October 25, 2006

December Cadaver Workshop and Review Course Adds Basic Level and New Format

Make Plans to Attend - ASIPP will hold an Interventional Techniques Review Course and Comprehensive Interventional Cadaver Workshop on December 2-3, 2006 in Memphis, TN.

To better accomadate our participants, a basic level has been added to the course. Additionally we have added a new feature of concurrent lectures geared specifially to the course levels of basic, intermediate, and advanced.

The course is planned as a CME activity to prepare physicians seeking board certification by ABIPP or as an in-depth review of Interventional Techniques.

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

Continue to Contact Congress

The House and Senate reconvene for a “lame duck” session November 13. Medicare’s Sustainable Growth Rate (SGR) formula, which mandates Medicare physician fee cuts whenever hikes in these expenditures outpace growth in Gross Domestic Product, will trigger the 5.1 % cut January 1, unless Congress acts to block it.

Both the House and Senate considered differing proposals aimed at averting the cut – including proposals that called for fee increases; some of which were tied to physician quality reporting -- but neither was able to reach an accord on the matter before recessing on Sept. 29. While there have been a number of legislative proposals such as H.R. 5866, which would give physicians a reprieve from the devastating SGR cuts. It is uncertain which proposals will be considered when the session resumes on Nov. 13 after the November elections. It is certain, however, it is certain that we must continue to e- mail, mail, fax, and call our members of Congress.

We have two main goals in front of us now; (1) a temporary fix of the SGR and (2) a permanent fix to prevent CMS from using their current antiquated and flawed methodology. The numbers don’t lie, no intervention takes place preventing this global cut, anesthesiology will take a 12% cut and radiology will be cut 16%. Furthermore physician fees will face drastic cuts – an epidural in a facility setting will be cut 1% to 5% while the same procedure in a non-facility will be cut from 23% to 38%. ASIPP’s comment letter to CMS which can be found on the ASIPP Web site homepage, illustrates these points more thoroughly.

ASIPP strongly encourages all of our members to send messages to their Representatives and Senators asking for prompt action to avert SGR cuts. Ask your family, friends, patients to also join you in this fight. You may call your members of Congress through the Capitol Switchboard, (202) 225-3121. We have provided you with a simple way to send your letter through Capwiz using the links below: Sample Letter for Physicians

Sample Letter for Staff and Patients

If you wish to send letters on your own letterhead, links to sample letters can be found on the ASIPP homepage. www.asipp.org

Also related to Medicare physician payment, ASIPP has communicated to CMS our strong opposition to additional reductions resulting from a proposed new practice expense methodology and work value changes stemming from the recently-conducted Five Year Review. For a copy of the comment letter ASA submitted to the Agency and for more information about the proposed rules, please click here. Comment Letter

Arkansas BC BS Lists ABIPP as Standard for Designation

In the Sept. issue of Arkansas Blue Cross and Blue Shield's Providers' News, the American Board of Interventional Pain Physicians (ABIPP) is listed as a qualification pathway for designation as a network pain management subspecialist.

Arkansas Blue Cross and Blue Shield, USAble Corporation, and Health Advantage are currently implementing new standards for a designation as a network pain management subspecialist.

For providers who practice as a pain medicine specialist and who would like to change designation within the networks must qualify based upon the requirements defined by various pathways, one of which is ABIPP.

Providers who meet the requirements through one of the pathways and desire to change their specialty designation to pain medicine must submit a request to the provider network administrator specifying their chosen pathway and presenting documentation verifying completion of the criterion listed in that specific pathway.

Providers' News

October Pain Physician Journal Now Available Online

The newest issue of the Pain Physician journal is now available on the ASIPP Web site. To access the October issue go to www.asipp.org

ASIPP Attends ASA Annual Meeting

ASIPP attended the American Society of Anesthesiology's Annual Meeting this week. ASIPP CEO, Laxmaiah Manchikanti, MD, delivered a well- attended refresher lecture on reimbursement titled, "Reimbursement in Pain Medicine: Coding, Compliance, and Getting Paid for Your Work." Additionally, Melinda Martin, ASIPP Director of Operations, and Ray Lane, Director of Education and Public Relations were on hand at the ASIPP exhibit to answer questions regarding ASIPP membership, education, certification, and publications.

Medicaid Federal Audit To Determine Whether States Made 'Erroneous' Payments

The HHS Office of Inspector General said it will conduct an audit to determine whether the state Medicaid agencies "make erroneous payments" on transportation services for beneficiaries, according to its recently released 2007 work plan, the Washington Times reported today.

According to the work plan, Medicaid transportation costs nationwide between 1999 and 2003 increased by 48% to $1.5 billion dollars. Health care consultant Robin Mathias said Medicaid programs can lose as much as 30% to 50% of nonemergency transportation spending to fraud and abuse, adding, "States may identify likely fraud months or years after payment by analyzing claims data, but the effort is often too little, too late." According to Mathias, transportation service fraud is "very common" because unlike nurses, physicians or medical parishioners, transportation workers do not need professional certification, which "opens it up to a much wider range of people." Donald White, spokesperson for HHS OIG, said, "Since so much money is involved here, the federal government certainly has a very keen interest in how it is spent"

Gov't Panel Recommends Shingles Vaccine

An influential government advisory panel voted this week to recommend routine vaccines to protect older adults against shingles. .

The Advisory Committee on Immunization Practices voted to recommend the vaccine for adults 60 and over. The committee's recommendations usually are accepted by federal health officials, and they influence insurance coverage for vaccinations

Shingles is a painful, blistering skin rash that is most common in people 60 and older. It usually goes away after four weeks, but one in five shingles sufferers develops excruciating long-term nerve pain known as postherpetic neuralgia. Complications also can include scarring and loss of vision or hearing.

Houston Chronicle

Medco to Pay to Settle Charges

Medco Health Solutions Inc., the biggest manager of employee prescription drug benefits, agreed to pay $155 million to settle U.S. allegations that it accepted kickbacks from drug makers and submitted false claims to the government.

The settlement resolves two civil cases and an investigation by the U.S. attorney's office in Philadelphia, the Justice Department said Monday. The government also accused the company of paying kickbacks to health plans to obtain business.

Bloomberg.com

MCAC to Hold Meeting on Spinal Fusion

The incidence of low back pain at some time in a person’s lifetime in the U.S. population is reported to be as high as 90%. There are numerous causes of low back pain and men and women are equally afflicted. The degenerative changes that occur in the intervertebral disc in the spine are thought to be part of the normal process of aging and do not always lead to low back pain. Low back pain secondary to lumbar degenerative disc disease (DDD) can usually be successfully treated conservatively. However, when conservative treatment is not successful, surgical intervention becomes an option to relieve the pain associated with DDD.

In response to this, on Nov. 30, 2006, the Medicare Coverage Advisory Committee (MCAC) will hold a meeting on Spinal Fusion for the Treatment of Low Back Pain Secondary to Lumbar Degenerative Disc Disease. The committee will hear presentations and discuss evidence relative to indications for spinal fusion, clinical outcomes (including adverse events) and the persistence of outcomes over time, outcome measurement tools, and outcomes related to different surgical spinal fusion procedures, as well as, the generalizability of this evidence to the Medicare population.

Federal Register notice

SAMHSA Highlights Efforts to Blend Research with Practice

Successful efforts to incorporate research findings into clinical practice are described in the September/October 2006 issue of SAMHSA News, the newsletter of the Substance Abuse and Mental Health Services Administration. The issue describes a joint effort by SAMHSA and the National Institute on Drug Abuse (NIDA) to decrease the 17-year gap that typically occurs between the publication of research results in scholarly journals and their application in clinical practice.

SAMHSA News

Medical Identity Threat

The Los Angeles Times (LA Times) recently reported on a Florida women who had been billed for a medical procedure she had never received - a foot amputation no less. An investigation determined that her medical information had been stolen, and someone else had received treatment under her name.

Medical identity theft occurs when a criminal obtains information about a person's identity, such as their name, address, social security number and health insurance information, then uses this information without the victim’s knowledge to make false claims or fraudulently receive medical goods or treatments. Cases of medical identity theft are becoming far too common.

A recent HealthLeaders article addresses the issue as well as the importance of keeping patient information secure.

See HealthLeaders

Read ‘Highly Accessed’ Articles on BioMed Central

More than 12,400 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 26,000 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 11,300 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