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American Society of Interventional Pain Physicians News  | May 27, 2015


    1. Article Addresses SGR: Good, Bad, Ugly  
    2. ASIPP Webinar: Get On The Road To ICD-10 Success For Your Pain Management Practice  
    3. Article Addresses Challenges of IT
    4. Registration Now Open for July Board Review Course in Chicago  
    5. ASIPP To Offer Controlled Substance Management, Coding, Compliance and Practice Management Courses in Chicago
    6. Pain Physician Accepting Section Editor Nominations 
    7. Doctors Among Dozens Held in Raids Against Illegal Sales of Prescription Drugs
    8. Opioid Users at Greater Risk for Atrial Fibrillation 
    9. Could Trans-Pacific Partnership Place Drugs Out of Reach? 
    10. Adding Opioids to Cannabis for Chronic Pain Won't Raise Substance Abuse Risk 
    11. Health Insurers Seek Hefty Rate Boosts Failure in Addiction Therapy Usually Seen Early 
    12. Many Parts to Solving Opioid Addiction Problem, Congress Told
    13. What is flakka (aka gravel) and why is it more dangerous than cocaine?
    14. State Society News 
    15. Physician Wanted 

carrotArticle Addresses SGR: Good, Bad, Ugly


In the May/June Issue of Pain Physician, Laxmaiah Manchikanti, MD, Peter S. Staats, MD, Mark V. Boswell, MD, PhD, and Joshua A. Hirsch, MD have published the article:

The Analysis of the Carrot and Stick Policy of Repeal of Sustainable Growth Rate Formula: The Good, The Bad, and The Ugly



The Balanced Budget Act which became law in 1997 was designed to help stem the increasing in costs of healthcare. The Sustainable Growth Rate (SGR) formula was incorporated into that law as a method of helping balance the budget through a complex formula tying reimbursement to the growth in the economy. Soon after its inception, the flawed nature of the formula, linking the balancing of the federal budget to physician professional fees was realized. Congress has provided multiple short-term fixes known as SGR patches over the years so as to avoid generally progressively larger negative corrections to professional reimbursement. The near annual SGR correction requirement has been compared to Groundhog Day in the legislative arena. Over the years, physician and other providers faced numerous looming, large cuts. Most recently, on April 1, 2015 physicians faced a 21.2% cut in provider payments. To the surprise of many, in April 2015 a bipartisan bicameral effort permanently repealed the Medicare SGR formula for controlling provider payment.


The repeal of SGR means the temporary measures to override the growth rate formula will no longer dominate Medicare policy discussions and now the focus turns to continue payment reforms. The MACRA provides physicians and other health care professionals with stable fee update for 5 years and it follows with a new incentive program, termed the Merit-based Incentive Payment System (MIPS) replacing and consolidating pre-existing incentive payment programs: meaningful use of electronic health records (EHR), physician quality reporting system, and the value-based payment modified. Thus, payments to clinicians will be subjected to adjustments based on participation in MIPS or other approved alternative payment mechanisms. This legislation also creates numerous other regulations.


The MACRA has been criticized for providing insufficient statutory updates, enacting a flawed quality and performance improvement program associated with MIPS and inappropriate use of utilization and payment data. Thus, the MACRA offers physicians a predictable schedule for Medicare rates - a carrot, and controls the physician behaviors with payment reforms analogous to a stick. Thus, it could be said that this legislation embodies some good, bad, and ugly aspects.





ASIPP Webinar: Get On The Road To ICD-10 Success For Your Pain Management Practice! 


Marvel Hammer, RN, CPC will host a webinar on May 28 from 11 am to 12:30 pm CST on ICD-10.


This webinar will focus on the actual ICD-10 codes and corresponding ICD-10 guidelines. Some of the important topics to be covered ...

  • The differences and similarities between ICD-9 and ICD-10
  • Is Your Documentation Up to Snuff?  Find Out What Needs to Change In Your Pain Management Notes to Continue Correct Coding in ICD-10
  • When pain management providers should report an acute or chronic pain ICD-10 code as the primary diagnosis
  • How to report bilateral conditions when ICD-10 only include specific unilateral codes
  • The importance of including "cause and effect" etiology in their notes by using  words such as "due to," "secondary to," "caused by," or "resulting from" to connect conditions to their underlying cause
  • What is the difference in reporting initial versus subsequent encounters in ICD-10...Hint: It doesn't necessarily match new patient versus established patient in CPT!
  • When a cervical spinal condition should be reported as "high cervical" versus "mid-cervical" versus "cervicothoracic"?



Click HERE to register


addressesArticle Addresses Challenges of IT


A Case for Restraint of Explosive Growth of Health Information Technology: First, Do No Harm

 Laxmaiah Manchikanti, MD, and Joshua A. Hirsch, MD


Information technology has brought significant advances to modern life. We, like many others, believe that IT properly utilized in the delivery of health care ultimately bodes well for the care of our patients. The challenge is that the current technology does not live up to that promised state of multiple elements of improved care through IT. Despite that, legislative mandates have required large-scale adoption of present day health care IT solutions. These regulations have been particularly challenging for independent practitioners. Our efforts at making these points are now supported by a growing body of research including a very important analysis by the Economic Cycle Research Institute.





Registration Now Open for July Board Review Course in Chicago


Make plans today to attend the 2015 Board Review Course set for July 21-24 at the Palmer House in Chicago, IL.


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




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.


Educational Objectives for Coding, Compliance, and Practice Management in IPM:

- Discuss documentation

- Review practice management topics

- Discuss coding and billing

- Examine compliance issues


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


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


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

sectionPain Physician Accepting Nominations for Editorial Board and Section Editors   


Pain Physician journal is currently looking for nominations for editorial board members and section editors. The editorial board is a key component to the success of Pain Physician.


The editorial board serves as reviewers for all manuscripts submitted to the journal.
The members of the Editorial Board will be asked to review a minimum of 6 manuscripts per year. Failure to review 2 manuscripts consecutively or 60% of the manuscripts sent will disqualify one from Editorial Board Membership. If you would like to become a reviewer for Pain Physician, please email your CV to the Editorial Coordinator, Holly Long, at hlong@asipp.org.

Section Editors are a relatively new part of the editorial decision-making structure for the journal. These positions were created, to both lighten the burden on the Editor-in-Chief and improve the quality of content. This will also help the editorial board. Pain Physician has experienced a dramatic increase in the number of submissions and we are working on ways to streamline production.


Consequently, we would like to take this opportunity to ask if you would be interested in a position as a Section Editor for Pain Physician. We are looking for individuals who have at least 30 published articles and an interest in one of the following areas:
Interventional Techniques 
NonInterventional Techniques 
Controlled Substances 
Basic Science 
Health Policy 
Cancer Pain

Section Editor responsibilities are as follows:

  • After peer review, each Section Editor is responsible for the selection and approval of manuscripts submitted in their subject area.  
  • Each Section Editor provides recommendations to the Editor-in Chief after evaluating the opinions provided through peer reviews by editorial board members.


Based on the Section Editor's evaluation, the Editor-in-Chief will recommend whether to accept or reject the manuscript. A process for conflict resolution will be developed. If interested, please send your CV to hlong@asipp.org.

dozens Doctors Among Dozens Held in Raids Against Illegal Sales of Prescription Drugs


Seven doctors and 41 others in four Southern states were arrested Wednesday in raids by Drug Enforcement Administration agents, officials said, part of what the agency called its largest operation against illegal trafficking of prescription drugs. The raids came after a 15-month investigation by the agency, which focused on the illegal sale and distribution of painkillers including oxycodone and hydrocodone and the tranquilizer Xanax.


At a news conference, officials said the arrests were in addition to 230 others made during the investigation, which targeted doctors, pharmacists, street-level dealers and others. The arrests Wednesday were made in Alabama, Arkansas, Louisiana and Mississippi. In Mobile, Ala., two doctors who ran two pain clinics and also owned a pharmacy were arrested and charged with dispensing controlled substances outside the usual course of medical practice, and for health care fraud.



New York Times


atrialOpioid Users at Greater Risk for Atrial Fibrillation


Analysis of data from a previous study indicates that opioid use may increase the risk of heart attack by triggering atrial fibrillation (AF).
The observation that opioid agonists can reduce the incidence of AF in animals led researchers from Wake Forest and the University of Alabama to hypothesize that AF might explain the long-observed link between opioid use and heart attacks in humans.



HCP Live

reachCould Trans-Pacific Partnership Place Drugs Out of Reach?
The agreement could raise prices, endanger public health, says Doctors Without Borders.


WASHINGTON -- As President Obama continues to promote a landmark Pacific-rim trade deal, one humanitarian physician group is sounding the alarm over the deal's provisions regarding generic drugs.


Doctors Without Borders, an international aid group, told MedPage Today that the Trans-Pacific Partnership (TPP) Agreement, considered the largest trade pact in U.S. history, would create monopolies for brand-name pharmaceutical drugs, limit generic competition, and lead to higher drug prices.



MedPage Today

cannabisAdding Opioids to Cannabis for Chronic Pain Won't Raise Substance Abuse Risk


Chronic pain patients using prescription opioids in conjunction with medical marijuana are not at increased risk for substance abuse.

This conclusion counters what researchers originally hypothesized in a recent study published in The Journal of Studies on Alcohol and Drugs.

"We expected that persons receiving both cannabis and prescription opioids would have greater levels of involvement with alcohol and other drugs. However, that wasn't the case," said lead author Brian Perron, PhD, in a press release. "Although persons who were receiving both medical cannabis and prescription opioids reported higher levels of pain, they showed very few differences in their use of alcohol and other drugs compared to those receiving medical cannabis only."


Pharmacy Times

boostsHealth Insurers Seek Hefty Rate Boosts


Major insurers in some states are proposing hefty rate boosts for plans sold under the federal health law, setting the stage for an intense debate this summer over the law's impact.

In New Mexico, market leader Health Care Service Corp. is asking for an average jump of 51.6% in premiums for 2016. The biggest insurer in Tennessee, BlueCross BlueShield of Tennessee, has requested an average 36.3% increase. In Maryland, market leader CareFirst BlueCross BlueShield wants to raise rates 30.4% across its products. Moda Health, the largest insurer on the Oregon health exchange, seeks an average boost of around 25%.

All of them cite high medical costs incurred by people newly enrolled under the Affordable Care Act.

Under that law, insurers file proposed rates to their local regulator and, in most cases, to the federal government. Some states have begun making the filings public, as they prepare to review the requests in coming weeks. The federal government is due to release its rate filings in early June.



Wall Street Journal


Access to this article may be limited.

failureFailure in Addiction Therapy Usually Seen Early


TORONTO -- Starting well in a prescription opioid addiction treatment program is no guarantee of long-term success, a researcher said here.


But starting poorly usually means failure down the road, according to Roger Weiss, MD, of McLean Hospital in Belmont, Mass.


MedPage Today


congress Many Parts to Solving Opioid Addiction Problem, Congress Told


WASHINGTON -- States need to have more interoperative prescription drug management programs (PDMPs) in order to better combat the opioid abuse epidemic, state officials told a congressional committee.


"We need better communication, and we need more real-time information," Indiana state health commissioner Jerome Adams, MD, MPH, told the House Energy and Commerce Subcommittee on Oversight and Investigations Thursday. "We need to share information across state lines."



MedPage Today


flakkaWhat is flakka (aka gravel) and why is it more dangerous than cocaine?


It goes by the name flakka. In some parts of the country, it is also called "gravel" because of its white crystal chunks that have been compared to aquarium gravel.


The man-made drug causes a high similar to cocaine. But like "bath salts," a group of related synthetic drugs that were banned in 2012, flakka has the potential to be much more dangerous than cocaine.


"It's so difficult to control the exact dose [of flakka]," said Jim Hall, a drug abuse epidemiologist at Nova Southeastern University in Fort Lauderdale, Florida. "Just a little bit of difference in how much is consumed can be the difference between getting high and dying. It's that critical."



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State Society News



WVSIPP Meeting Set for  Aug 13-16, 2015

The West Virginia Society of Interventional Pain Physicians will hold its annual meeting at the Eden Roc Miami Beach, Miami Beach, FL Aug. 13-16, 2015. For more information, go to www.painconfreg.info     

Save The Date! CASIPP Meeting set for October 2015
The California chapter of the American Society of Interventional Pain Physicians  will hold its 6th Annual Meeting in Monterey, CA at the Monterey Plaza Hotel Resort over the weekend of October 16-18. Agenda and registration can be found online at www.casipp.com or by calling 661-435-3473. 


NY and NJ Societies to hold Pain Symposium Nov. 5-8

The New York and New Jersey Societies of Interventional Pain Physicians will host a Pain Symposium titled Evolving Pain Therapies on November 5-8, 2015 at the Hyatt Regency, Jersey City, NJ. Click HERE for Schedule and more information.


SAVE the DATE: FSIPP Meeting May 20-22, 2016

The Florida Society of Interventional Pain Physicians will hold its annual meeting in 2016 on May 20-22. The meeting will be held at the Orlando World Center Marriott in Orlando.

Watch FSIPP.org for more details.





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



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