniq, the morphine naltrexone combination marketed as Embeda, and reformulated Oxycontin -- have been granted abuse-deterrent labeling, but the FDA has made no secret of its desire to expand the number of these agents.


MedPage Today



Busted: 6 physicians facing jail time


The year 2014 has been one of reckoning for doctors grabbing headlines for all the wrong reasons: crime.

Overprescribing, cavorting in Medicare fraud schemes, even spiking a colleague's coffee with a common antifreeze component were all acts committed by physicians that answered to the gavel in 2014.


These docs join the 2,247 physicians convicted between 1990 and 1999 and the countless others who have been sentenced to jail before and since (The Public Citizen reported such numbers in 2006 - firm physician conviction rates through the millennium remain elusive).



Medical Practice Insider


76% of Physicians Don't Like CMS Quality Reporting Programs


A new survey of physician practices shows a high rate of dissatisfaction with several Medicare programs that are meant to improve quality and cost.


The Medical Group Management Association (MGMA), representing more than 33,000 executives and administrators of medical practices, surveyed more than 1,000 medical groups in October to assess how three quality reporting programs under Medicare Part B are affecting patient care and processes.


The Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VBPM), and Meaningful Use EHR incentives (MU-EHR) are supposed to work in tandem to improve the quality and cost of patient care. But many providers who responded to MGMA's survey say the programs are not helping their organizations achieve those goals.



HealthLeaders Media


Health Insurers "Expect at Least 20% Growth" From 2015 Enrollment

That was the lead in a Reuters story this morning saying, "health plans expect at least 20% growth in customers and in some states anticipate more than a doubling in sign-ups" from the 2015 Obamacare open-enrollment.

Well they better do a hell of a lot better than that!

The CBO has estimated that 13 million people will ultimately be covered in the Obamacare insurance exchanges in 2015.


Health Policy and Market
Prescription Opioids Involved in Most Overdoses Seen in Emergency Departments

In a national study of hospital emergency department visits for opioid overdoses, 67.8% of the overdoses involved prescription opioids (including methadone), followed by heroin, other unspecified opioids, and multiple opioids, according to a study published online by JAMA Internal Medicine.


Michael A. Yokell, Stanford University School of Medicine, Stanford, California, and colleagues analysed the 2010 Nationwide Emergency Department Sample using diagnostic codes to define opioid overdoses. They identified 135,971 weighted ED visits that were coded for opioid overdose.

DG News


New technique to switch off pain at source


Researchers have developed a new technique to switch off pain directly at the source, potentially eliminating the need for highly addictive painkillers.


The breakthrough from the Flinders Medical Centre in South Australia means chronic pain sufferers may not need drugs, such as morphine, that have so many side effects.


The research team, led by Associate Professor Nick Spencer, is closing in on a way to suppress pain arising from conditions such as neuropathic pain, inoperable tumours or terminal cancers that trigger pain receptors at specific sites in the body.



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Call for Abstracts! Make Plans Today to Participate in 17th Annual Meeting Abstract Session


Make your plans now to participate in the American Society of Interventional Pain Physicians abstract and poster presentation at the 17th Annual Meeting, April 9-11 in Orlando Florida.


This year's abstract session will be bigger and better. In response to your many suggestions, the top 20 posters will be on  display through our new  electronic poster presentations with Q & A time with poster presenters. They will also be published in Pain Physician journal.


In addition the Top 8 posters will be presented for judging during Friday's session. The top three abstracts will receive cash prizes.


Posters will be on display during the meeting on both Thursday and Friday in the exhibitor hall.


The abstract submission deadline will be February 6, 2015.



For a complete set of rules and to access the online submission application, please go to:  http://www.asipp.org/0415-Abstract-registration.htm


stateState Society News




Save The Date! CASIPP Meeting set for October 2015


The 2015 Annual Meeting of the California chapter of theAmerican Scoeit of Interventional Pain Physicians will be Oct. 16-18, 2015.  The event will take place at the Monterey Plaza Hotel in Monterey, California.  Registration will open early next year.  





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


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