The Office of Inspector General (OIG) has published reports regarding Inappropriate Medicare Payments for Transforaminal Epidural Injection Services (OEI-05-09-00030).

The report states that 34 percent of transforaminal epidural injection services allowed by Medicare in 2007 did not meet Medicare requirements, resulting in approximately $45 million in improper payments. Medicare allowed an additional $23 million in associated facility claims for transforaminal epidural injections performed in error. In addition, services provided in offices were more likely to have a documentation error than those provided in ambulatory surgical centers or hospital outpatient departments.

Transforaminal epidural injections are a type of interventional pain management technique used to diagnose or treat pain. Transforaminal epidural injections may be used to treat pain that starts in the back and radiates down the leg, such as that from a herniated disc pressing on a nerve.

Medicare Part B physician payments for transforaminal epidural injections increased from $57 million in 2003 to $141 million to 2007. This represents an increase of almost 150 percent.

Medicare Part B contractors are responsible for implementing program safeguards to reduce payment error. To safeguard payments, they may create local coverage determinations (LCD), implement electronic edits, or conduct medical review.

The report found that in 2007, 9 of 14 contractors had an LCD for transforaminal epidural injection services, but reported limited use of other safeguards. Only one contractor enforced all of its LCD requirements with edits. No contractor staff reported performing a medical review.

This is your last day to receive a discount on registration to attend the September 17-19 didactic and hands-on cadaver workshop in Memphis, TN.. This meeting is the first time, the American Society of Interventional Pain Physicians (ASIPP) and the North American Neuromodulation Society (NANS) are collaborating to bring you the most focused and comprehensive review course in spinal cord stimulation.

This state-of-the-art educational program features didactics covering key aspects of spinal cord stimulation as well as a comprehensive hands-on cadaver workshop. This course is designed to meet the credentialing needs of interventional pain physicians but is also valuable to those who want to improve their skills or are new to the procedure and would like to know more.

This in-depth review course and comprehensive spinal cord stimulation cadaver workshop will cover all the important aspects of these techniques and provide a comprehensive overview of the subject, with extensive case discussions, and interaction with the faculty. It is planned as a CME activity to prepare physicians seeking credentialing and as an in-depth review of spinal cord stimulation. During this three-day event, you can improve existing skills and learn new skills.

A New Jersey appellate court refused to expand physician assistants' scope of practice to include a procedure that it said the Legislature intended only licensed physicians to perform.

In a July ruling, the court said only physicians can perform needle electrodiagnostic tests, including needle electromyography studies and nerve conduction velocity tests.

Judges relied on a plain reading of the law that "a person shall not perform needle electromyography unless that person is licensed to practice medicine and surgery" in New Jersey. Under state law, "physician assistants are 'not licensed to practice medicine and surgery' " the court said in Selective Insurance Co. of America v Rothman.

For years, John Finkenberg, an orthopedic surgeon in San Diego, sent patients who needed MRIs to outside imaging centers. But last year, he and his five partners bought their own million-dollar machine. Now, he says, the doctors can work more closely with the technicians and give their patients immediate results.

The group's decision to install its own machine puts it squarely in the middle of a controversy over whether doctors should be allowed to order advanced diagnostic imaging tests - MRIs, CT or PET scans - for Medicare and Medicaid patients in their offices.

If you're like most people, your medical history is probably scattered across multiple healthcare facilities and locked within the walls of each hospital. As a result of these healthcare information silos and an educated patient population already accustomed to using web-based technology, relationships between patients and physicians are changing, and patients are taking a more active role in managing their medical history.

In diagnostic imaging, patients have assumed the responsibility of medical courier, transporting their imaging data from provider to provider in an increasingly complex role. This increased level of participation in the healthcare process leads many patients to want more from their "radiology experience." According to a Wake Forest University study published last year in the Journal of the American College of Radiology, in general, patients are dissatisfied with the level of detail and amount of time it takes to get medical imaging results.

This is your chance to get the voice of Interventional Pain Management heard. Please participate in the second Interventional Pain Management Practice Benchmark Survey. This information will be utilized to determine data for interventional pain. There is no other source for this information in the Interventional Pain Management community and we must depend on one another for this key practice information.

Our purpose is to provide the ASIPP membership with timely information that you can use to compare your practice performance with your peers. The higher the level of participation, the more value the survey will have to our membership.

We urge you to complete the attached Interventional Pain Management 2010 Practice Benchmark Survey and send to Gary Janko at the earliest possible date, but certainly by the submission deadline of September 10, 2010.

Please Send Completed Survey To: ASIPP Practice Benchmark Survey c/o Gary M. Janko Executive Vice President Pain Solutions Management Group 21 Eastman Avenue Bedford, NH 03110

Make plans to attend the Comprehensive Imaging Review in Interventional Pain Management & Competency Certification in Fluoroscopic Interpretation and Radiation Safety on September 17-18, 2010, in Memphis, TN.

This comprehensive seminar is designed to provide interventional pain physicians with the ability to understand radiological evaluations and fluoroscopic interpretation. In addition, we offer to all interested physicians the opportunity to sit for a radiation safety competency examination.

This course is an essential component for interventional pain physicians and will provide educational opportunities to assist you in providing high quality, competent, safe, accessible and cost-efficient services to your patients. This course, as with all ASIPP courses, focuses on doing the right things, the right way and for the right reasons.

Shams Qureshi, MD, a pain management physician of the Pain Center of North Jersey in Clifton, N.J., also known as the Bergen Passaic Ambulatory Surgery Center, was sentenced to probation, medical license suspension and home confinement after he plead guilty to billing fraud, according to NorthJersey.com, the online edition The Record.

Dr. Qureshi was charged in 2004 with submitting fake bills, leading to charges of healthcare fraud and theft by deception, according to the report.

He plead guilt in January and was ordered to pay $125,000 to the state Office of the Insurance Fraud Prosecutor, had his license suspended for one year and was sentenced to two years of probation, with the first 30 days under house arrest.

The U.S. Drug Enforcement Administration has announced a nationwide prescription drug "take-back" initiative aimed at preventing pill abuse and theft.

DEA will be collecting unused, expired and unwanted prescription drugs at sites around the country on Sept. 25. The pills will later be destroyed.

Steve Derr, special agent in charge of the DEA for New England, said the free and anonymous program is an opportunity to get rid of unwanted medications before they can be abused, cause an accidental overdose or hurt the environment.

Washington -- The Senate has unanimously passed legislation that would give physicians and consumers additional options for disposing of unused prescription drugs.

By providing safe and lawful ways for patients and physicians to get rid of unused medicines, illicit drug use could be curtailed and potential deaths could be avoided, said lawmakers who supported the bill, which passed Aug. 4.

"Unused and unwanted medication creates a health hazard, but federal law currently prohibits people from giving their old medication to established drug take-back programs," said Sen. John Cornyn (R, Texas), who introduced the legislation with Sen. Amy Klobuchar (D, Minn.). "As a result, unused medication is often diverted by drug abusers or improperly flushed into our water system. This cost-free and common-sense bill will allow state and private entities to institute responsible drug take-back programs."

With physician smartphone use nearing a saturation point, doctors are in an unfamiliar position when it comes to health information technology -- demanding that others adapt to their needs, rather than the other way around.

Physicians' rapid embrace of mobile devices -- well beyond the rate the general population uses them, as measured by several surveys -- has caught many involved in health information technology off-guard. That's particularly true of hospitals, which report being besieged by physician demands that electronic clinical information systems be available through their BlackBerrys or iPhones.

"Five to 10 years ago they were saying, 'If only my docs would be using computers,' " said C. Peter Waegemann, vice president for development of the mHealth Initiative, a Boston-based organization that promotes mobile technology in health care. Now hospital executives bemoan the fact that doctors are "using these smartphones all the time ... and I don't know how to integrate it," he said.

Two speaker presentations from the 12th Annual ASIPP Meeting are now available. Dr. Roger Chou and Dr. Laxmaiah Manchikanti gave presentations at the ASIPP 12th Annual Meeting during the session titled 'Interventional Pain Management in the Era of Evidence-Based Medicine (EBM) and Comparative Effectiveness Research (CER) and Moderated by Joshua Hirsch, MD. Dr Chou's presentation gave the pro viewpoint of the APS Guidelines and was followed by the con viewpoint presented by Dr. Laxmaiah Manchikanti, ASIPP Chairman of the Board and Chief Executive Officer.

Archived ASIPP Meeting Presentations Presentation Title: American Pain Society Guidelines Debate: Pro Presentation Date: Saturday June 26, 2010 Speaker: Roger Chou, MD Scientific Director, Oregon Evidence Based Practice Center, Portland, Oregon Time: 30 minutes

Presentation Title: American Pain Society Guidelines Debate: Con Presentation Date: Saturday June 26, 2010 Speaker: Laxmaiah Manchikanti, MD, ASIPP Chairman of the Board and CEO Time: 30 minutes

If you missed a previous ASIPP Webinar, you can still view it online or order the CD at http://asipp.peachnewmedia.com/store/provider/provider09.php?. If you had previously registered for the webinar and missed it there will be no additional charge and you can view it at your convenience. The pdf document of the powerpoint presentation is also available. If you need help to access the recorded version you can click HERE to contact our customer support team or call us at 1-866-702-3278.

If you did not register previously, you may order the recorded webinar and view it online at your convenience or order the CD. The pdf document of the presentation will be available, as will the CME and/or CEU credit certification.

Each new webinar will be archived for future reference or purchase. Current webinar topics available are:

• Staying Ahead Of Government Enforcement Efforts. Speaker: Vicki Mykowiak, JD
• Evidence-Based Interventional Techniques: An Algorithmic Approach To Keeping It Simple, Safe, and Successful. Speaker: Laxmaiah Manchikanti, MD, ASIPP CEO and Chairman of the Board
• Coding: Be Prepared for 2010. Speaker: Joanne Mehmert CPC, CCC-PM, ACS-PM

Visit the ASIPP Web site to find available positions for IPM physicians.