September 12, 2012
CRNA Issue CAPWIZ
Letters of Utmost Importance: Can't Afford to Delay!
On July 6, the Centers for Medicare & Medicaid Services (CMS) released
a proposed rule on the Physician Fee Schedule which includes new language on
chronic pain management.
In other words, under the
proposed rule a CRNA will be reimbursed for services related to chronic pain
management as long as the CRNA is permitted to perform the service under the
state scope of practice law. We ask that you join ASIPP in contacting CMS and
Congress to express your concern. You must reference CMS-1590-P when
Frankly, the lack of action
to date is shocking to us. Fortunately it is not too late to take action. While
the time for a response to CMS has expired, we can still contact the Members of
Use this link to access
Here is a copy of the comment
letter that ASIPP sent to CMS for your reference. It may be
quite helpful to you as you reach out to your senators and representative. In
addition, using the Capwiz link below, please continue to send daily Capwiz
letters to Congress. It is also simple and imperative to get your patients
involved. Customize the following letter to your state leaders, have your
patients sign it before they leave the office, then have your staff enter it in
Capwiz for the patient. Sample Patient
If you think you are too
busy to act on this now, don't worry, you will soon have more time on your hands
if you do not, as there will be plenty of CRNAs willing to take on your patient
Please act immediately -
before it is too late!
Medicare Region C
Recovery Auditor to Begin Audits
CMS has alerted the AMA
that it has approved the Medicare Region C Recovery Auditor(RAC) Connolly to
begin conducting audits of coding for E&M services in physician offices,
specifically CPT code 99215.
We have been informed that
in the next several weeks, Connolly will begin complex medical review of CPT
code 99215, and will be permitted to extrapolate their findings based on a
statistical sample of such claims. Connolly is the Medicare FFS RAC contractor
who conducts RAC audits in AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, SC, TN, TX,
VA, WV, Puerto Rico and the U.S. Virgin Islands. However, it has not yet been
announced if all or only a subset of these states will be under review.
These reviews are expected
to begin imminently in Region C and, according to CMS, are likely to be approved
in other Medicare regions in the near future. The AMA has sent the
attached letter to CMS Acting Administrator Marilyn Tavenner strongly objecting
to these audits and urging CMS to rescind approval of RAC review of E&M
codes. We also have alerted CMS staff that there will be significant
opposition and questions about these audits among medicine and have requested
that they provide briefings for state medical societies and specialty societies
in the next few weeks to hear these concerns directly. We have yet to confirm
these briefings but will inform you of their status once confirmed. As
additional background for your information on this issue, the AMA and 101 state
and specialty societies sent a letter to CMS in March 2009 strongly opposing RAC audits of E&M services.
Recently, however, there
has been increased pressure on CMS to review physicians' coding of E&M
services. The HHS Office of Inspector General (OIG) issued a report in May on
this topic that specifically urged CMS to encourage its contractors to conduct
these reviews and "if CMS determines that inappropriate claims have been paid,
it should take steps to recover those overpayments."
Please Take Part in ASIPP Use of Antithrombotics
in IPM Survey
The American Society of
Interventional Pain Physicians (ASIPP) is conducting a survey on bleeding
complications, specifically epidural hematomas. The goal of this survey is to
gain a better understanding of current and future trends in managing patients on
antithrombotics undergoing spinal and other interventional techniques. The
results will eventually be utilized in the ASIPP guidelines.
All information will remain
confidential, and only aggregate not individual responses will be published. As
a participant, you will receive a copy of the survey results. This data will be
extremely helpful for the future of our speciality. The survey should only take
about 5 to 10 minutes to complete.
If you are willing to
participate, click on the following link to download the survey form.
the link below to take survey:
Physicians be Forced to 'Heel' by Executive Order?
POINT, CA, September 10, 2012- Under Article II, Section 1, Clause
1, President Obama could issue an order to bring physicians into line with his
grand vision of universal health coverage in America.
"By the authority vested in
me as President..." could be the words preceding perhaps the most massive change
to the U.S. healthcare system in history-eclipsing in effective scope even the
Obamacare law itself. In one of President Obama's first executive orders issued
in the post-election days of November 2012, if he is re-elected on November 6th,
this phrase would shoot like hot lead from the barrel of the Affordable Care Act
into the lives of physicians and patients everywhere.
As of today, physicians do
not have to see patients with an Obamacare plan, and, by all polls, many
physicians are not fans of the new law in the first place. This is keeping the
President's advisors up at night.
New FDA Device
Helps ID Fake Drugs
The FDA is using simple technology it designed to help nab counterfeit products,
but the agency's development of such innovations may face trouble in the future,
agency commissioner Margaret Hamburg, MD, said Monday.
The agency displayed its
Counterfeit Detection Device No. 3 -- CD3 for short -- at an FDA
The device sprays 10
different wavelengths of visible and invisible light on products the FDA is
inspecting. When they aim it over tablets, boxes, and accompanying documents,
inspectors are able to spot counterfeit products and documents because they
appear a different color or shade.
Industry Experiments with New Payment, Care Models
A recent bundled payment
contract hatched among three major players within Connecticut's health care
industry could provide a sneak preview into the future of health
The Connecticut Joint
Replacement Institute at St. Francis Hospital signed a contract with Farmington
health insurer ConnectiCare, in which the medical providers will receive one,
preset payment to provide a defined set of services for hip and knee replacement
The hospital, surgeons and
anesthesiologists will be responsible for coordinating the entire episode of
care for the patient from the time they walk into the hospital, have their
surgery and get discharged. They will also monitor outcomes and other quality
measures, and receive a set payment as reimbursement.
Pain Pill Recall
for Over-Potency Issue
Qualitest, a subsidiary of
Endo Health Solutions (Nasdaq: ENDP), today issued a voluntary, nationwide
retail level recall for one lot of Hydrocodone Bitartrate and Acetaminophen
Tablets, USP 10 mg/500 mg.
The recall includes the
following product lot:
- Hydrocodone Bitartrate and Acetaminophen Tablets, USP 10 mg/500 mg,
NDC 0603-3888-21, 100 count, Lot Number C1440512A, expiry date
Heath, Medical, and Science
Health Care System
Wastes $750 Billion a Year
The U.S. health care system
squanders $750 billion a year, roughly 30 cents of every medical dollar, through
unneeded care, byzantine paperwork, fraud and other waste according to a report
by the Institute of Medicine, says CBS News.
The report highlights
inefficiencies in the current health care system and the need to quickly address
billion goes toward unnecessary services
billion goes toward inefficient delivery of care.
billion goes toward excessive administrative costs.
billion goes toward inflated prices.
failures make up $55 billion.
finally, fraud accounts for $75 billion
this in perspective, eliminating the $750 billion in inefficiencies is
equivalent to more than 10 years of Medicare cuts in Obama's health care law.
candidates agree that something needs to be done about the rising health care
costs. Obama's plan would rely on a board to cut payments to service providers.
In addition, he would reward payments to doctors based on results and not
volume. Romney, on the other hand, would limit the amount of money future
retirees can get from the government medical insurance, allowing the private
market to find efficient solutions.
U.S. Revokes Drug
Licenses for 2 Fla. CVS Pharmacies
Two Central Florida CVS
pharmacies have lost their licenses to dispense controlled substances after the
U.S. Drug Enforcement Administration accused them of ignoring the state's
prescription drug abuse epidemic by dispensing excessive amounts of oxycodone, USA TODAY's Donna Leinwand Leger
Focus to Compliance as ICD-10 Deadline Set
that organized medicine has secured a one-year delay in the deadline for moving
to the ICD-10 diagnostic coding system, physicians and hospitals turn their
attention to the work of transitioning from ICD-9. The American Medical
Association and other physician organizations said the delay did not go far
enough to alleviate concerns about the substantial costs and other burdens
associated with the upgrade.
On Aug. 24, the Centers for
Medicare & Medicaid Services issued a final rule that effectively changed
the date for complying with the new ICD-10 medical data code sets to Oct. 1,
Deception: How to Handle a Malingering Patient
Ronald Schouten, MD, knew
immediately that something was strange about the patient who lurched oddly into
his exam room and collapsed into a chair. The man, who complained of a head
injury, appeared to understand Dr. Schouten's words, but the patient's voice was
garbled and his mannerisms were overdramatic.
"His speech deficit didn't
make any sense," said Dr. Schouten, an associate professor of psychiatry at
Harvard Medical School and director of the Law & Psychiatry Service at
Massachusetts General Hospital. "His hands were shaking violently, and he asked
for water. Miraculously, he didn't spill a drop."
Anatomy of an
Epidemic: The Opioid Movie
Driving home from a hunting
trip in 2008, Johnny Sullivan called his wife to say he was having trouble
It was early afternoon, but
Mary Lou Sullivan wasn't surprised. Her husband was a long-time user of the
narcotic painkiller OxyContin (oxycodone) and frequently dozed off as a side
effect,sometimes in the middle of chewing his food.
About 10 years earlier,
Sullivan and six other chronic pain sufferers had been featured in a Purdue
Pharma promotional video for the drug, which Purdue makes. In the video,
Sullivan stood at a construction site and talked about how the powerful narcotic
eased his back pain and enabled him to run his company again.
Copyright © 2008
American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394