June 29, 2006

Annual Meeting, Legislative Session and Capitol Hill Visits a Great Success!

The ASIPP 8th Annual Meeting, SIPMS 1st Annual Meeting, along with the Legislative Session and Capitol Hill Visits were a great success. Conference participants gathered on Capitol Hill on Tuesday morning where they were honored by 11 congressional speakers. Those addressing the ASIPP members were Rep. Ed Whitfield (R-KY), Sen. Jeff Sessons (R-AL), Rep. Sherrod Brown (D-OH), Rep. Rodney Alexander (R-LA) Rep. Anne Northup (R-KY), Rep. Bar Stupak (D-MI), Rep. Bobby Jindal (R-LA), Sen. David Vitter (R-LA), Rep. Frank Pallone, Jr (D-NJ), Rep. Geoff Davis (R-KY), and Rep. Nancy Johnson (R-CT).

Following the legislative session, ASIPP members representing 32 states, visited with members of congress and representatives of their states to present to them ASIPP’s legislative issues for 2006; Physician Payment Reform, Out Patient Interventional Procedures in ASCs, and NASPER Funding.

Doc Sentenced in Medicare/Medicaid Fraud

Anant Mauskar was sentenced to 11 years and three months in prison on June 16 for his alleged role in a scheme that defrauded Medicare and Medicaid, according to the U.S. Attorney's Office for the Southern District of Texas. Mauskar will pay $14 million in restitution and will forfeit another $644,000, the feds say. He was convicted in 2005 for conspiracy to commit health care fraud and receiving kickbacks. The feds allege that from August 1999 to January 2000, Mauskar submitted false claims for physical therapy evaluations and services that (1) were not performed by a physician, (2) were not performed at all, or (3) were performed by unqualified persons without the supervision of a physician. Mauskar also allegedly authorized the use of motorized wheelchairs for beneficiaries who did not qualify for them, prosecutors say. Mauskar's attorney, Marcia Shein, says that the sentence is "terribly harsh" and that she will be appealing. "We consider it — at 73 years old — to be the rest of his life," she notes. A lesson learned here, Shein says, is that doctors need to check out the physical therapy companies and durable medical equipment companies they are working with.

Reprinted from the June 26, 2006, issue of REPORT ON MEDICARE COMPLIANCE.

OIG Says More Training Needed In Consultations Coding

According to a report from the Office of Inspector General (OIG), published in March 2006 by the Department of Health and Human Services (HHS), Medicare overpaid physicians by $1.1 billion in 2001 on claims for consultations.

The report shows that 75 percent of sampled services billed to Medicare as consultations did not meet the requirements. The consultations services that were billed did not meet the Medicare’s guidelines, the wrong type or level, or no supporting documentation.

Because of these findings, HHS has directed provider education coordinators to train physicians and other practitioners in the criteria and proper billing for all types and levels of consultations, with an emphasis on the highest billing levels and followup inpatient consultations. Additionally, Medicare will target consultation claims for continued scrutiny through 2006.

Registration Still Open for ABIPP Part I and Pain Medicine Board Review

ABIPP is still accepting applications to sit for the ABIPP Part 1 Examination and registration is still open for the Comprehensive Pain Medicine Board Review Course. The review course is designed for physicians seeking board certification or re-certification for ABMS Pain Medicine examination or for American Board of Interventional Pain Physicians (ABIPP) Part I examination.

The exam will be held on Aug. 5 – 9 in St. Louis. This five-day in-depth review Board Review Course is a CME activity which also serves as an ideal review for the specialty of pain medicine. To register on-line or for more information on the review course or to register, visit our Web site…Meetings

Send your ABIPP exam application in today!

AMA: Tax Incentives and Penalties To Require Health Coverage

In a major policy move for the Association, the AMA for the first time voted to support a requirement that people with sufficient means obtain a minimum level of preventive and catastrophic health care coverage. The requirement would start with individuals and families earning greater than 500% of the federal poverty level and would expand to the rest of the nation once sufficient federal tax credits or other subsidies are in place to help out with the purchase.

Under the AMA plan, the government would use the tax code to achieve compliance, possibly by handing out significant tax penalties to people who choose not to follow the directive.

Subscribers can read more at AMNews.com

Specialty Hospital Plans Heat Up As Ban Nears End

CMS has eased the threat of extending the moratorium on physician-owned specialty hospitals and many specialty-hospital developers are sending a message to legislators telling them they are ready to build. Evidence being that just days after CMS Administrator Mark McClellan testified at a Senate hearing that the CMS will likely not extend the ban past Aug. 8, there are already signs of growth.

Read the full story on modernphysician.com

Doctors vote to fight Medicare imaging cuts and audit project

Physician delegates from the American Medical Association last month voted to actively oppose two elements of the Medicare system that so far have unfairly impacted only a minority of doctors.

The AMA will work with Congress to rescind Medicare's recovery audit contractor program, under which private firms comb through physician claims data to find instances in which the federal government overpaid doctors and to recoup those dollars. In a separate action at the Annual Meeting, the House of Delegates also decided to support the repeal or delay of medical imaging cuts that are due to start in January 2007.

http://www.ama-assn.org/amednews/2006/07/03/gvsb0703.htm

Bush Administration Releases Interim Final Regulation Implementing The Next Phase Of Welfare Reform

In a Health and Humans Services News Release July 27, 2006, HHS Secretary Mike Leavitt announced interim final regulations for the Temporary Assistance for Needy Families (TANF) program to implement statutory changes to the TANF program in the Deficit Reduction Act of 2005. The regulations ensure consistent measurement of work participation rates in state welfare programs.

Read the news release:

http://www.hhs.gov/news/press/2006pres/20060628.html

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

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

Second Annual GSIPP Summer Meeting - July 21-23

The second annual summer meeting for the Georgia Society of Interventional Pain Physicians "Pain Summit At Lake Oconee” will be held on July 21-23 at Lake Oconee in Greensboro, GA.

It is strongly suggested that all physicians attending the meeting should stay at the Ritz Carlton (800-241-3333) in the reserved GSIPP block of rooms. If this becomes full, or if you’re seeking an alternate to the Ritz, there are two nearby hotels: Jameson Inn, Greensboro, 706-453-9135; and The Lodge, Greensboro, 706-485-7785. Both are about six miles from the meeting facility.

See the GSIPP brochure for registration and meeting information. Please mail your registration form and check early – we anticipate this meeting WILL fill up!