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.

Recovery Audit Contractors (RACs) function based on Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Section 306 requires CMS to conduct a 3-year demonstration project to evaluate whether RACs could provide a cost-effective means of identifying and reconciling improper payments. Reimbursed on a contingency fee basis, the RACs would keep a percentage of overpayments and have a strong financial incentive to recover improper payments.

At the present time, there are three RACs evaluating claims in three states as part of demonstration project in California, Florida, and New York and the program will extend nationwide after March 2008.

However, this is an extremely onerous situation. We really can't sit tight and wait around. ASIPP is doing something about it. We are preparing a letter to send to CMS. The next step would be to contact Congress on these issues. Currently there is a bill in Congress dealing with this issue and there are approximately 40 cosponsors to the bill. We should begin work ing on this and increase the cosponsor list to see that this bill gets passed. Please wait for further news.

Please contact me with information: Laxmaiah Manchikanti, MD, 2831 Lone Oak Road, Paducah, KY 42003, Phone 270.554.8373 ext. 101, or e-mail at drm@asipp.org

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/viewtrackingsh eet.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

Many of you may have received the decision from Blue Cross Blue Shield, specifically Anthem in Kentucky and Indiana on bundling fluoroscopy codes into the procedure based on the determination of adhesiolysis code. Admittedly, adhesiolysis the code incorporates, and the relative value of fluoroscopy has been included in the code, however this is not true for all the other codes. Thus, once again it appears that there is not only a misunderstandings but also there may be a potential loss of revenue and a fight be ensuing in the future months.

ASIPP has written to CPT Executive Committee to clarify the situation. Meanwhile, we would like to know the experiences across the country with all the insurers. Please contact me with information: Laxmaiah Manchikanti, MD, 2831 Lone Oak Road, Paducah, KY 42003, Phone 270.554.8373 ext. 101, or e-mail at drm@asipp.org

This course is an essential component for interventional pain physicians and will provide educational opportunities to assist you in providing high quality, competent, safe, and cost-efficient services to your patients.

Based on the new fee schedule, ASCs were supposed to receive an approximate 3% cut for 2008 and an unknown amount for 2009. However, due to misunderstanding many carriers are using the final rate for 2008 rather than transitional rate; this is causing a significant increase in cuts. Further, due to the issues related to software programs we can no longer use modifier 50. We have been advised to file the first procedure with 2 items, either times 2 or on 2 separate lines, however, it seems that this system is not working and we are not getting paid for the second procedure in the bilateral.

We are working on this issue with CMS, as well as some local carriers. Please let us know what your experiences are. Contact me at: Laxmaiah Manchikanti, MD, 2831 Lone Oak Road, Paducah, KY 42003, Phone 270.554.8373 ext. 101, or e-mail at drm@asipp.org

On May 16 - 18, ASIPP will hold a Review Course in Fluoroscopy Cadaver Workshop in Spinal and Non-Spinal Interventional Techniques covering basic and intermediate levels. The course will be held at the Memphis Marriott Downtown and the Medical Education Research Center (MERI) in Memphis, TN.

At the completion of the Fluoroscopy course, physicians will also have the opportunity to sit for the ABIPP Competency Certification Examination in Fluoroscopic Interepretation and radiation Safety.

Register early and save. Registrations received on or before April 25 may take advantage of the early registration discount.

The Memphis Marriott Downtown is our host hotel for this event. Book your room on or before April 23 to recieve the ASIPP discount group rate of $159. Call 1- 888-557-8740.

Meetings

Drug Enforcement Administration agents searched a chain of pain management clinics in Jefferson and St. Tammany parishes Tuesday that law enforcement officials and the state's medical board said had been selling prescriptions for addictive opiates.

Federal agents and local law enforcement swarmed over Global Care clinics in Covington and Metairie on Tuesday morning and interviewed the doctor operating a third office for the firm in Harvey. By the afternoon they had collected surrendered licenses for prescribing controlled substances from three doctors, none of whom specializes in pain management, and took boxes and filing cabinets of medical and financial records.

Times-Picayune

The cost of diagnosing and treating back and neck problems rose substantially over the past decade, but Americans might not be getting their money's worth, a study suggests today. (Rubin, USA Today, Feb. 13, 2007)

Back and neck problems are among the main reasons for doctor visits, the authors write in the Journal of the American Medical Association. In a 2002 survey of U.S. adults, the authors write, just over a quarter of respondents said they'd had lower back pain in the previous three months.

USA Today

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

The Online Abstract Submission deadline has been extended to March 31, 2008. ASIPP is seeking abstracts submissions for the 10th Annual Meeting of the American Society of Interventional Pain Physicians is now open. The meeting will be held June 21- June 25, 2008 at the Crystal Gateway Marriott in Washington, DC.

To be considered for a presentation at the meeting, abstracts must be submitted by the submission deadline of 5 pm Central Standard Time (CST) March 31, 2008.

Click here for rules and submission directions.

Botox and Botox Cosmetic (Botulinum toxin Type A) and Myobloc (Botulinum toxin Type B) have been linked in some cases to adverse reactions, including respiratory failure and death, following treatment of a variety of conditions (Feb. 8, 2008)

Automated Healthcare Solutions (AHCS) utilizes proprietary state-of-the-art technology to provide innovative, revenue-enhancing business solutions for the healthcare industry.

AHCS, founded and managed by knowledgeable physicians, offers programs, products and services that allow medical practices to capture ancillary revenues all-the-while streamlining its operations.

New York Attorney General Andrew Cuomo announced an "industry-wide" investigation into an alleged scheme in which he believes insurers have manipulated reimbursement rates via health information firm Ingeniz. Cuomo said in a news release that he plans to file a lawsuit against Ingenix and its parent, UnitedHealth Group as well as three New York subsidiaries of UnitedHealth. (Feb. 13, 2008 Modern Physician)

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