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American Society of Interventional Pain Physicians News  | November 12, 2014


  1. FDA Meeting on Epidural Steroid Use set for Nov. 24
  2. Affordable Care Act in the News
  3. Take a Moment to Participate in Physician Survey on Epidural Steroid Injections
  4. Obama's call for an open Internet puts him at odds with regulators
  5. Trevi Therapeutics gets $26M for opioid anti-itch drug 
  6. Doctors Cash in on Drug Tests for Seniors, and Medicare Pays the Bill 
  7. CMS Releases Physicians Fee Schedule for all Services 
  8. Dr. Devi Interviews on Various Medical Issues 
  9. What to expect from the lame duck Congress 
  10. Call for Abstracts! Make Plans Today to Participate in 17th Annual Meeting Abstract Session 

meetingFDA Meeting on Epidural Steroid Use set for Nov. 24


On November 24-25, 2014 the FDA Anesthetic and Analgesic Drug Products Advisory Committee Meeting will hold a meeting to discuss the risk of serious neurologic adverse reactions associated with epidural steroid injections (ESI) administered to reduce inflammation for pain management. The committee will also consider the efficacy of ESI and the overall risk benefit balance of injecting steroids in the epidural space to treat pain. The outcome of this meeting will determine future regulatory options, including but not limited to changes to the product labeling. This FDA hearing could be the greatest threat to IPM than anything we have faced in the past.


It is our understanding that several pain organizations and other societies such as ASA, PMR, etc., will also be presenting both pro and con views. In addition and most importantly, there are many patient groups such as the Arachnoiditis Association, which may be presenting in opposition to epidural injections.


The open public portion of the meeting will take place on Monday, November 24 from 8:00 a.m. to 5:00 p.m. If you would like to attend you would need to arrive on Sunday and could leave Monday afternoon and there are numerous hotels available in the area. The meeting location is:


FDA White Oak Campus

Building 31

The Great Room (Rm. 1503)

White Oak Conference Center

10903 New Hampshire Avenue

Silver Spring, Maryland


It is crucial that we have good representation at the meeting. If you are planning to attend please let us know.


ACA Architect: 'The Stupidity Of The American Voter' Led Us To Hide Obamacare's True Costs From The Public


You've got to hand it to MIT economist Jonathan Gruber. The guy dubbed the "Obamacare architect" is a viral YouTube sensation. A few months back, he was caught on tape admitting that Obamacare doesn't provide subsidies for federally-run insurance exchanges; it's now the topic of a new case before the Supreme Court.

Today, new video surfaced in which Gruber said that "the stupidity of the American voter" made it important for him and Democrats to hide Obamacare's true costs from the public. "That was really, really critical for the thing to pass," said Gruber. "But I'd rather have this law than not." In other words, the ends-imposing Obamacare upon the public-justified the means.



The new Gruber comments come from a panel discussion that he joined on October 17, 2013 at the University of Pennsylvania's Leonard Davis Institute of Health Economics. He was joined on the panel by Penn health economist Mark Pauly. Patrick Howley of the Daily Caller was the first to flag Gruber's remarks.







It was about Obamacare. Big time. 


A number of liberal pundits working off of White House talking points became heavily invested in the argument that the election was not about Obamacare. They seemed to believe if the election was about something else, Obamacare wouldn't be repudiated or the GOP would lack a mandate to get rid of it. This was, to put it mildly, silly and desperate.


No matter how many GOP ads were cut, how much direct mail was distributed, or campaign Web sites were created pledging to eliminate Obamacare or attacking Democrats for supporting it, the election could not be a referendum on Obamacare, according to the left-wing blogosphere. But it was. Of all the president's policies that were on the ballot, Obamacare was the most significant.



The Washington Post




SCOTUS Surprises With Review of ACA Subsidy Case


WASHINGTON -- The fact that the Supreme Court has agreed to hear so soon a case involving the legality of subsidies given to consumers using the federally run health insurance exchange means that the plaintiff's effort to overturn the subsidies may have a better chance of succeeding than originally expected, experts say.


On Friday, the court agreed to hear the case, known as King v. Burwell, which is similar to a more well-known case called Halbig v. Burwell. In both cases, the plaintiffs argue that the subsidies being issued in the federally run exchanges to help people pay their insurance premiums are illegal because of the wording allowing for the subsidies in the Affordable Care Act (ACA).



MedPage Today





Health-Law Enrollment in 2015 Won't Meet Forecast


WASHINGTON-Millions fewer people will enroll in private health plans under the Affordable Care Act next year than the Congressional Budget Office had predicted, the Obama administration said Monday.


The developments are the latest sign that the law, which Democrats passed in 2010 to provide near-universal health insurance, is struggling to reach that goal quickly. Attracting new enrollees to the health law's insurance exchanges has proven more difficult than advocates had predicted, and a slice of those who do sign up for plans haven't kept up with premiums.



Wall Street Journal


Access to this article may be limited.





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. 


Obama's call for an open Internet puts him at odds with regulators


Hours after President Obama called for the Federal Communications Commission to pass tougher regulations on high-speed Internet providers, the agency's Democratic chairman told a group of business executives that he was moving in a different direction.


Huddled in an FCC conference room Monday with officials from major Web companies, including Google, Yahoo and Etsy, agency Chairman Tom Wheeler said he has preferred a more nuanced solution. That approach would deliver some of what Obama wants but also would address the concerns of the companies that provide Internet access to millions of Americans, such as Comcast, Time Warner Cable and AT&T.



The Washington Post



Trevi Therapeutics gets $26M for opioid anti-itch drug


New Haven biotech Trevi Therapeutics is developing a treatment for chronically unscratchable itches - its oral drug is an extended release opioid meant to treat a number of pruritic conditions. These can be quite serious, after all - chronic itching can lead to a markedly reduced quality of life in a number of dermatologic, metabolic, hematologic and neuropathic conditions. It's often classified as chronic pain.


The startup just closed an additional $11 million in its Series B, bringing the total round to $26 million. It's led by TPG Biotech, the life sciences venture investing arm of private equity firm TPG Capital.



MedPage Today


Doctors Cash in on Drug Tests for Seniors, and Medicare Pays the Bill


Doctors are testing seniors for drugs such as heroin, cocaine and "angel dust" at soaring rates, and Medicare is paying the bill.


It is a roundabout result of the war on pain-pill addiction.


Medical guidelines encourage doctors who treat pain to test their patients, to make sure they are neither abusing pills nor failing to take them, possibly to sell them.



Wall Street Journal


Access to this article may be limited.


Dr. Devi interviews on Various Medical Issues


October 25:

MSNBC: "Weekends With Alex Witt"




October 30: Second Ebola-Infected Nurse Released From Hospital

CNN: "CNN Newsroom With Brooke Baldwin"




October 31: Is Kaci Hickox a Threat to the Public?

MSNBC: "The Daily Rundown"




October 31: Judge Lifts Quarantine

MSNBC: "Politics Nation with Rev. Al Sharpton"




November 2: How To Fall Asleep in 60 Seconds

Fox News Channel: "Fox and Friends"




November 3: Brittany Maynard Dies With Dignity

HLN: "HLN Now"





What to expect from the lame duck Congress


Washington (CNN) -- Triumphant Republicans return to Washington Wednesday to prepare for a new era of GOP dominance on both sides of the Capitol.


But first, they have to get through a short, final Senate session under Democratic control.


The post-election lame duck session should be fast-paced as lawmakers work to clear leftover business, including a must pass bill to fund the government, and other bills to arm Syrian rebels and extend expiring tax breaks. Republican leaders are anxious to start the new Congress in January with a clean slate when they could control as many as 54 seats.






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

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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 the American Society 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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