May 30, 2012
Publishes 5 Systematic Reviews on Interventional Techniques
These systematic reviews
were developed utilizing very strict criteria prior to the publication of
guidelines for managing chronic spinal pain. The results of systematic reviews
are as follows:
Injections in the Management of Chronic Low Back Pain: A Systematic Appraisal of
Allan T. Parr, MD, Laxmaiah
Manchikanti, MD, Haroon Hameed, MD, Ann Conn, MD, Kavita N. Manchikanti, MD,
Ramsin M. Benyamin, MD, Sudhir Diwan, MD, Vijay Singh, MD, and Salahadin Abdi,
There was good evidence for short- and long-term relief
of chronic pain secondary to disc herniation or radiculitis with local
anesthetic and steroids and fair relief with local anesthetic only. Further,
this systematic review also provided indicated evidence of fair for caudal
epidural injections in managing chronic axial or discogenic pain, spinal
stenosis, and post surgery syndrome.
Therapeutic Lumbar Transforaminal Epidural Steroid Injections in Managing Lumbar
Laxmaiah Manchikanti, MD,
Ricardo M. Buenaventura, MD, Kavita N. Manchikanti, MD, Xiulu Ruan, MD,,
Sanjeeva Gupta, MD, Howard S. Smith, MD, Paul J. Christo, MD, and Stephan P.
evidence is good for radiculitis secondary to disc herniation with local
anesthetics and steroids and fair with local anesthetic only; it is fair for
radiculitis secondary to spinal stenosis with local anesthetic and steroids; and
limited for axial pain and post surgery syndrome using local anesthetic with or
Effectiveness of Thermal
Annular Procedures in Treating Discogenic Low Back Pain
Standiford Helm, II, MD,
Timothy R. Deer, MD, Laxmaiah Manchikanti, MD, Sukdeb Datta, MD, Pradeep Chopra,
MD, Vijay Singh, MD, and Joshua A. Hirsch, MD
evidence is fair for IDET and poor for discTRODE and biacuplasty is being
evaluated in 2 ongoing randomized controlled trials.
A Systematic Evaluation
of Prevalence and Diagnostic Accuracy of Sacroiliac Joint Interventions
Thomas T. Simopoulos, MD,
Laxmaiah Manchikanti, MD, Vijay Singh, MD, Sanjeeva Gupta, MD, Haroon Hameed,
Sudhir Diwan, MD, and
Steven P. Cohen, MD
evidence for the diagnostic accuracy of sacroiliac joint injections is good, the
evidence for provocation maneuvers is fair, and evidence for imaging is limited.
A Systematic Evaluation
of the Therapeutic Effectiveness of Sacroiliac Joint Interventions
Hans Hansen, MD, Laxmaiah
Manchikanti, MD, Thomas T. Simopoulos, MD, Paul J. Christo, MD, Sanjeeva Gupta,
Howard S. Smith, MD, Haroon
Hameed, MD, and Steven P. Cohen, MD
evidence was fair in favor of cooled radiofrequency neurotomy and poor for
short-term and long-term relief from intraarticular steroid injections,
periarticular injections with steroids or botulin toxin, pulsed radiofrequency,
and conventional radiofrequency neurotomy.
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
Attend the Comprehensive
Review Course in Coding, Compliance and Practice Management Aug. 2-3 and take
that competency exam Aug.5.
be at the Westin San Francisco Market Street.
Headed for Penalty over Medicare Quality Reporting
Absent a significant change
in the trajectory of Medicare's physician quality reporting system, a large
majority of doctors will set themselves up for future rate cuts by failing to
report enough quality measures to the federal government in 2013.
A recent trends report from
the Centers for Medicare & Medicaid Services shows that fewer than 200,000
physicians, out of the more than 600,000 who were eligible for the incentive
program, reported PQRS measures in 2010. More than 125,000 physicians reporting
as individuals met enough of the requirements to share a total of nearly $400
million in bonuses, but hundreds of thousands of eligible doctors did not
attempt to meet the pay-for-reporting criteria. More than 50,000 tried for the
bonuses but did not report enough quality measures to hit the
Act to Threaten Quality of Treatment Says Hudson Institute
In The Secretary Shall: How
the Implementation of the Affordable Care Act Will Affect Doctors, Hudson
Institute Senior Fellow Tevi Troy evaluates the potentially hazardous impact
that the Affordable Care Act (ACA) will have on a critical actor in American
health care--the physician.
As the political and legal
worlds debate the virtues and viability of the ACA and the nation follows along
in confusion, America's doctors must prepare for the potentially large and
deleterious impact that the new law may have on their careers, incomes, and
relationships with their patients. A survey by the Doctors Company indicates
that 60 percent of physicians feel that the health care law will have a negative
influence on overall patient care and 51 percent feel that the law will
negatively impact their relationships with patients. In light of this troubling
reality, Tevi Troy, a former Deputy Secretary of the Department of Health and
Human Services, examines the 2,700 page law to explain why these concerns may be
Painkillers should be Monitored Electronically: N.Y. Grand
NEW YORK-A New York grand
jury investigating an epidemic of controlled substance abuse has called on
pharmaceutical manufacturers to help fund electronic monitoring of opioid pain
County, N.Y., District Attorney Thomas Spota released
a 99-page report on Thursday that contains several other recommendations from
the Suffolk County Supreme Court Special Grand Jury, which was first empanelled
The report also criticizes
drug manufacturers' profit motives and the medical establishment for
overprescribing addictive pain medications.
The grand jury's many
recommendations include mandating electronic prescribing for controlled
substances or else mandating that all pharmacy dispensers enter controlled
substance prescription data into a central registry.
Such efforts could inhibit
doctor shopping by patients while helping hold prescribers accountable when
discipline is warranted, the report states.
The grand jury also called
for pharmaceutical manufacturers to subsidize the proposed monitoring of
controlled substance prescriptions.
"Manufacturers provide the
supply of controlled substances, pay to market them and reap enormous profits,"
the report states. "It is therefore reasonable to require that, as a cost of
doing business in New York, manufacturers subsidize the implementation and
operation of the (registry) here. There is precedent for this in Florida.
Manufacturers must also contribute to a research fund for addiction evaluation
Medicaid money trail?
Doctors are shunning
Medicaid patients because of low fees, a trend that is likely to become a crisis
in less than two years, when the ranks of patients are expected to swell.
Budget talks in Springfield
last week to reduce a $2.7 billion annual deficit in the health care program for
the poor won't help ease the chronic shortage of doctors willing to treat
patients at rates that are among the lowest in the nation. Fees are one reason
many Chicago-area specialists don't make appointments with Medicaid patients,
two studies have found.
Roughly 16 percent of the
state's 47,000 doctors aren't signed up for the program. Even among those who
are, the overwhelming majority infrequently see patients, leaving the care
concentrated in the hands of a few, according to a Crain's analysis
of payment records.
About 25 percent of
Medicaid doctors account for just 0.4 percent of the $2.8 billion paid from 2009
through 2011 and make less than $1,400 a year in the program,
Crain'sfinds. At the other end, the top 10 percent of
Medicaid earners received more than 55 percent of the total payments, making at
least $70,000 a year, the analysis shows.
|Pain Meds Linked
to Lower Risk for Skin Cancer
People who used common
nonsteroidal anti-inflammatory drugs (NSAIDs) had a significantly lower risk of
melanoma and squamous-cell skin cancer (SCC), and the benefit increased with
duration and drug dose, according to a large Danish cohort study.
Any NSAID use was
associated with a 15% reduction in the relative risk of SCC and a 13% lower risk
of melanoma. NSAID use had no overall effect on basal-cell skin cancer (BCC),
but was associated with a statistically reduced risk of BCC at sites other than
the head and neck.
to Psychiatric Manual Could Impact Addiction Diagnosis
What's in a name? That's a
question that experts are wrestling with as they prepare to revise the
diagnostic manual that spells out the criteria for addiction and other
The catalyst for this
discussion is a set of proposed changes to the Diagnostic and
Statistical Manual of Mental Disorders, the reference guide upon which
clinicians, researchers, insurers and others rely to identify and classify
psychiatric disorders. The revised guide, called DSM-5, will
incorporate changes to more than a dozen categories of disorders, including
those related to mood, eating and personality, as well as substance use and
Developed under the
auspices of the American Psychiatric Association, the revised manual is scheduled for release in May 2013.
AMA, MGMA letters
to lawmakers suggest SGR alternatives
WASHINGTON - Letters sent
last Friday to House Ways and Means Committee chairs Dave Camp (R-Mich.) and
Wally Herger (R-Calif.) from the American Medical Association (AMA) and Medical
Group Management Association (MGMA) suggest a number of different payment
approaches aimed at a long-term solution to the current Medicare sustainable
growth rate (SGR).
Both letters were submitted
in response to a request from the committee seeking ideas on how to create new
"There is widespread
agreement among experts and stakeholders that the existing physician payment
system under the Medicare program is inadequate," wrote Susan Turney, MD,
president and CEO of MGMA. "Although Congress has repeatedly intervened to
prevent rate cuts, it has never eradicated the formula that dictates these
Individual Health Plans Fall Short of ACA Standards
More than half of the
people who have health insurance coverage through an individual insurance plan
are enrolled in plans that won't meet minimum coverage requirements for plans
sold in 2014 as defined by the Affordable Care Act, according to research
supported by The Commonwealth Fund.
The study, published in the
May issue of Health Affairs sought to quantify the number of
individual health plans sold today that fail to an actuarial value of 60
percent, the bare minimum for plans that will be sold at the "bronze" level on
the health insurance exchanges starting in 2014.
According to the findings
the average actuarial value for all health plans sold on the individual market
was 60 percent and among that group 51 percent of the plans provided an
actuarial value below 60 percent. These so-called "tin" plans see the insurance
companies responsible for less than 60 percent of total healthcare costs, and
the individual members responsible for more than 40 percent due to deductibles,
co-payments and other out-of-pocket expenses
Faces 105-Count Federal Indictment
A Chattanooga doctor is
facing a 105-count federal indictment.
Dr. Ishaan Al Amin, 61, was
brought into a federal courtroom in handcuffs on Tuesday afternoon as the
indictment was unsealed.
It charges that the
operator of O'Neil Medical Clinic in Brainerd has been illegally dispensing
controlled substances. He is also charged with money laundering and possession
of a weapon in furtherance of a federal offense. Authorities said he was found
with two firearms.
Challenges to Peer
Review Confidentiality Rising
have enjoyed state protections when discussing a colleague's behavior or
analyzing an adverse event in peer review committees. At least 45 states prevent
disclosure of what is said during such meetings to facilitate open communication
and foster better health care.
But a recent rise in legal
challenges against peer review protections is putting doctors' confidentiality -
and the process itself - at risk, legal experts and physicians say.
Sign-up Highest Among Small Practices
Government incentives aimed
at e-prescribing and electronic health record use had the intended effect, as
they are considered the primary reasons for the great interest in e-prescribing
among small practices.
The 2011 "National Progress
Report on e-Prescribing and Interoperable Health Care" by Surescripts, the
largest e-prescribing network, found that 58% of office-based physicians are
using e-prescribing systems and the highest use - and largest growth - has been
among small practices. Solo practices saw the most significant growth from 2010
Doctors Offer Cash Discount for Medical Bills
Unknown to most consumers,
many hospitals and physicians offer steep discounts for cash-paying patients
regardless of income. But there's a catch: Typically you can get the lowest
price only if you don't use your health insurance, says the Los Angeles
That disparity in pricing is coming under fire from people like Jo
Ann Snyder, whose share of a $6,707 CT scan amounted to $2,336 after her Blue
Shield of California negotiated price. The cash price?
National Center for Policy
Compensation in U.S. Among Lowest for Western Nations
GA - A recent study by Alpharetta, Ga.-based staffing company Jackson Healthcare
found that U.S. physician compensation is among the lowest of western nations.
Researchers obtained salary
data from the Organisation for Economic Co-Operation and Development and the
Medical Group Management Association to determine compensation percentages for
nations with modern healthcare systems.
Total U.S. physicians'
salaries comprised 8.6 percent of the nation's total healthcare costs. Of the
western nations with modern healthcare systems, only Sweden devoted less money
to physician salaries than the U.S, at a portion of 8.5 percent.
Charged in Massive Manhattan Illegal Prescription Pill Diversion, Distribution
--More than 10,000 Prescription
Pills Distributed Weekly--
May 23 - (New York)
- Wilbert L. Plummer, the Acting Special Agent in Charge of the New
York Field Office of the Drug Enforcement Administration, Preet Bharara, the
United States Attorney for the Southern District of New York, and Raymond Kelly
of the New York City Police Department (NYPD), today announced charges against:
Julio Cesar Guerrero Brito, Hector Luis Vargas-Paredes, Jonathan Cruz, Virgilio
Antonio Diaz Garciano, Ruben Alexander Santiago Guillermo, Plino Ramos, Eward
Delrosario, Agustin Cabrea-German, and Arturo Lara for conspiring to distribute
oxycodone and oxymorphone.
In a second complaint,
Jenny Gomez, Felix Abreu, and Joanna Fuertes are charged with conspiring to
distribute oxycodone and oxymorphone. In a third complaint, Walid Zeyad Asmar
and Hector Jiminez are charged with conspiring to distribute
The defendants allegedly
participated in the distribution of illegally diverted prescription pills
through open-air, hand-to-hand, and car sales on certain blocks in Upper
Manhattan. Multiple defendants also allegedly assisted in transporting these
drugs to New England, where they command higher prices on the illegal market.
The oxycodone was distributed in various forms, including what is commonly known
as "Percocet," and the oxymorphone was distributed in a form commonly known as
ASIPP Welcomes New
Summer Moffitt comes to
ASIPP as an administrative assistant. Her role as an administrative assistant
include, typing correspondence reports and other documents, making phone calls,
organizing documents, and giving assistance to other staff members. She has
earned her Associates of Science in Health Information Technology at Daymar
She will be handling the
CME certificates as well. For any questions regarding your CME certificates,
please contact Summer at firstname.lastname@example.org or call 270-554-9412.
Copyright © 2008
American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394