August 2, 2006

Opioid Guidelines Included on AHRQ/ NGC Web Site

ASIPP is proud to announce the 2006 “Opioid Guidelines in the Management of Chronic Non-Cancer Pain,” accepted this past March for inclusion on the AHRQ/NGC Web site. The Web site offers a summary abstract along with a link to access the full article. The current Guidelines were originally published in the January 2006 Pain Physician journal (Volume 9, Issue 1). They were developed over a six-month period by a large group of pain practitioners representing both academic and private practices.

“These guidelines should help pain physicians prescribe opioids safely, effectively, and appropriately,” said lead author, Andrea Trescot, MD. The document, with over 350 references, reviews the best available evidence as well as the consensus of national experts regarding opioids. Topics covered include the economic impact of chronic pain, drug diversion, opioid metabolism, drug interactions, prescription drug monitoring programs, clinical effectiveness, adherence monitoring, and principles of opioid use.

NGC Web site: http://www.guideline.gov/

AHRQ Web site: http://www.ahrq.gov/clinic/epcix.htm

Or you may view the guidelines at: http://www.asipp.org/Guidelines.htm

Pre-election Push for Medicare Payment Fix

Efforts to get a bill passed by October are complicated by the news that Medicare premiums will rise more than 10% next year and lawmakers on Capitol Hill are being urged to reverse next year's Medicare physician pay cut before Congress adjourns for the mid-term elections. This effort is occurring against a backdrop of rising federal spending and beneficiary premiums.

The American Medical Association (AMA) has called on lawmakers to turn next year's projected 4.7% reimbursement reduction into an increase before they leave town in October. Eighty senators signed onto a July 17 bipartisan letter to Senate leadership backing this call to action.

A mid-year budget review released by the White House just days before the letter came out, however, concludes that Medicare is spending more on physician services as time goes on even without taking reimbursement rates into account as reported by the AMA News. The Bush administration's projection of what Medicare will spend on doctor care in the next five years now stands at just over $1 trillion, an increase of $30 billion over its estimate from February. The change is largely due to an unexpected jump in the number and complexity of services that doctors are delivering.

Read the GAO report on Medicare Physician Payments: http://www.gao.gov/new.items/d061008t.pdf

Subscribers can read more about Medicare Payment Fix at:

http://www.ama-assn.org/amednews/2006/08/07/gvl10807.htm

Manchikanti Testifies at Congressional Hearing

Laxmaiah Manchikanti, MD, ASIPP CEO testified on July 26 in a congressional hearing entitled, “Prescription Drug Abuse: What is Being Done to Address This New Drug Epidemic?” The hearing is being conducted by the Subcommittee on Criminal Justice, Drug Policy, and Human Resources, in the Committee on Government Reform, U.S. House of Representatives.

The hearing was held in response to the epidemic problem of prescription drug abuse. In a recent Household Survey, it was determined that prescription drug abuse is second only to marijuana abuse. The survey also indicated that drug abuse started with prescription drugs more often than with marijuana.

The Subcommittee will make recommendations concerning potential legislation based upon the information gained at the hearing. Read Dr. Manchikanti’s official written testimony along with other panel members at:

http://reform.house.gov/CJDPHR/News/DocumentSingle.aspx?DocumentID=47907

Press the hearing overview: http://www.dea.gov/pubs/cngrtest/ct072606.html

Voice Of America online news article on the hearing:

 http://www.voanews.com/english/2006-07-28-voa59.cfm

To learn more about the Subcommittee on Criminal Justice, Drug Policy, and Human Resources, in the Committee on Government Reform visit their Web site: http://reform.house.gov/CJDPHR/

CCI Quarterly Update

CMS released the quarterly update to the Correct Coding Initiative (CCI) edits, version 12.2, effective July 1, 2006. No major changes were reported.

See the update: http://www.asipp.org/documents/CCIJuly2006.pdf

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5064.pdf

Physician Self-Referral Exceptions for Electronic Prescribing and Health Records Tech

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) amended the Act to establish a prescription drug benefit in the Medicare program. As part of the new benefit, Congress directed the Secretary to establish standards for electronic prescribing with the objective of improving patient safety, quality of care, and efficiency in the delivery of care.

Because the donation of electronic prescribing technology may create a financial relationship that is subject to the physician self-referral prohibition, the MMA directed the Secretary, in consultation with the Attorney General, to create an exception to the physician self-referral prohibition to permit certain entities to provide non-monetary assistance to physicians to encourage their use of electronic prescribing technology. This final rule (CMS-1303-F) sets forth the terms and conditions of the MMA-mandated physician self-referral electronic prescribing exception and also sets forth the conditions for a new regulatory exception for arrangements involving the donation of electronic health records software or information technology and training services.

The MMA mandated a similar safe harbor under the anti-kickback statute for donations of electronic prescribing technology made to physicians and certain other entities. The HHS Office of Inspector General (OIG) is simultaneously issuing a final rule regarding the MMA-mandated anti-kickback statute safe harbor for certain electronic prescribing arrangements, as well as a safe harbor for the donation of electronic health records software or information technology and training services.

See the CMS fact sheet with background and required criteria: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1920

CMS Announces Proposed Changes to Physician Fee Schedule Methodology

The Centers for Medicare & Medicaid Services (CMS) issued a notice proposing changes to the Medicare Physician Fee Schedule (MPFS) that will improve the accuracy of payments to physicians for the services they furnish to Medicare beneficiaries.  The proposed notice includes substantial increases for “evaluation and management” services, that is, time and effort that physicians spend with patients in evaluating their condition, and advising and assisting them in managing their health.  The changes reflect the recommendations of the Relative Value Update Committee (RUC) of the American Medical Association.

“It’s time to increase Medicare’s payment rates for physicians to spend time with their patients,” said CMS Administrator Mark McClellan, M.D., Ph.D. “We expect that improved payments for evaluation and management services will result in better outcomes, because physicians will get financial support for giving patients the help they need to manage illnesses more effectively.”

The proposed notice addresses two components of physician payments under the MPFS: (1) a comprehensive review of physician work relative value units (RVUs), as well as (2) a proposed change in the methodology for calculating practice expenses.  Other changes in physician payment policy will be addressed in a separate proposed rule to be published at a later date.  CMS will respond to public comments on both sets of proposals and announce final policies in a final rule to be issued in early November.  The changes will apply to payments for services furnished to Medicare beneficiaries beginning with 2007.

To find out more go to CMS

Read ‘Highly Accessed’ Articles on BioMed Central

More than 10,600 people have accessed the article “A randomized, controlled trial of spinal endoscopic adhesiolysis in chronic refractory low back and lower extremity pain,” earning it a “highly accessed” flag on BioMed Central’s online journal, Anesthesiology. The article, authored by Laxmaiah Manchikanti, Mark V. Boswell, Jose J. Rivera, Vidyasagar Pampati, Kim S. Damron, Carla D. McManus, Doris E. Brandon and Sue R. Wilson, has been on the web site since Aug. 1, 2006. The “highly accessed” graphic appears on the journal’s table of contents and search results to identify those articles that have been especially highly accessed, relative to their age, and the journal in which they were published. See it at: http://www.biomedcentral.com/bmcanesthesiol/

Also “highly accessed” on BioMed Central is the May 2004 article “Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic and lumbar regions” by Laxmaiah Manchikanti, Mark V. Boswell, Vijay Singh, Vidyasagar Pampati, Kim S. Damron and Carla D. Beyer. This article has been accessed by more than 23,000 people since it first appeared on BioMed Central.

 http://www.biomedcentral.com/1471-2474/5/15

You can also access the article, “Risk of whole body radiation exposure and protective measures in fluoroscopically guided interventional techniques: a prospective evaluation.” The article, written by Laxmaiah Manchikanti, Kim A. Cash, Tammy L. Moss, Jose Rivera, and Vidyasagar Pampati, was published in 2003, has been viewed over 10,700 times, and as the articles mentioned above, is available to open access on the BioMed Central Web site: http://www.biomedcentral.com/1471-2253/3/2

Clinical Trails on New Category of Painkillers

Drug makers Pain Therapeutics Inc. and King Pharmaceuticals Inc. announced the beginning of early-stage clinical trials on a painkiller that is part of a new category of drugs intended to prevent prescription-drug abuse.

The drug, known as PTI-202, is a long-acting opioid painkiller. The companies began collaborating in 2005 to develop and commercialize four proprietary lead drug candidates, intended to be long-acting, abuse-resistant opioid painkillers. Two of the drugs, including PTI-202, are in clinical testing. Another drug, Remoxy, is in late-stage clinical trials.

Read more on Medical News Today: http://www.medicalnewstoday.com/medicalnews.php?newsid=37991

http://www.chron.com/disp/story.mpl/ap/fn/4089519.html

Comprehensive Imaging Review Course in IPM – San Diego

ASIPP will offer a Comprehensive Imaging Review Course in Interventional Pain Management on Sept. 14-16 along with ABIPP Competency Certification in Fluoroscopic Interpretation & Radiation Safety (exam for IPM physicians only) on Sept. 17. The 3-day Comprehensive Imagining Review Course is planned as a CME activity to prepare physicians seeking competency certification or as an in-depth review in fluoroscopic interpretation and radiation safety.

The early registration discount date has been extended to Aug. 30, 2006 – Register Today!

For more information or to register online go to: http://www.asipp.org/meetings.htm

October Cadaver Workshop and Review Course

Make plans to attend the next Interventional Techniques Review Course and Comprehensive Interventional Cadaver Workshop on October 21-22, 2006 in Memphis, TN.

The Review Course is planned as a CME activity to prepare physicians seeking board certification by ABIPP or as an in-depth review of Interventional Techniques. Additionally the Review Course will be based on the specifications of the Cadaver Workshop and will assist in preparation for ABIPP Part I or Part II (FIPP) examinations.

Learn more about the course, workshop, and hotel information and REGISTER ONLINE at: http://www.asipp.org/meetings.htm

State Society News

If your state society would like to announce meetings or share news stories with our readers, send your new items to Melinda Martin - mmartin@asipp.org

Florida

FSIPP Board Elections

The Florida Society of Interventional Pain Physicians held its annual executive officers' meeting on Sunday, July 16th at the Breakers in Palm Beach. The FSIPP hosted dinner meeting was held in conjunction with the FAPM meeting and supported by ANS and Stryker. There were sixty attendees.

New FSIPP president Lora Brown, MD said of outgoing president Andrea Trescot, MD, "She has set a very high bar for all future FSIPP officers. I know, however, that she will continue to support our interests at a national level as ASIPP's President Elect."

The new FSIPP Board is as follows:

President – Lora Brown, MD

President Elect and Regional Director Central Florida - Harold Cordner, MD

Vice President and Executive Chair for Membership Development  - Raymon Priewe, MD

Secretary - Debra Tracy, MD

Executive Chair For Regional Task Force Development - Marshall Bedder, MD

Member at Large and  Regional Director Southwest Florida - James Worden, MD

Immediate Past President and Executive Co-Chair For Legislative Affairs - Andrea Trescot, MD

Executive Co-Chair For Legislative Affairs - Rafael Miguel, MD

Treasurer - Scott Kramarich, MD

Regional Director North Central Florida - Chuck Grudem, MD

Regional Director Northeast Florida - Rob Dehgan, MD

Regional Director Pan Handle - Frank Zondlo, MD

Regional Director Tampa Bay Area - Francisco Torres, MD

Please…Save the Date!!!

The New Hampshire Society of Interventional Pain Physicians Annual Meeting

The New Hampshire Society of Interventional Pain Physicians Annual Meeting will take place on Wednesday, September 27, 2006 at 6:00 p.m.CR Sparks, Bedford, NH

Your nursing and management staff are encouraged to attend as well. Guest speaker to be announced.

To register or for more information, contact:

Kacey Guay 603-577-3003 x31

kguay@painsolutionsusa.com