May 24, 2006

Medicare Trustees Report Projects a 4.7% Cut

The Medicare Trustees Report projects a 4.7%cut in physician reimbursements in 2007 and 37% in cumulative cuts over the next nine years. Unless Congress steps in, each year of the next decade will likely feature an approximate 5% cut in doctors' pay while the costs to physicians for providing care will increase by more than 2%.

Centers for Medicare & Medicaid Services (CMS) Administrator Mark McClellan, MD, PhD, said Congress could accomplish a long-term solution to the doctor pay problem in a budget-neutral fashion, meaning the funds to pay for the fixes will come from elsewhere in the system, rather than from new appropriations.

"We can't reduce physician payment rates by 4% to 5% each year for many years to come," he was reported to say. "But conversely, nor can we simply add more money into a payment system that is already projected to grow much faster than the economy."

Meanwhile spending on the Part B side of the program continues to rise at alarming levels and puts growing strain on beneficiary and government pocketbooks, the trustees said. Health and Human Services Dept. Secretary Michael Leavitt stated "The message of this report is urgency."

Physician Update/Medicare Economic Index for projection:

Graph information from Medicare Trustees Report and AMNews.com

Limited Service – Lot of Fuss: CMS Unlikely to Extend Specialty Hospital Moratorium

The specialty-hospital debate grew more heated last week as two powerful U.S. senators applied pressure on CMS to deal with quality and safety concerns through the enforcement of regulation and oversight. They argued for more information on the oversight of such facilities and one hospital that has become a poster child in the controversy was fighting to stay in the Medicare program.

Senate Finance Committee Chairman Chuck Grassley (R-Iowa) said in a news release, "Patient care should always come before profit, and these reports should help us understand these facilities better to ensure that this is the case."  Montana Sen. Max Baucus, the committee's ranking Democrat support his stance that physician-owned specialty hospitals should not be permitted, saying, “One thing we should not be promoting is the development of more facilities…that are hospitals in name only.”

But CMS Administrator Mark McClellan, MD, PhD said the agency does not plan to extend a suspension on Medicare payments to new physician-owned specialty hospital past August 8, 2006. McClellan told the Senate Finance Committee that specialty hospitals open for business will likely face tighter financial disclosure and transparency rules.

The federal government prohibited new physician-owned specialty hospitals from billing Medicare for services during an 18-month moratorium that ended last June. CMS also suspended medicare enrollment of new specialty hospitals until Feb 15, and Congress extended the suspension until August under the Deficit Reduction Act.

Sources: Modern Health and CQ Today. See Modern Health article with graph of national breakdown of specialty hospitals and related article: http://www.modernhealthcare.com/storyPreview.cms?articleId=39045&archive=Y

Opt-Out Program to Keep Prescribing Data from Drug Reps

The American Medical Association (AMA) has implemented a plan that will allow doctors to restrict access to personal information stored in the AMA’s Physician Masterfile database. The Prescribing Data Restriction Program is now in place, allowing physicians to opt out of having their prescriber data accessed by drug reps or their direct supervisors. The option is effective for three years, after which time doctors would need to reenroll in the program.

To enroll in the AMA’s Prescribing Data Restriction Program, physicians should visit the Prescribing Data Information Center’s Web site: www.ama-assn.org/go/prescribingdata

According to amednew.com, physicians are required to log in to the AMA Web site with individual login accounts (for security purposes). Members and nonmembers alike can create AMA Web login accounts online at no charge. For assistance with the online opt-out process, contact the center by phone (800-621-8335) or e-mail (pdrp@ama-assn.org)

Attend ASIPP Annual Meeting- Register Today to Assure Your Capitol Hill Visit!

The ASIPP 8th Annual Meeting and SIPMS 1st Annual Meeting will be held on June 24-28 in Washington, DC. Along with the Annual Meetings, plan to attend the Legislative Session and take part in the Capitol Hill visits. This year’s event promises to be not only informative but also memorable with the second day of our legislative session taking place on Capitol Hill.

On Tuesday, June 27, the ASIPP annual meeting will convene in the Cannon Caucus Room on Capitol Hill where we will be honored with the presence of several congressional speakers. We encourage you to sign up for and participate in the Capitol Hill visits which will take place on June 27- 28. This is your opportunity to make your voice heard! But please register early – late registrants (after June 12) may not be able to meet with their state representative. We will make every effort to schedule your request but to increase the likelihood of your visit; we strongly encourage you to register soon.

Don’t miss this opportunity to “make your voice heard.” The Annual Meeting Brochure along with registration and hotel information can be found on the ASIPP Web site. Make Plans to Attend ASIPP Annual Meeting-Register online today! Or if you have questions, call us directly at 270.554.9412.

http://www.asipp.org/meetings.htm

The DASIS Report on Opiate Use

The Substance Abuse and Mental Health Statistics’ (SAMHS) Drug and Alcohol Services Information System (DASIS) (Issue 14 – 2006) recently released a report on the use of opiates. With the following highlights:

• In 2003, opiates other than heroin (non-heroin opiates) were the primary substance of abuse for 51,000 substance abuse treatment admissions (3 percent of all admissions)
• Some 47 percent of non-heroin opiate admissions were female compared with 32 percent of heroin admissions
• Non-heroin opiate admissions were more likely than heroin admissions to be entering treatment for the first time (40 vs. 22 percent)

Read the report: http://oas.samhsa.gov/2k6/opiatesTX/opiatesTX.htm

Revised CMS 855 Provider Enrollment Application – NPI Number

On May 1, 2006, CMS introduced a revised CMS 855 Medicare provider form (as reported in previous ASSIP news update). As part of the revised enrollment process, initial enrollees and existing enrollees making changes to their enrollment information must include their National Provider Identifier (NPI) number and a copy of the National Plan and Provider Enumeration System (NPPESS) NPI notification.

Starting May 23, 2007, the NPI will replace all existing provider numbers used to bill Medicare, Medicaid, and other health care payers. CMS encourages you to begin sharing this information with Medicare, other payers, and your other health care partners in order to make the transition to NPI as smooth as possible.

To enroll and obtain your NPI number go to http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/EnrollmentSheet_WWWWH.pdf

Interventional Pain Management Added to New CMS-855I Form

The new CMS-855I form has added interventional pain management as a physician specialty category. You should use the form to change specialty code designation to 09 for interventional pain management. The 2006 revision date on the new form is 4/2006 - see page 8, section D.

Find the 4/2006 form on the ASIPP Web site at: http://www.asipp.org/documents/cms855i.pdf

Pain Physician Journal Now Accepting Article Submissions

The Pain Physician Journal, recently included and indexed on MEDLINE, is accepting manuscript submittals for publication consideration. Pain Physician is a peer-reviewed, multi-disciplinary journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine.

Pain Physician is the official publication of the American Society of Interventional Pain Physicians (ASIPP). Pain Physician requires that all manuscripts be prepared in accordance with the uniform requirements for manuscripts submitted to biomedical journals, with the exception of reference citations and format. For information on manuscript submittals go to http://www.painphysicianjournal.com/infoforauth1.php Submit articles to: editor@painphysicianjournal.com

Pain Physician, April 2006 is now available online at www.painphysicianjournal.com

Register for ABIPP Part I and Pain Medicine Board Review Today

Come to the “Gateway to the West” for ASIPP’s premiere Comprehensive Pain Medicine Board Review Course 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

Put your Board Review Course to work and apply for the ABIPP Part 1 exam which will be administered on Aug. 10, 2006.  Registration is separate for the exam and the minimum requirements for eligibility are as follows:

A primary ABMS board certification.

An active license to practice medicine in the United States.

Visit the ASIPP Web site for more information … click here. Send your application in today!

AMNews Stories

Iowa Legislature passes "I'm sorry" bill

With unanimous votes, the Iowa Senate in April passed a bill that would allow physicians and other health care professionals to apologize to patients without the statements being used against them in court. The measure cleared the House in March.

Doctors anticipate Gov. Tom Vilsack will sign the legislation. The bill would help reduce medical liability lawsuits against physicians by encouraging better communication with patients, said Stephen Richards, DO, immediate past president of the Iowa Medical Society, which supported the measure.

If the legislation is enacted, Iowa would become one of about 21 states with a safe apology statute, according to data from the American Medical Association.

Doctor sentenced in case that sparked concern about government searches

A Tennessee oncologist was sentenced in April to 15½ years in prison after a federal jury convicted the doctor of defrauding Medicare, TennCare and BlueCross BlueShield of Tennessee by giving patients diluted chemotherapy drugs and billing for the full amount. Young Moon, MD, was also ordered to pay $432,238 in restitution by the U.S. District Court for the Middle District of Tennessee, Nashville. Dr. Moon plans to appeal.

The case sparked physicians' concerns that an invasive search of Dr. Moon's office in January 2002 exceeded the government's authority and violated patient privacy.

Subscribers can read these articles and others at http://www.ama-assn.org/amednews/site/toc.htm

State Society News

Georgia Society - GSIPP

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!

California Society - CSIPP

The California Society of Interventional Pain Physicians held its third Annual Meeting on May 17, 2006, in Costa Mesa, CA, featuring Carl Brakensiek, MBA, JD, Executive Vice President of the California Society of Industrial Medicine and Surgery. Dr. Brakensiek gave a stimulating and informative presentation on the impact of the 2003 and 2004 reforms in Workers’ Compensation and upcoming legislative efforts to refine those reforms and clarifying case law.

Election for officers were held, with results as follows:

Standiford Helm II, M.D. as President, Francis Riegler, M.D. as CEO, Mike Tassos CPA as Secretary Treasurer and Ed Anderson, M.D., Phyliss Cullen, M.D., K.A. Erdmann, Jan Maddox, M.D., Rebecca Patchin, M.D., Ray d'Amours, M.D and Miguel Dominguez, M.D. as Directors.

Dr. Helm presented a review of the year’s activities:

• Working with the CA Medicare Medical Director, Dr. Quinn, to ensure that the transition to use of the KD modifier for pump refills was understood both by Medicare and by interventional physicians;
• Ongoing involvement with the Division of Workers’ Compensation to ensure that an interventionalist is on the committee to develop new treatment guidelines; and
• Introduction of AB 2896, which would bring California’s Prescription Monitoring Program into Compliance with NASPER, and CSIPP’s role in supporting that legislation.

The meeting was enjoyed by all and an example of the Society’s continuing importance to and usefulness for interventionalists in California!

Illinois Society - ISIPP

The Illinois State Society held a special meeting on May 5, in conjunction with the ASIPP Competency Review Courses, at the Westin on Michigan Avenue in Chicago. ISIPP president Scott Glaser, M.D. reported on the status of Illinois’ progress on their bill to implement a controlled substance monitoring program which will meet the requirements of NASPER. The Illinois state bill is currently stalled in committee but it is hoped that it will be revived again after the November elections. A physician’s advisory committee will meet this summer to work on the bill’s passage.

Honored speakers at the event were ASIPP CEO, Laxmaiah Manchikanti, M.D. and Representative Judy Biggert (R-IL). Biggert has been a friend to IPM and AIPP and when approached in 2004 for her support of NASPER, she understood the need and demonstrated her support by co-sponsoring it in the House of Representatives. Biggert spoke on several issues important to physicians, such as HHS funding for NASPER and pay-for-performance.