Update on FDA Steroid Saga

As you all know, ASIPP has worked on FDA issue to reverse the present warning and avoid the so called 17 recommendations developed by Multi-Society Pain Workgroup and eventually published in Anesthesiology journal. A citizens petition was submitted with 1,040 signatures. We have also testified at FDA hearings and published multiple manuscripts on the issue with one more manuscript in press at the present time in response to FDA warning and Multi-Society Pain Workgroup release of the warnings.  

FDA Warning

 Multi-Society Pain Work Group Warnings
 

Rathmell's Article in Anesthesiology:

Safeguards to prevent neurologic complications after epidural steroid injections: Analysis of evidence and lack of applicability of controversial policies. 

Neurological complications associated with epidural steroid injections. 

Epidural steroid injections safety recommendations by the Multi-Society Pain Workgroup (MPW): More regulations without evidence or clarification. 

Epidural steroid warning controversy still dogging FDA. 

We finally received a reply from FDA which essentially seems is not going anywhere with this issue. Their statement states the following: The FDA has been unable to reach a decision on your petition because it raises complex issues requiring extensive review and analysis by agency officials. They also stated that they will respond to our petition as soon as they have "reached a decision on our request.

Registration Now Open for July Board Review Course in Chicago

This intensive and comprehensive high-quality review will prepare physicians appearing for the American Board of Medical Specialties (ABMS)-Subspecialty Pain Medicine examination and for the American Board of Interventional Pain Physicians (ABIPP)-Part 1 examination.

- A five-day review covering anatomy, physiology, pharmacology, psychology, ethics, interventional techniques, non-interventional techniques, controlled substances and practice management

- Unique lectures by experts in the field

- Extensive educational materials

 MEETING LINKS  |  REGISTRATION  |  BROCHURE  |  PALMER HOUSE  |  

ASIPP To Offer Controlled Substance Management, Coding, Compliance and Practice Management Courses in Chicago

The ASIPP Comprehensive Review Courses and Exams in Controlled Substance Management and Coding, Compliance, and Practice Management will be held in Chicago, Illinois, on July 22-24, 2015.

The Coding, Compliance and Practice Management is so beneficial to practices, both office-based and ASCs, that many physicians send their staff early to keep them current on the cutting edge aspects of practice management. These intensive review courses are 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 course features many nationally recognized experts in pain management billing and coding and practice management as well as controlled substance management. In today's environment of regulations and litigations, you can't afford not to broaden your knowledge and refresh your skills in these areas.

- Discuss documentation

- Review practice management topics

- Discuss coding and billing

- Examine compliance issues

CLICK HERE to register for Coding, Compliance and Practice Management Course 

- 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

CLICK HERE to register for Controlled Substance Management Course 

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 and Coding, Compliance, and Practice Management.

Click HERE for Reservations at The Palmer House Hotel  

17 East Monroe Street, Chicago, IL 60603 | Phone: 312-726-7500

What a difference a year makes.

Last year the California Obamacare insurance exchange, Covered California, was touted as the poster child for the Obamacare launch. Supporters said it worked well, enrolled lots of people, and was off to the kind of start that proved how successful Obamacare could be.

But after the second open enrollment new sign-ups have hit a wall, customer renewal rates are among the worst in the country, and consumer complaints are growing:

• Covered California enrollment "increased by only one percentage point this year, despite a big investment in outreach."
• Total enrollment has stalled out at 40% of potential enrollment.
• Yelp gives Covered California a single-star rating based upon almost universally highly critical consumer reviews.

Health Policy and Market 

On April 14, 2015, Congress ended over a decade of repeated "doc fixes" which temporarily suspended scheduled Medicare provider reimbursement cuts, by passing the Medicare Access and CHIP Reauthorization Act (the "Act").  If signed by President Obama, the Act would permanently end the Centers for Medicare & Medicaid Services' ("CMS") use of the physician payment formula known as the "Sustainable Growth Rate" ("SGR"). Without the approval of the Act, or the passage of a doc fix, providers would have seen Medicare reimbursement rates drop by 21 percent starting on April 15, 2015.

The SGR formula has long been criticized for inaccurately calculating the costs of providing health services in its attempt to link physician reimbursement to the nation's economic growth rate via the gross domestic product and inflation.[1] Since the SGR adoption in 1997, the threatened SGR-mandated cuts in physician payment rates have prompted Congress to pass doc fixes at least annually since 2003, and as much as five times in 2010 alone. The chief stumbling block to earlier repeal had been disagreement over how to pay for the repeal, with conservatives pushing for a package that was fully offset in the federal budget. However, this year there was bipartisan support for only partial financing of an SGR repeal. The Act is estimated to cost approximately $210 billion, with extenders for certain programs accounting for about $70 billion of the package.

National Law Review

As the number of healthcare data breaches increase, so will the number of HIPAA violation settlements, according to Adam Greene, a privacy attorney and former regulator at HHS.

In an interview at HIMSS15 in Chicago with Information Security Media Group, Mr. Greene said the HHS' Office of Civil Rights is facing "a significant pipeline of unprecedented settlement agreements," according to Govinfosecurity.

"It wouldn't be surprising for us to start seeing in the latter part of this year some really surprising settlement agreements with respect to potential record-breaking [financial penalties]," Mr. Greene said.

Becker's Health IT Review

WASHINGTON -- Women with an average risk of breast cancer should have screening mammography every 2 years during ages 50 to 74, according to updated recommendations from the United States Preventive Services Task Force (USPSTF).

After reviewing available data, the panel concluded that women, ages 60 to 69, derive the greatest benefit from screening mammography in terms of preventing breast cancer death.

Selected women 40 to 49 might reduce their risk of dying of breast cancer with regular mammographic screening, but the benefit is much smaller as compared with older women and leads to too many false-positive tests and unnecessary breast biopsies, the USPSTF concluded in a draft document posted on the task force website. The posting begins a 30-day public comment period.

MedPage Today

Two changes to the pain medication market, the introduction of tamper-resistant OxyContin and the removal of propoxyphene, were followed by decreases in opioid prescription-related overdoses and dispensation of these medications, researchers reported.

Two years after these two market interventions, opioid-related overdoses dropped by 20%, and opioid dispensation rates dropped by 19%, from the expected rate of increase over a decade, Marc R. Larochelle, MD, MPH, of Boston University School of Medicine, and colleagues, reported online April 20 in JAMA Internal Medicine.

MedPage Today

Medicare spent approximately $316 billion less between 2009 and 2013 than would have occurred had pre- 2009 spending trends persisted, according to a new HHS report.

From 2000 to 2008, Medicare spending on beneficiaries - those in traditional Medicare and Medicare Advantage - grew at an average rate of 5.9 percent annually, according to HHS. That annual growth rate plummeted to 1.8 percent from 2009 to 2012, and then to 0.2 percent in 2013.

If the 2000 to 2008 growth rates had continued through 2013, Medicare would have spent $316 billion more during the 2009 to 2013 period, HHS said. Data in the report shows that $198 billion of the savings came from traditional Medicare, while $118 billion came from Medicare Advantage.

Becker's Hospital CFO

NPR's Melissa Block talks with Beth Meyerson of the Rural Center for AIDS/STD Prevention at Indiana University about the nearly 130 confirmed HIV cases, which are linked to injection drug use.

A small rural county in Indiana is dealing with a dramatic spike in cases of HIV. Typically, Scott County sees five new HIV cases each year. Already in 2015, they have seen 128. And today the governor of Indiana, Mike Pence, extended a public health emergency in Scott County. This allows a temporary needle exchange program to continue there. State lawmakers are now considering a bill that would let other counties run needle exchange programs of their own. Beth Meyerson testified at the state capitol today in support of needle exchange. She's co-director of the Rural Center for AIDS/STD Prevention at Indiana University and joins me now. Welcome to the program.

NPR