July 11, 2012
What's Next for Physicians after Affordable Care Act Ruling
Washington The U.S. Supreme Court's decision to uphold the Affordable Care Act has refocused stakeholder attention on the implementation of the law's provisions but also re-energizes efforts by opponents to repeal parts or all of the statute.
"One of the most frustrating things has been having so much uncertainty about how we move forward," said Glen Stream, MD, president of the American Academy of Family Physicians. Now "we can focus on the best possible implementation of the Affordable Care Act and its key provisions and work to fix the parts that need improvement."
The ability of the ACA to move to this next stage came with the high court's 5-4 decision on June 28 ruling the health system reform law constitutional. The court deemed valid the measure's most controversial and targeted provision - that nearly all Americans obtain health insurance by 2014 or pay a penalty. This individual mandate is considered the backbone of subsidized coverage expansions that are projected to decrease the number of uninsured in the U.S. by more than 30 million people.
Congress OKs Plan to Combat Drug Shortages
As part of what probably will be the only major piece of health care legislation to get through Congress in a heated election year, House and Senate lawmakers in late June approved a plan to mandate early warnings from drugmakers about possible shortages of crucial medications.
The final bill to reauthorize the Prescription Drug User Fee Act, which contained the shortage provisions, largely satisfied members of organized medicine. Some physician organizations, however, had been pressing Congress to adopt stricter enforcement language and include biologic drugs in the early notification system that would alert federal officials of potential shortages.
Register Now for San Francisco Board Review Course
ASIPP's comprehensive board review course is set for July 30 to Aug. 3 in San Francisco.
This intensive and comprehensive high-quality review is geared to prepare physicians appearing for the American Board of Medical Specialties (ABMS)-Subspecialty Pain Medicine examination and for the American Board of Interventional Pain Physicians (ABIPP)-Part 1 examination.
- A five-day review covering anatomy, physiology, pharmacology, psychology,
ethics, interventional techniques, non-interventional techniques,
controlled substances and practice management
- 39 unique lectures by experts in the field
- Participants can earn up to 44.25 AMA PRA Category 1 Credits
The course will be held The Westin San Francisco Market Street.
Click HEREfor brochure.
Click HERE to register.
ASIPP Offers Review Courses, Competency Exams in San Francisco
Attend the Comprehensive Review Course in Controlled Substance Management July 30-31 and take that Competency Exam on Aug. 1
Click HERE to see Brochure.
Attend the Comprehensive Review Course in Coding, Compliance and Practice Management Aug. 2-3 and take that competency exam Aug.5.
Click HEREto see brochure.
Courses will be at the Westin San Francisco Market Street.
Click HEREfor hotel reservations.
ASIPP Releases Opioid Guidelines Update
The American Society of Interventional Pain Physicians (ASIPP) Guidelines for Responsible Opioid Prescribing in Chronic Non-Cancer Pain: Part I - Evidence Assessment and Part 2 - Guidance will be published in a special issue of Pain Physician. This issue will be posted online next week and released in print later this month. In addition to the guidelines, about a dozen support reviews regarding various opioid subjects will be in the online issue of the journal.
Below is the abstract from Part 1 found in this Opioid Guidelines update:
Background: Opioid abuse has continued to increase at an alarming rate since the 1990s. As documented by different medical specialties, medical boards, advocacy groups, and the Drug Enforcement Administration, available evidence suggests a wide variance in chronic opioid therapy of 90 days or longer in chronic non-cancer pain. Part 1 describes evidence assessment.
Objectives: The objectives of opioid guidelines as issued by the American Society of Interventional Pain Physicians (ASIPP) are to provide guidance for the use of opioids for the treatment of chronic non-cancer pain, to produce consistency in the application of an opioid philosophy among the many diverse groups involved, to improve the treatment of chronic non-cancer pain, and to reduce the incidence of abuse and drug diversion. The focus of these guidelines is to curtail the abuse of opioids without jeopardizing non-cancer pain management with opioids.
1) There is good evidence that non-medical use of opioids is extensive; one-third of chronic pain patients may not use prescribed opioids as prescribed or may abuse them, and illicit drug use is significantly higher in these patients.
2) There is good evidence that opioid prescriptions are increasing rapidly, as the majority of prescriptions are from non-pain physicians, many patients are on long-acting opioids, and many patients are provided with combinations of long-acting and short-acting opioids.
3) There is good evidence that the increased supply of opioids, use of high dose opioids, doctor shoppers, and patients with multiple comorbid factors contribute to the majority of the fatalities.
4) There is fair evidence that long-acting opioids and a combination of long-acting and short-acting opioids contribute to increasing fatalities and that even low-doses of 40 mg or 50 mg of daily morphine equivalent doses may be responsible for emergency room admissions with overdoses and deaths.
5) There is good evidence that approximately 60% of fatalities originate from opioids prescribed within the guidelines, with approximately 40% of fatalities occurring in 10% of drug abusers.
6) The short-term effectiveness of opioids is fair, whereas the long-term effectiveness of opioids is limited due to a lack of long-term (> 3 months) high quality studies, with fair evidence with no significant difference between long-acting and short-acting opioids.
7) Among the individual drugs, most opioids have fair evidence for short-term and limited evidence for long-term due to a lack of quality studies.
8) The evidence for the effectiveness and safety of chronic opioid therapy in the elderly for chronic non-cancer pain is fair for short-term and limited for long-term due to lack of high quality studies; limited in children and adolescents and patients with comorbid psychological disorders due to lack of quality studies; and the evidence is poor in pregnant women.
9) There is limited evidence for reliability and accuracy of screening tests for opioid abuse due to lack of high quality studies.
10) There is fair evidence to support the identification of patients who are non-compliant or abusing prescription drugs or illicit drugs through urine drug testing and prescription drug monitoring programs, both of which can reduce prescription drug abuse or doctor shopping.
GlaxoSmithKline Pays Over $3B to Resolve Fraud Charges
NEW YORK - Large pharmaceutical company GlaxoSmithKline (GSK) has agreed to pay $3 billion in order to resolve charges of engaging in illegal schemes related to unlawful marketing and pricing of some of the drugs it manufactures in what has become the largest healthcare fraud scheme in the country's history.
New York Attorney General Eric T. Schneiderman announced Monday that as part of a national settlement with New York, 42 states, Washington, D.C. and the federal government, GSK will pay a total of $2 billion in damages and civil penalties in order to compensate for the company's illegal activities. GSK manufactures a number of big-name drugs including Paxil, Wellbutrin and Advair.
Healthcare Finance News
Pain Physician Impact Factor Increases to 10.722
Thomson Scientific's 2011 Journal Citation Report was released June 28, 2012. Pain Phyisician received a ranking of 10.722, up from the 7.793 received for the 2010 JCR.
Pain Physician's online content was included in this year's ranking.
The 2011 JCR data for PAIN PHYSICIAN are provided below.
Total Citations: 2790
Journal Impact Factor: 10.722
Rank in Category (by Journal Impact Factor): 5 of 191 journals in "Neuroscience"
Immediacy Index: 1.569
Eigenfactor(tm) score: 0.00460
Data is courtesy: Journal Citation Reports(r) Science Edition - a Thomson Reuters product.
NCCI 3rd Quarter Edits Released
Effective from 07/01/2012 to 09/30/2012 . These new edits have been effective since July 1, 2012 and will be effective through September 30, 2012.
For detailed analysis of NCCI for most commonly used interventional techniques, please follow link:
This quarter's listing includes a table showing all of the additions and deletions on the last page. This should make it much easier for the members to identify the changes.
FDA Proposes Identification System for Medical Devices
The FDA has proposed an identification system for most medical devices distributed in the United States.
A UDI is a unique code that acts as a key to certain basic identifying information about a device, such as the name of the manufacturer and the type of device. This information will be contained in a publicly available UDI database, and no identifying patient information will be stored in this device information center.
The FDA proposes that a UDI system could allow more accurate reporting of adverse events related to medical devices and a more consistent way of entering information about a device into health IT systems.
This proposal was introduced in response to requirements in the recently passed Food and Drug Administration Safety and Innovation Act.
Becker's Hospital Review
Methadone Tied to One-Third of Prescription Painkiller Deaths
If you are not grappling with cancer-related pain, you probably should not be taking prescription methadone.
That is the message spiraling out of startling statistics suggesting using methadone inappropriately is linked to one-third of prescription painkiller overdose deaths.
Methadone accounted for a mere 2% of prescriptions in 2009, according to Centers for Disease Control and Prevention data that spans 10 years and 13 states, but was responsible for 30% of prescription painkiller deaths.
Fighting Prescription Drug Abuse, while Treating Pain, is a Health Care Crisis
The abuse, misuse and diversion of prescription drugs is a public health crisis. This is particularly apparent to those of us working in the emergency department, which is the largest ambulatory source of opioid medications. We all too frequently see individuals with untreated addiction issues, with life-threatening overdoses, and trying to obtain opioid medications for recreational use or to sell for profit.
The costs to individuals and society are devastating:
Davie Pill Mill Owner Sentenced in Operation Snake Oil
Defendant Owned and Operated Six Area Pain Management Clinics that Dispensed Oxycodone, Profited More than $22 Million
MIAMI- Mark R. Trouville, Special Agent in Charge, U.S. Drug Enforcement Administration (DEA), Miami Field Division, Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, and José A. Gonzalez, Special Agent in Charge, Internal Revenue Service, Criminal Investigation Division (IRS-CID), Miami Field Office, announced today's sentencing of Vincent Colangelo, 44, of Davie, for his role in a large-scale conspiracy involving the illegal distribution of prescription pain medication and related criminal offenses between October 2008 and February 23, 2011.
Colangelo pled guilty on April 2, 2012, to conspiracy to distribute and dispense large amounts of oxycodone without a legitimate medical purpose and outside the usual course of professional practice. Colangelo also pled guilty to money laundering and filing a false 2009 federal income tax return. U.S. District Judge Marcia G. Cooke sentenced Colangelo to 20 years in prison, to be followed by three years of supervised release. In addition, Colangelo was ordered to forfeit five properties valued at more than $2.5 million, approximately $911,951 seized from seven bank accounts and a safety deposit box, 52 vehicles and vessels worth more than $6 million and jewelry valued at approximately $20,000.
The charges arose from Operation Snake Oil, an undercover DEA investigation that began in approximately September 2009. Previously sentenced for their roles in the drug conspiracy by U.S. District Judge Marcia G. Cooke were: Wayne Richards to 20 months in prison; Nicholaus Thomas and Rachael Bass to 120 months and 50 months in prison, respectively; and Michael Plesak to 60 months in prison. Two remaining co-defendants are awaiting sentencing.
Opinion: Good News About Open Access Publishing
By George Lundberg, MD, Editor-at-Large, MedPage Today
Hello and Welcome. I'm Dr. George Lundberg and this is At Large at MedPage Today.
"I gave at the office."
I am an American taxpayer just like most of you, the audience. My tax dollars, and yours, fund the great majority of health-related research in the United States, mostly through the National Institutes of Health.
Thus, I, and you, the taxpayers, own the results of that NIH funded research. We paid for it.
Real-Time Drug-Tracking Systems Aim to Curb Diversion
Federally funded pilot projects in Indiana and Ohio will give pharmacists and physicians in office-based practices and emergency departments real-time access to state prescription-drug monitoring information to prevent diversion of controlled substances, the Dept. of Health and Human Services announced in June.
"Technology plays a critical role in our comprehensive efforts to address our nation's prescription drug abuse epidemic," said Gil Kerlikowske, director of the White House Office of National Drug Control Policy.
As part of the pilot projects, physicians will have access to patients' history of controlled-substance use directly through their electronic health records at the point of care. All states but one have enacted legislation authorizing drug-monitoring programs, and more than three dozen already are active. However, doctors report that the records available often are out of date and poorly integrated with their EHR.
West Virginia Sues Pill Mill Suppliers
West Virginia politicians are taking an increasingly prominent role on the national stage in the fight against prescription drug abuse.
This week U.S. Senator Joe Manchin went to the Senate floor to plead for an amendment that would place tighter controls on Vicodin and other painkillers containing hydrocodone.
And state Attorney General Darrell McGraw filed a lawsuit seeking injunctions against 14 out-of-state drug suppliers for their alleged roles in creating and profiting from the epidemic of prescription drug abuse.
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