" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

August 15, 2012








crnaCMS Proposes IPM Privileges for CRNAs: Time to Act Now or Never


The Centers for Medicare and Medicaid Services (CMS) is now accepting public comments on a proposed rule establishing national policy for CRNA pain management services. We NEED your voice now to protect patient safety. Following the comment period (Sept. 4, 2012 deadline), the final rule as it is written, would allow CRNAs to perform IPM techniques. This has sweeping ramifications, from compromised patient safety to an increase in fraud and abuse. I implore you to let CMS know that this proposed rule is unacceptable and dangerous.

It is essential that you submit your comments and opinions on this issue. Medicare officials read and evaluate each INDIVIDUAL comment submitted on the issue. We expect the opposition to submit a substantial number of comments, so your action today is very important. You may submit your comments in a variety of ways.


1. Electronically

You may submit electronic comments on this regulation to: http://www.regulations.gov/#!submitComment;D=CMS-2012-0083-0075 


2. By regular mail

You may mail written comments to the following address ONLY:

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Attention: CMS-1590-P,

P.O. Box 8013

Baltimore, MD 21244-8013

Please allow sufficient time for mailed comments to be received before the close of the comment period.


3. By express or overnight mail

You may send written comments to the following address ONLY:

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Attention: CMS-1590-P

Mail Stop C4-26-05

7500 Security Boulevard

Baltimore, MD 21244-1850

4. Capwiz

Use the following link to send your Capwiz letter to CMS, your senators, and representative. Sample text is provided but you are encouraged to edit and personalize your letter. http://capwiz.com/asipp/issues/alert/?alertid=61589631

It is simple to get your patients involved by customizing the following letter to your state senators and representatives, have your patients sign it before they leave the office, then have your staff enter it in Capwiz for the patient. Sample Patient Letter: ASIPP's Letter to CMS (you may use as a sample for your own)

Our goal is to send approximately 20,000 letters but this cannot happen without your help. Please act immediately on this important issue.


asippEarly Registration Deadline Aug. 21 for ASIPP's Vertebroplasty Course and the Comprehensive Review Course and Cadaver Workshop


    The Comprehensive Review Course and Cadaver Workshop - Basic, Intermediate, and ABIPP Preparation will be held Sept. 14-16 at the Hilton Memphis in Memphis, TN and the MERI Center.


Click here to register: https://secure.jotformpro.com/form/12975431212


The Vertebroplasty Comprehensive Review Course and Cadaver Workshop will be Sept. 15-16 at the Hilton Memphis and MERI Center.





Early registration is available until Aug. 21.


Click HERE for Hilton hotel reservations.




surveyPhysicians Needed to Take Survey


We invite additional physicians to complete a survey to help us understand physician's attitudes about patients who were terminated from their pain management practice. The survey should take no more than 10 minutes to complete. The results will be used to help physicians identify difficult patients and more effectively tailor treatment and communication strategies. Your participation is important because a greater number of responses results in a stronger understanding.


Your decision to be in this research is voluntary. If you have any questions, please contact Alan D. Kaye, MD, PhD, Chair, Department of Anesthesia, Louisiana State University, New Orleans (akaye@lsuhsc.edu) or Gaurav Jain, MD, Southern Illinois University School of Medicine, Springfield, IL (gjain@siumed.edu). Thank you for your time and response.


Please click the following link to complete the survey:





sendASIPP Members: Send in Your Published Article Information



 A new feature of the ASIPP enews will offer ASIPP members the opportunity to send in and have their published works listed.  Please email in notification of any published article that was not published in Pain Physician journal and we will ist in the weekly enews.



 Send in notification of your published works today to Holly Long (hlong@asipp.org)

 Pain Med. 2012 Feb;13(2):198-203.  


eprescribeE-prescribing Up, But Progress by States is Uneven


Minnesota has passed Massachusetts to become the state with the highest rate of electronic prescribing. Massachusetts held the top ranking for five years.

Credit for Minnesota's rise to the heights of Surescripts' annual Safe-Rx Awards is being given to the public-private collaborative efforts to promote e-prescribing in the state. That collaboration led to an e-prescribing mandate that passed in 2008 and took effect in 2011.


Eighty-two percent of prescribers in Minnesota have adopted e-prescribing, up from 49% in 2010, according to e-prescribing network Surescripts. Prescribers there routed 61% of prescriptions electronically last year, surpassing Massachusetts, which has an 86% adoption rate but had 57% of eligible prescriptions sent electronically.


AMA news



ruralRural substance abuse treatment admissions significantly more likely than urban counterparts to be referred by criminal justice system


New report shows significant differences in demographics and abuse patterns of substance abuse treatment admissions in rural versus urban communities


A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that rural and urban substance abuse treatment admissions in 2009 differed by nearly every aspect examined.


For example, in 2009 rural substance abuse treatment admissions were more likely than urban admissions to be referrals from the criminal justice system (51.6 versus 28.4 percent) and less likely to be self-referrals or referrals from family members or friends (22.8 versus 38.7 percent).

In addition, rural admissions were more likely than urban admissions to report primary abuse of alcohol (49.5 versus 36.1 percent) or non-heroin opiates (10.6 versus 4.0 percent), while urban admissions were more likely than rural admissions to report primary abuse of heroin (21.8 versus 3.1 percent) or cocaine (11.9 versus 5.6 percent).






obamacareObamacare Undermines Physicians, Quality of Care


The Association of American Medical Colleges projects a shortage of 63,000 physicians within the next few years. But rather than encourage doctors to continue practicing medicine, President Obama's health law will do exactly the opposite.


While the bill was being debated, the American Medical Association advocated two big policy changes. First, it asked that Congress overhaul the arbitrary formula used to annually update Medicare's reimbursement rates. The current formula invariably calls for massive cuts in payments. And Congress invariably overrides the cuts for fear that it would force thousands of physicians to stop accepting its enrollees, thereby making it difficult for seniors to access medical care.



Orlando Sentinel



mittMitt Romney, Obama Duel over Medicare as Campaign Intensifies


DUBUQUE, Iowa - The presidential campaigns of Mitt Romney and President Obama dueled Wednesday over Medicare, potentially a key issue in swing states that both camps are targeting in the November elections.


As Obama continued a swing through Iowa on the third and final day of a bus tour, Romney's Republican surrogates scheduled events in Dubuque and Davenport - where Obama is speaking Wednesday - to highlight what the Romney campaign said was Obama's decision to "cut $716 billion from Medicare to pay for his disastrous health care law."



Washington Post


boomerStudy: Healthcare System's Not Equipped to Deal With Boomers' Substance Abuse Needs


The aging of America holds profound consequences for the nation, especially when it comes to healthcare, says a report recently released by the Institute of Medicine, and the system isn't equipped to deal with the substance abuse and mental health needs of the baby boomer population.


Part of the issue is growing ethnic, cultural, and racial diversities, and researchers believe that the healthcare demands and costs that will result from these demographic shifts will be "unprecedented."


In light of growing concern regarding older adults' mental health and substance abuse (defied as misuse of, or dependency on alcohol and drugs, whether illicit or legal), the Department of Health and Human Services (HHS), as directed by Congress, asked the Institute of Medicine to conduct a study on the geriatric MH/SU workforce.



Senior Housing News



tragicSeeking Answers to Tragic Use of Painkillers

Recent suicides reveal lack of services to deal with problem


Would Daniel Placek Jr. still be alive if his addiction to prescription painkillers had been treated differently?

That's a question that haunts his parents, Cheryl and Daniel, little more than six months since their son, a 28-year-old Navy veteran, committed suicide.


The Niagara Falls family is still in shock, reeling from their introduction to the nation's alarming rise in opioid abuse and misuse. They are trying to come to grips with how a powerful narcotic given to their son for a back injury turned his life into a nightmare of anxiety, paranoia and hallucinations.



Buffalo News



ACOAccountable Care Organizations: Panacea or Train Wreck?


One of the hottest new ideas in health care is the Accountable Care Organization (ACO). Similar to health maintenance organizations, ACOs are designed to bring hospitals, physicians and insurers together to reduce health care costs by improving quality and reducing expenditures for unnecessary tests and procedures. ACOs aim to do so by restructuring the financial incentives for providers, say Roberta Herzberg, a senior fellow with the National Center for Policy Analysis and an associate professor of political science at Utah State University, and Chris Fawson, a professor of economics and finance at Utah State University.

However, there are problems with ACOs, including:

  •  ACOs assume financial risk, but have no formal control over patients' choice of treatment or providers.
  •  Patients are assigned to an ACO based on past service use, not explicit agreement. That is, providers do not know in advance which patients count as members of their ACO, and patients are retrospectively assigned to an organization based on receiving much of their primary care from the ACO.
  •  Higher regulatory burdens: To qualify as an ACO, a provider network must meet a variety of benchmarks for quality measurement, governing structure and information transmission. Meeting these requirements and demonstrating compliance is expected to add millions of dollars in administrative costs, at least in the short run. Whether the expected savings will offset the additional costs is unclear.
  •  Reduced competition: The creation of large ACO provider networks will reduce competition for the business of consumers and insurers.
  •    Data collection requirements raise costs and privacy concerns.

Providers will be tied to ACOs. There are concerns that providers are being enticed into ACO networks with promises of rewards for efficient behavior, but over time their reimbursements could be squeezed. Providers may be hesitant to leave as the economics change. Moreover, since other providers and regulators have information regarding a provider's practice, it may be impossible for that provider to operate independently again.






ambiAmbiguity in Health Law Could Make Family Coverage Too Costly for Many

Under rules proposed by the Internal Revenue Service (IRS), some working-class families would be unable to afford family coverage offered by their employers, and yet they would not qualify for subsidies provided by the Affordable Care Act (ACA), says the New York Times.


The fight revolves around how to define "affordable" under provisions of the law that are ambiguous. The definition could have huge practical consequences, affecting who gets help from the government in buying health insurance.


  •  The law specifies that employer-sponsored insurance is not affordable if a worker's share of the premium is more than 9.5 percent of the worker's household income.
  •  The IRS says this calculation should be based solely on the cost of individual coverage for the employee, what the worker would pay for "self-only coverage."




 photos San Francisco Photo Gallery Now Available


The Photo Gallery of the San Francisco ASIPP Board Review meeting is now available at the ASIPP web site (http://www.asipp.org/0812-San-Francisco/) or on ASIPP's Facebook page at http://www.facebook.com/AsippMember.


pqrs2012 Physician Quality Reporting System (PQRS) Program Reminder


It is not too late to start participating in the 2012 Physician Quality Reporting System (PQRS) and potentially qualify to receive an incentive payment equal to 0.5% of an eligible professional's total Medicare Part B allowed charges for services furnished during the reporting period.  A new six month reporting period using the registry submission option began on July 1, 2012. In addition, there are still ways to participate in the 12-month reporting period using claims, registry or EHR submission.


To access all available educational resources on PQRS please visit, http://www.cms.gov/PQRS on the CMS website.  Eligible professionals are encouraged to visit the PQRS webpage often for the latest information and downloads on PQRS. 


Eligible professionals also should note that 2012 is the last reporting year tied exclusively to an incentive payment. Beginning in 2015, CMS will apply a negative payment adjustment to eligible professionals who do not satisfactorily report data on quality measures for covered professional services. Reporting during the 2013 PQRS program year will be used to determine whether a PQRS payment adjustment applies in 2015. The proposed criteria for satisfactorily reporting data on quality measures to avoid the 2015 PQRS payment adjustment is detailed in the 2013 Medicare Physician Fee Schedule Proposed Rule, which was published on July 30, 2012. A link to the proposed rule is provided in the resources section below.


2013 Medicare Physician Fee Schedule Proposed Rule at







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American Society of Interventional Pain Physicians ®
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Phone 270.554.9412, Fax 270.554.5394
E-mail asipp@asipp.org