" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

December 19, 2012



  1. CDC Webinar: Update on the Multistate Outbreak of Fungal Meningitis and Other Infections
  2. Upton Prepares 'Doc Fix' Package in Case Broader Deal Falls Apart
  3. Phoenix in February: ASIPP Offers Three Different Courses
  4. Obama: Pot users not 'top priority'
  5. It's a Mad, Mad, Mad, Mad ObamaCare
  6. More Predictions of Rate Shock Because of the New Health Law
  7. Health rankings: USA is living longer, but sicker
  8. Costly Cancer Therapy Dinged Proton-Beam Treatment for Prostate Tumors No Better Than Radiation, Study Says
  9. FDA Looks to ASIPP for Interventional Pain Therapy Guidelines as Alternatives to Opioids
  10. ASIPP Expert Training Series Jan. 17-18
  11. A Pain-Drug Champion Has Second Thoughts
  12. How Safe Are Your Medical Records?
  13. Court: NJ Nurse Anesthetists Must be Supervised by Anesthesiologists
  14. Tampa Pharmacist Guilty Of Filling Hundreds Of Fraudulent Oxycodone Prescriptions
  15. Online Learning Portal ? New Resource for Clinicians Just a Click Away
  16. State Society News
  17. Physician Wanted  

uptonUpton Prepares 'Doc Fix' Package in Case Broader Deal Falls Apart


House Energy and commerce Chairman Fred Upton is working on a stand-alone package that would extend current payment rates for Medicare providers, even if leaders don't reach a deal to avert the fiscal cliff.


Upton, R-Mich., said he is working on a "Plan B" that would stop a scheduled 27 percent cut in Medicare reimbursement rates for physicians starting Jan. 1. The package, which he said would cost $30 billion over 10 years, is likely to maintain current reimbursement rates for one year as well as extend some other expiring Medicare payment policies. Upton said he had a list of offsets that "are not creative" to cover the extension's cost.


The stand-alone package would assure that physicians aren't hit with the payment cuts, even if lawmakers can't agree on a deficit-reduction deal. A so-called "doc fix" would presumably be part of any big year-end fiscal package.


Upton did not guarantee passage of a full extension of the higher Medicare payment rates, but seemed confident something would pass the House.


"I can't promise what the Senate will do," he said.


Despite his Plan B, Upton has not given up hope on the chances for a bipartisan deficit-reduction deal to avoid the steep across-the-board spending cuts scheduled for 2013.

He said he was hoping for "a grand package that makes a lot of sense to the taxpayers."


"We have time. The wheels are spinning...Stay tuned," said Upton, an adviser in the debt talks to Speaker John A. Boehner of Ohio. "We need to be working together on spending reform. So far, we don't have much of an answer out of the White House," Upton added. "We are ready as a conferences to have a big package if we can get it through."


Lobbyists and health care provider groups have been pushing lawmakers for weeks to avert the planned reductions in reimbursement rates. Leaders from rovider groups have been meeting with staffers recently to try to hammer out details of another payment patch.


CQ News

potObama: Pot users not 'top priority'


President Obama says the federal government will not target recreational users of marijuana in states that have now legalized pot.


"We've got bigger fish to fry," Obama told Barbara Walters of ABC News, in his first public comments on the topic since Colorado and Washington voted to legalize marijuana on Nov. 6 referendums.


"It would not make sense for us to see a top priority as going after recreational users in states that have determined that it's legal," Obama said.



USA Today


madIt's a Mad, Mad, Mad, Mad ObamaCare


For sheer political farce, not much can compete with ObamaCare's passage, which included slipping the bill through the Senate before dawn three Christmas eves ago. But the madcap dash to get ready for the entitlement's October 2013 start-up date is a pretty close second.


The size and complexity of the Affordable Care Act meant that its implementation was never going to easy. But behind the scenes, even states that support or might support the Affordable Care Act are frustrated about the Health and Human Services Department's special combination of rigidity and ineptitude.



Wall Street Journal


note: some WSJ content is subscription online


predictionsMore Predictions of Rate Shock Because of the New Health Law


Last week, I reported on my informal survey of health insurance companies and their estimate for how much rates will rise on account of the Affordable Care Act ("Obamacare").

Today, there are press reports quoting the CEO of Aetna with their estimate. The Aetna estimate is worse than mine.


From Bloomberg:

Health insurance premiums may as much as double for some small businesses and individual buyers in the U.S. when the Affordable Care Act's major provisions start in 2014, Aetna Inc. (AET)'s chief executive officer said.




Health Policy and Market Blog

rankingsHealth rankings: USA is living longer, but sicker


Americans are living longer, with fewer deaths from heart disease and cancer, but more chronic illnesses, an annual snapshot of the USA's health shows.


The 2012 America's Health Rankings highlight troubling levels of obesity, diabetes, high blood pressure and sedentary behavior. Medical advances are allowing more people to live with those conditions.


The bottom line: Americans "are living longer, sicker" with more chronic illness, says Reed Tuckson of theUnited Health Foundation, a not-for-profit foundation that sponsors the report with the American Public Health Association and the Partnership for Prevention.


USA Today

costlyCostly Cancer Therapy Dinged Proton-Beam Treatment for Prostate Tumors No Better Than Radiation, Study Says


In a finding likely to add fuel to the debate over treatments for prostate cancer, proton-beam therapy provided no long-term benefit over traditional radiation despite far higher costs, according to a study of 30,000 Medicare beneficiaries published Thursday in the Journal of the National Cancer Institute.


Proton radiotherapy uses atomic particles to treat cancer rather than X-rays and theoretically can target tumors more precisely. But it requires a particle accelerator roughly the size of a football field that typically costs about $180 million.


Wall Street Journal


Note: some WSJ content is subscription only

fdaFDA Looks to ASIPP for Interventional Pain Therapy Guidelines as Alternatives to Opioids


With chronic pain conditions now affecting more than 116 million Americans, The American Society of Interventional Pain Physicians (ASIPP) has seen an increased demand for interventional pain therapies to treat them. Epidurals are an essential component of chronic pain treatment, particularly to curtail the use of addictive painkillers (opioids), the use of which has reached epidemic proportions in this country. While Americans age and live longer than ever before, the numbers of those affected with chronic conditions will only continue to rise.


ASIPP emphasizes the need for established guidelines for epidurals being that they have become a mainstay of interventional pain management. These guidelines include when to use epidurals, who should administer them, and why they should be embraced by the entire healthcare industry. In 2012, the FDA requested that ASIPP and other pain organizations provide guidelines to address certain safety concerns which have arisen.


Given the recent meningitis outbreak associated with the use of interventional pain therapies, many well-intentioned healthcare professionals are debating their continued use to treat chronic pain conditions. Situations like these concern ASIPP's Chairman of the Board and CEO, Laxmaiah Manchikanti, M.D. who states, "The meningitis outbreak was not at all indicative of the efficacy and safety of epidural injection treatments, it appears to have been the result of negligence on the part of the company that manufactured the batches of steroidal medication. Epidural injection therapy is still a safe and effective solution to treating chronic pain, is a significantly less invasive and less risky treatment than surgery and poses no threat of addiction as with narcotics."

expertASIPP Expert Training Series Jan. 17-18


We are pleased to announce a new and personalized training opportunity. The first ASIPP Expert Training Series will take place on January 17 &18, 2013. This is an exceptional educational experience on a variety of interventional pain topics that provides a unique opportunity for a group limited to 4 physicians that will spend two full days training exclusively on one specific interventional procedure. The course series provides a full day in the operating room observing the expert instructor performing the particular interventional procedure on several patients. The January 17 &18 course will cover neurostimulation with IPM expert, Frank Falco, MD, in Elkton, MD.


The course features a dinner/didactics session on the first night and lunch/didactics on both days. The second day is a full 8 hours of cadaveric training on the interventional procedure with 2 attendees per cadaver side by side with the expert instructor. Attendees will be able to interact with the expert instructor, staff, and patients during the course. Attendees will receive at the end of the second day a certificate of course attendance with 20 CME credits.


This course is limited to only 4 physicians so act fast!


To Register and for more information click here.


championA Pain-Drug Champion Has Second Thoughts


It has been his life's work. Now, Russell Portenoy appears to be having second thoughts.


Two decades ago, the prominent New York pain-care specialist drove a movement to help people with chronic pain. He campaigned to rehabilitate a group of painkillers derived from the opium poppy that were long shunned by physicians because of their addictiveness.


Dr. Portenoy's message was wildly successful. Today, drugs containing opioids like Vicodin, OxyContin and Percocet are among the most widely prescribed pharmaceuticals in America.



Wall Street Journal

Note: some WSJ content is subscription only

safeHow Safe Are Your Medical Records?


If you think your medical records are shielded from prying eyes, think again.


Health-care providers, insurers, employers, the government, marketers, financial institutions, debt collectors and data miners are among the growing horde that can get access to your health-care information.



Wall Street Journal


Note: some WSJ content is subscription only

jerseyCourt: NJ Nurse Anesthetists Must be Supervised by Anesthesiologists


The Superior Court of New Jersey ruled against the New Jersey Association of Nurse Anesthetists, and held up a state requirement that anesthesiologists must be present when nurse anesthetists administer anesthesia in hospitals, according to the American Society of Anesthesiologists.

The New Jersey Department of Health requires anesthesiologists be physically present during patient induction, emergence and critical change in status when nurse anesthetists administer general or major regional anesthesia, the ASA reported.

The ANA argued the Department of Health was overstepping its authority, but the court disagreed for several reasons. The court referenced a previous case, which established the administration of anesthesia as the practice of medicine and also made note of the differences in education and training of nurse anesthetists and anesthesiologists.



Court document link: http://www.judiciary.state.nj.us/opinions/a3852-10.pdf


Becker's ASC Review


localTampa Pharmacist Guilty Of Filling Hundreds Of Fraudulent Oxycodone Prescriptions


Tampa, Florida - A federal jury yesterday found Emmanuel I. Mekowulu (56, Tampa) guilty of conspiring with other persons to knowingly and intentionally distribute and dispense a controlled substance, primarily Oxycodone, outside of a legitimate medical purpose and not in the usual course of professional practice. Mekowulu faces a maximum penalty of 20 years in federal prison. As part of the sentence, he will also forfeit his Florida Department of Health Pharmacist License and the DEA Registration and Florida Department of Health Pharmacy License for Felky Rx, LLC, which were used to commit or facilitate the offense.


Mekowulu was indicted on April 26, 2012. His sentencing is scheduled for March 11, 2013.



Justice Department

onlineOnline Learning Portal ? New Resource for Clinicians Just a Click Away


Kimberly-Clark Health Care recently held its first live cadaver course lecture via its online, proprietary physician education training portal. The lecture, which was broadcast and attended by a record number of viewers in more than 14 countries, showcased a new method of training for its minimally-invasive cooled radiofrequency procedures for treating chronic pain. During the live streaming lecture, viewers were able to directly interact with faculty while observing procedural technique.


The lecture will be made available for on-demand viewing later this month. This is the first of several lectures leveraging this new platform for global training to be offered on their cooled radiofrequency technology. To register for the next lecture or keep abreast of developments/information on Kimberly-Clark's cooled radiofrequency technology visit http://kcpain.docstream.com/




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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