ASIPP is pleased to announce Advanced Neuromodulation Systems is now our first Diamond Sponsor.

ANS is a leader in neurostimulation technologies, setting standards in the advancement of treatment for chronic pain and neurological disorders.

ASIPP wishes to thank ANS for joining us in the work of promoting the development and practice of safe, high quality, cost-effective interventional pain management techniques for the diagnosis and treatment of pain and related disorders, as well as the preservation of patient access to these interventions.

On Dec. 4, 2008 the American College of Occupational and Environmental Medicine (ACOEM)  released a chapter on low back disorders as an update to its evidence-based practice guidelines. These guidelines are currently being used or considered by various state workers' compensation programs as coverage criteria for a wide-range of pain-related tests, therapies and interventions.

Unfortunately these guidelines contain a number of flaws which prevent  them from being used as a credible tool to guide clinical decisions. Because of this, the American Society of Interventional Pain Physicians (ASIPP), along with the American Academy of Pain Medicine (AAPM), the International Spine Intervention Society (ISIS), the Neuromodulation Academy Coalition (NTAC), and the North American Neuromodulation Society (NANS) have joined together to show our concern.

While we all strongly support the use of evidence- based medicine to guide clinical decisions, we oppose the inappropriate use of evidence-based guidelines as strict coverage criteria by public or private payers.

The guidelines are so troubling in fact, Representatives Bart Stupak (D-MI) and Ed Whitfield (R-KY) have issued a letter to the ACOEM expressing their concern.

On Nov. 26, 2007, ASIPP presented its specific concerns with the guidelines in a comment letter from CEO Laxmaiah Manchikanti to ACOEM President Robert McLellan.

Pain Medicine News covered the issue in its January edition. On Jan. 9, 2007 the Wall Street Journal also addressed issues with the ACOEM's guideline process.

Click on the following links to learn more about this pressing issue:

• ASIPP Comments
• Letter from ASIPP President
• Joint Position Letter
• Joint Letter to ACOEM
• Congressional Letter

CMS (Centers for Medicare Medicaid Services) has opened a public comment period for Thermal Intradiscal Therapy to make a National Coverage Determination (NCD). This includes IDET, percutaneous intradiscal radiofrequency thermocoagulation (PIRFT), and disc biacuplasty.

After this comment period CMS will review the evidence to determine if Thermal Intradiscal Therapy is reasonable and necessary for coverage under the Medicare Program. The comment period ends January 30, 2008. You can view this bulletin at: https://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?from2=viewtrackingsheet.asp&id=215&

The scope of this NCD does not include disc nucleoplasty, which involves the creation of a series of channels to remove tissue from the nucleus and is intended to decompress the disc.

The public comment period ends February 14, 2008. CMS expects a decision memo by July 15, 2008, with a final analysis completed by October 13, 2008.

To submit public comments go to: http://www.cms.hhs.gov/InfoExchange/02_publiccomments.asp

The 2008 final physician fee schedule for interventional pain management procedures is now posted on the ASIPP Web site.

The Massachusetts Supreme Judicial Court has now given physicians another reason to pause before prescribing painkillers. The state's highest court allowed a lower court to hear a lawsuit resulting from a car accident in which a 75-year-old man, who was on various medications for medical ailments, killed a 10-year-old boy. The man, who had cancer, has since died, but the boy's family sued the man's physician because he had prescribed the medications without adequate (according to the lawsuit) instructions about driving.

Boston.com

Clinicians are facing increased liability related to the management of their patients in chronic pain, as the numbers of both malpractice claims and settlement amounts have risen in recent years.

The share of claims involving patients with chronic pain claims nearly doubled-to 12% from 7%- between 1985 and 2004, according to a new study of the Closed Claims Project. Although the percentage of claims that resulted in payment dropped to 40% from 54% across those years, payment amounts in 1999 dollars nearly tripled, from $52,000 to $153,000, during the study period.

Pain Medicine News

A class of osteoporosis drugs may cause severe and sometimes debilitating pain, the FDA warned Monday. The drugs, bisphosphonates, already carry warning labels about painful side effects, but some doctors still fail to consider whether the treatments are responsible for extreme pain in patients, the agency said.

FDA Alert

On Nov. 19, 2007, the U.S. Drug Enforcement Administration (DEA) released its long-awaited final rule on the use of multiple prescriptions for Schedule II controlled substances (the "DNF rule"). The rule took effect Dec. 19, 2007, and its prescriptions will be subject to state approval.

On Sept. 6, 2006, the DEA published in the Federal Register a notice of proposed rulemaking to amend existing regulations to allow practitioners to provide individual patients with multiple prescriptions for the same Schedule II controlled substance. The multiple prescriptions would enable patients to receive over time "up to a 90-day supply" of medication.

Pain Medicine News

In a study of nearly 240 patients with lower back pain, the doctors said that the Prodisc, an artificial spinal disk, had worked much better than conventional surgery in which patients' vertebrae were fused.

"As a surgeon, it is gratifying to see patients recover function more quickly than after fusion and return to their normal activities more easily," Dr. Jack E. Zigler, a well-known spine specialist and one of the study's lead researchers, said in a 2006 news release announcing the latest results of the Prodisc clinical trial.

The New York Times

Pain Physician journal will feature three special topical issues this year, in addition to the regular bimonthly publications. The American Society of Interventional Pain Physicians' official journal, Pain Physician, will feature these special issues:

February: Opioids - This issue will include the 2007 updated Opioid guidelines in addition to systematic reviews, and health policy reviews

June: Ethics - Topics will cover:
1. general issues in normative and applied medical ethics as relevant to the care of pain;
2. clinical ethical issues focal to under- and/or over- treatment of pain;
3. conceptual and practical issues related to informed consent;
4. conceptual and practical issues related to (institutional) review of (experimental, quasi- experimental and/or clinical) studies of pain assessment, and/or therapeutics;
5. ethical issues relevant to medico-legal concerns and/or development and articulation of health policy and law.

December: health policy and practice management

All written materials should follow Pain Physician manuscript for author's instructions. The topical issues will also undergo peer review. For more information contact Holly Long at hlong@asipp.org

For your convenience, you may now pay your dues online. Click here then click on "Renew Here." No password is required to renew. If you have questions or need assistance contact the ASIPP office at 270-554-9412 Ext. 208

ASIPP is offering a new feature for those who advertise on our Postions Wanted section of the ASIPP Website. As a service to our advertisers and our members, we will list the link to each current job posting.

Fellowship Trained Physician — Northwest Indiana

Outpatient Interventional Pain Physician — Atlanta, Georgia

BC/BE Physiatrist — Shrewsbury, New Jersey

100% Pain Practice — Eau Claire, Wisconsin

Partnership Opportunity — Milwaukee, Wisconsin

Interventional Pain Physiatrist Wanted — Nevada

Interventional Pain Specialist — Bethlehem, Pennsylvania

Pain Management Opportunity — Pennsylvania

Entrepreneurial Opportunity — Lake Tahoe, Nevada

Florida Opportunities

Pain Medicine Fellowship Program Opportunity

Interventional Pain Specialist — Paducah, KY and Marion, IL

Interventional Pain Medicine Physician — St. Cloud, Minnesota