" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

March 30, 2011


·  Washington State Approves Multiple Injections Except Therapeutic Facet Joint Injections

·  Ultrasound at $59,490 Spurs Aetna Outrage in Suit Naming Doctor

·  Uncertainty Surrounds Healthcare Reform on Its First Anniversary

·  Plan to Attend the 13th Annual ASIPP Meeting

·  Mark your Calendars: August Board Review, Controlled Substance Management, and Coding, Compliance and Practice Management Courses

·  More Adults Going Without Medical Care Because of Costs

·  Bill Would Set Rhode Island Physician Pay Minimum

·  More Than 50 Percent of Cardiology Guideline-Writing Physicians Report Conflicts Of Interest.

·  Pay Rises Slightly for Physicians in Academia

·  Kentucky: The Other End of the Oxy Pipeline

·  Medicare Records Reveal Troubling Trail of Surgeries

·  State Society News

·  Physicians Wanted

Washington State Approves Multiple Injections Except Therapeutic Facet Joint Injections

On March 18, the Washington State's Health Technology Assessment (HTA) committee issued coverage policies for two medical products: a non-coverage decision for a new implanted continuous glucose monitor; and a determination that several pain relieving spinal injections should not be covered while others should be available only under certain circumstances. Therapeutic facet joint injections were determined as non-covered procedures.

Under Washington State law, the HTA committee has authority to determine if medical technologies subject to its review are available to eligible state residents, including state employees, Medicaid patients, and injured workers.

While the determination allows for continued coverage for some spinal injections, we are disappointed that several treatments that are not covered or are covered but with inappropriate restrictions. ASIPP will continue to seek an amendment to the decision throughout the public comment period.

The HTA committee reported the findings for spinal injections as:

  • · Evidence overall is low to support the use of injections of pain medicine around the nerves in the spine - with many trials showing no better outcomes than the placebo or saline injection. Epidural spine and sacroiliac joint injections had slightly stronger evidence of short term pain relief, and coverage under certain conditions was approved, while others were not approved based on the very low evidence or conflicting evidence showing no benefit.

ASIPP would like to thank ISIS for the lead role it has taken in working with the Washington State Heath Care Authority's Health Technology Assessment Program. Multiple societies helped ISIS in the effort to respond to the Health Technology Assessment Program's poorly written protocol.

ASIPP's supported the effort through multiple communications, comment letters, and member involvement. Additionally through ASIPP's public relations resources, we were extremely effective in generating publicity directed at the non-medical community alerting them of the issue. Feature articles were published in the Wall Street Journal, The New York Times, on Fox Business, CNBC, and many others.

The committee's decisions will be published on the HTA Web site (www.hta.hca.wa.gov) for public comment beginning next week. The decisions will not be finalized until the next quarterly meeting in May 2011.

Washington State Health Care Authority

Ultrasound at $59,490 Spurs Aetna Outrage in Suit Naming Doctor

Aetna Inc. (AET) is suing six New Jersey doctors over medical bills it calls "unconscionable," including $56,980 for a bedside consultation and $59,490 for an ultrasound that typically costs $74.

The lawsuits could help determine what pricing limits insurers can impose on "out-of-network" physicians who don't have contracts with health plans that spell out how much a service or procedure can cost.

One defendant billed $30,000 for a Caesarean birth, and another raised his fee for seeing a critically ill patient in a hospital to $9,000 in 2008 from $500 the year before, the insurer alleges in the suits. The Caesarean price was more than 10 times the in-network amount Aetna quotes on its website.

Bloomberg News

Uncertainty Surrounds Healthcare Reform on Its First Anniversary

Wednesday marked the first anniversary of the Affordable Care Act (ACA) being signed into law by President Obama, and one year into the new era of healthcare reform it's clear that Americans remain divided in their views of the benefits of the law. A poll from the Kaiser Family Foundation found that the public is confused about the provisions of the ACA and the timelines for their implementation, with many people feeling that they lack sufficient information explaining how the ACA will affect them.

According to Kaiser, "Americans like the idea of state flexibility, with the caveat that the plans they offer are of equal quality and cover just as many people, but are opposed to the idea of defunding health reform. The public is still split on repeal, with slightly more wanting to expand the law or leave it as is than wanting it repealed entirely or repealed and replaced." The poll also found that, depending on how the question is phrased, a majority of respondents wants to repeal the individual insurance mandate. Another poll conducted by Rasmussen Reports shows less support for the ACA, with 53% of likely voters at least "somewhat" in favor of repeal (including 43% who "strongly favor" repeal) and 42% of respondents opposed to repeal (including 27% who are "strongly opposed").

Physician's Money Digest

Plan to Attend the 13th Annual ASIPP Meeting

Mark you calendar to attend the 13th Annual Meeting, Legislative Session, and Capitol Hill Visits June 25-29 in Washington, DC.

This year in an effort to meet the needs of interventional pain physicians and other providers as well, we have created an educational program of the highest caliber with a focus on three very important topics for physicians, staff, and other healthcare providers all under the primary theme "A Vision For IPM In A New Decade e"; Evidence-Based Medicine, as well as Comparative Effectiveness in Interventional Pain Management and the Essentials of Practice Management.

The faculty is made up of experts in the field of IPM, practice management, and governmental affairs. We are honored to have Joseph T. Rannazzisi, DEA Deputy Assistant Administrator for the Office of Diversion Control will address the agencies' role in controlling substance abuse. Dr. James Rathmell speaks on Evidence-Based Medicine: An Academic Perspective from Harvard. From the U.K., speaker Dr Sanjeeva Gupta gives us a sneak peek of IPM in the U.K. and Europe.

Click HERE to view brochure.

Submit your Abstract Proposal

Selected Abstracts and accompanying posters will be presented at the annual meeting. o be considered for a presentation at the meeting, abstracts must be submitted and completed by the submission deadline of 5:00pm Central Standard Time (CST) Friday, May 6, 2011. Abstract submission must be completed through ASIPP's interactive online form.

Click HERE to access Abstract proposal submission form

Register Today!

Mark your Calendars: August Board Review, Controlled Substance Management, and Coding, Compliance and Practice Management Courses

Make your plans today to attend the ASIPP Board Review, Controlled Substance Management, and Coding, Compliance and Practice Management Courses scheduled during the week of August 1-6 in St. Louis, Mo.

August 1-5, 2011 ASIPP Board Review Course Register Brochure

August 6, 2011 ABIPP Part I Examination (ABIPP application must be submitted prior to the exam for approval)

August 1-3, 2011 Comprehensive Review Course in Controlled Substance Management (August 1 -August 2) and Competency Examination (August 3) Register

August 4-6, 2011 Comprehensive Review Course in Coding, Compliance and Practice Management (August 4-5) and Competency Examination (August 6) Register

Register today

More Adults Going Without Medical Care Because of Costs

Washington -- More working-age Americans are going without health insurance and not seeking physician care for injuries or illness because they can't afford it, according to two new studies released in March.

A report by the New York-based Commonwealth Fund found that the portion of patients delaying medical treatment in the last year is trending upward. Findings from the group's biennial health insurance survey in 2010 show that an increasing percentage of working-age adults skipped office visits, medical tests and prescriptions because of costs.

AMA news

Bill Would Set Rhode Island Physician Pay Minimum

Rhode Island lawmakers are set to take up a bill that would set the minimum physician pay rate at 125% of what Medicare pays in an effort to bring pay rates closer to those in neighboring states.

The bill's sponsor, Democratic state Rep. Donald Lally Jr., said he worked with physicians to draft the bill after learning that low pay rates were driving physicians and dentists out of state and making it difficult to recruit young doctors to Rhode Island.

AMA news

More Than 50 Percent of Cardiology Guideline-Writing Physicians Report Conflicts Of Interest.

The Wall Street Journal (3/29, Burton) reports that, according to a newly published paper in the Archives of Internal Medicine, more than 50 percent of physicians with financial ties to drug and device makers who pen cardiology practice guidelines experience conflicts of interest. And, even though such incidents are often reported, researchers at the University of Pennsylvania say the risk of bias is increased, which could adversely affect patient care.

Before reaching those conclusions, investigators looked at "the 17 most recent American College of Cardiology/American Heart Association clinical practice guidelines issued through 2008," HealthDay (3/28, Preidt) reported. "Of the 498 people involved in creating those guidelines, 277 (56 percent) reported a conflict of interest (COI)," and the "most common types of conflict of interest were: being a consultant or member of an advisory board, receiving a research grant, being on a speaker's bureau and/or receiving honoraria, and owning stock. Through these types of links, there were 510 commercial companies involved in the 17 guidelines, compared with only 18 non-commercial organizations." 

In "a joint statement on Monday, the cardiology and heart associations said that they had tightened their conflict-of-interest controls in 2010 to align with recommendations from the Council of Medical Specialty Societies," the New York Times (3/29, B3, Wilson) reports. They "now require that the people leading the group and a majority of members of any guideline-writing group be free of conflicts of interest." Still, "in a related commentary in the journal, Dr. Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic and a former president of the American College of Cardiology, called for banning most of those conflicts rather than just disclosing them."

Wall Street Journal

Pay Rises Slightly for Physicians in Academia

Compensation for physicians working in academic settings increased slightly last year, according to an annual survey, with strong demand and candidate shortages resulting in higher pay for internal medicine faculty.

Median compensation for primary care faculty physicians was $163,704 in 2010, up 3.47% from the previous year, while compensation for specialty care faculty increased 2.70% to $241,959, according to Medical Group Management Association's Academic Practice Compensation and Production Survey for Faculty and Management: 2011 Report Based on 2010 Data. 

As is typical, compensation for faculty members continued to trail pay in private practices. Median compenstion for primary care physicians in non-hospital settings was $191,981, while specialty care physicians earned $353,549, according to another MGMA survey.

Physician's Money Digest

Kentucky: The Other End of the Oxy Pipeline

LEXINGTON, Ky -- In large part, South Florida sees the pain pill epidemic from the supply end - the long lines at the pain clinics, the occasional raids with doctors hauled away in handcuffs., the political battles over whether and how to regulate so-called pill mills.

Shawn Clusky is at the other end of the oxy pipeline: Kentucky. Clusky first tried OxyContin at age 17 with his school buddies, shortly after the high-powered narcotic painkiller went on the market. He went from occasional user and seller until about age 21, when he became fully addicted.

Miami Herald

Medicare Records Reveal Troubling Trail of Surgeries

PORTLAND, Ore.-Dr. Vishal James Makker had already operated on Ronald Johnson's spine six times in less than two years, but he had some grim news for the former machine-tool operator: X-rays showed Mr. Johnson needed a seventh surgery.

Mr. Johnson, 62 years old, says he had felt progressively worse after each operation. He told the doctor he was done with surgeries. Dr. Makker took a second look at the X-rays and changed his tune, Mr. Johnson recalls. "Actually, you're going to be all right," he says Dr. Makker told him, adding that he had been looking at the films wrong.

Wall Street Journal

State Society News

FSIPP Annual Meeting 2011 set for May 13-15, 2011

Be sure to save the dates of May 13 - 15, 2011, for FSIPP's Annual Meeting, Conference & Tradeshow, to be held again at The Gaylord Palms, Kissimee (Orlando). The event will kick off Friday evening, May 13, with a Welcome Reception and a presentation on The Health Benefits of Wine!

Continuing education lectures will go on all day Saturday and Sunday morning, as has been our format for the last couple of years.

Please watch http://flsipp.org/ for developing program and registration details, or call 904-221-9171.

CASIPP Second Annual Meeting set for June 3-5, 2011 in Santa Barbara

The California Society of Interventional Pain Physicians (CASIPP) is proud to present the Second Annual Meeting June 3-5 2011 in Santa Barbara. As with last year's successful event, CASIPP will welcome leading experts to lecture on clinical techniques, political issues and state programs relevant to the Pain Management physician and staff.

Earn eight CME credits while enjoying the luxurious grounds of the Four Seasons Biltmore Resort. To sweeten the deal, the Biltmore has offered discounted rooms to those who register early for the meeting!

Registration is easy online at https://www.casipp.com/register.html.

New Jersey Society of Interventional Pain Physicians

Will hold a meeting on June 9, 2011 from 6:30 pm - 10:30 pm at Pines Manor in Edison, NJ. For more information call Lisa Hansen at 732-297-2600 or e-mail: njsipp_lisah@yahoo.com

Physicians Wanted

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

Physicians Wanted




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American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394
E-mail asipp@asipp.org