" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

September 5, 2012


  1. CRNA Comment Period Comes to Close: Still Time to Write Congress
  2. Unsupervised Anesthesia Care by a Nurse Anesthetist is a Threat to Patient Safety
  3. Three Courses: ASIPP to Host November Board Review, Coding and Controlled Substance Courses in Denver
  4. Please Take Part in ASIPP Use of Antithrombotics in IPM Survey
  5. Doctors Say Methadone Too Risky for Pain Management
  6. Few Doctors Know How to Treat Addiction. New Program Aims to Change That.
  7. Drug Shortage Dilemma: Trying New Tactics in a Tough Arena
  8. Physicians Resist States Interference in Practice of Medicine
  9. What Physicians Should Know Before Selling Their Practice to a Hospital
  10. California Bill AP 369 on Governor's Desk
  11. Finalized ICD-10 Deadline Sparks Relief Across Industry
  12. ASIPP Members: Send in Your Published Article Information
  13. 12 Things Still Wrong with Health Reform
  14. State Society News
  15. Physicians Wanted

crnaCRNA Comment Period Comes to Close: Still Time to Write Congress


The comment period for the proposed rule establishing national policy for CRNA pain management services ended yesterday. We hope that you did your part. Based on the number of letters that were sent through CAPWIZ (1,404) most members did not.


Frankly, the lack of action 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 the Congress.


Unlike physicians, CRNAs are not complacent about the monumental rule. It appears that the CRNAs in your state and across the country have done a really great job of promoting their ability to perform interventional pain management. We are asking that you please your representatives' offices, today if possible. If you know your Congress member personally, please contact them directly to explain this dire situation


I am providing you with acopy 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 Letter


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 load.


Please act immediately - before it is too late!


threatUnsupervised Anesthesia Care by a Nurse Anesthetist is a Threat to Patient Safety


No matter how quickly you tried to switch the television channel lately, you probably couldn't escape the trial of Dr. Conrad Murray or avoid hearing about propofol, an anesthesia drug that can be fatally easy to use.

What you may not have heard is that the American people just dodged a serious threat to their anesthesia care, and most don't know how near a miss it was.


The Centers for Medicare and Medicaid Services (CMS) recently issued new rules concerning the conditions of participation in Medicare and Medicaid for hospitals and health care providers. Despite intense pressure, CMS sensibly left in place the rule that requires nurse anesthetists to be supervised by physicians. We should all be thankful, and stay on guard in case anyone tries to change that rule again.


MedPage Today


denverThree Courses: ASIPP to Host November Board Review, Coding and Controlled Substance Courses in Denver




During the 2½-day Comprehensive Review Course and Cadaver Workshop, you

can improve existing skills and/or learn new techniques. Whether you have been

practicing interventional pain management for many years or are new to the field with

basic skills, we are confident you will find this course and workshop to be beneficial

- as it is essential that we continue learning and exploring new procedures and

techniques in our specialty.



 Brochure: http://www.asipp.org/documents/1112-cadaver_001.pdf


To Register:https://secure.jotformpro.com/form/12961252254





 This intensive review course is designed to present interventional pain management

specialists and other health care providers an in-depth review of multiple areas of

interventional pain management-the areas we were never taught, yet are crucial

for our survival. The course features many nationally recognized experts in pain

management billing and coding and practice management as well as controlled

substance management. In today's environment of regulations and litigations, you

can't afford not to broaden your knowledge and refresh your skills in these areas.

In addition to the review course, the American Board of Interventional Pain Physicians

(for physicians) and the American Association of Allied Pain Management Professionals

(for non-physicians) offers the opportunity for examination in order for physicians to

obtain competency certification to and non-physicians to obtain associate certificates

in Controlled Substance Management and Coding, Compliance, and Practice





Register for coding: https://secure.jotformpro.com/form/12962502202


Register for CSM: https://secure.jotformpro.com/form/12971356214


The Comprehensive Review Course will be held concurrently at the same venue as

the 7th Annual Comprehensive Board Review Course . Please note that you can only

register for the Board Review Course or the Controlled Substance Management and

Coding, Compliance and Practice Management Review

Course (not both).

All Three course will be held at Renaissance Denver Hotel, 3801 Quebec Street, Denver, CO 80207 | Tel. 303-399-7500

Cadaver Workshop Location:

Science Care, 19301 East 23rd Avenue Aurora, CO

* Special room rates until October 3, 2012


surveyPlease 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.

 Click the link below to take survey:


methDoctors Say Methadone Too Risky for Pain Management


Methadone is increasingly being used by physicians to manage pain and treat heroin addiction, but it is a risky drug to prescribe, according to an article published in the Journal of the American Medical Association (JAMA).


The article cites a recent study by the Centers for Disease Control and Prevention (CDC), which found that methadone was involved in over 30 percent of overdose deaths linked to painkillers, even though the drug makes up only about 2% of painkiller prescriptions. Over 5,000 methadone overdose deaths occur annually - more than the combined overdose deaths caused by cocaine or heroin.


Part of methadone's appeal is its low cost. Many states and insurance companies list methadone as the preferred opioid medication in their formularies. Methadone-related deaths surged in Washington after the state began encouraging patients in its health care system to use the drug, according to an investigation by the Seattle Times.



American News Report


twelve12 Things Still Wrong with Health Reform


The U.S. Supreme Court may have upheld most of the Patient Protection and Affordable Care Act ACA), but that won't fix its many flaws. Here are 12 problems that still riddle the 2,700-page law known as ObamaCare, says Merrill Matthews, a resident scholar with the Institute for Policy Innovation.

  •   Imposes a bevy of new taxes.
  •    Expands a nation of takers.
  •   Creates a maze of cross subsidies.
  •   Hands control to unelected bureaucrats.
  •   Empowers the IRS.
  •   Imposes perverse economic incentives.
  •   Explodes health care spending.
  •   Enhances rationing under the Independent Payment Advisory Board.
  •   Allows fewer health insurance options.
  •   Creates more inefficiency.
  •   Includes pork and calls it prevention.
  •   Cooks the Medicare books.



fewFew Doctors Know How to Treat Addiction. New Program Aims to Change That.


They are seen every day in doctors' offices, outpatient clinics and hospital emergency rooms: men in their 50s with bleeding ulcers; young adults pulled from car crashes; middle-aged women fighting a losing battle against chronic pain.


As dissimilar as they seem, many of these patients are also suffering from another illness - alcohol or drug abuse - that is at the root of the more obvious ailments that keep them cycling through the medical system. Even so, their addiction is rarely addressed by doctors.



Washington Post

shortageDrug Shortage Dilemma: Trying New Tactics in a Tough Arena


Fresh strategies for grappling with the chronic, and at times critical, shortages of cancer drugs that have frustrated the oncology community for the past decade are likely to help alleviate supply problems, oncology and pharmaceutical leaders say. Yet they predict that forging significant and lasting improvements will be difficult due to the complexity of the issues underlying the shortages.


Bolstered by new legislation that takes effect in October, the FDA will gain resources to evaluate generic drug candidates and more clout to monitor supplies. The American Society of Clinical Oncology (ASCO) and the American Society of Hematology (ASH) have endorsed the changes.


Nevertheless, the Food and Drug Administration Safety and Innovation Act was enacted amid much disagreement among government officials, oncology leaders, pharmaceutical executives, and political figures about the causes for shortages.




resistPhysicians Resist States' Interference in Practice of Medicine


An organization representing internists has drafted principles designed to protect the physician-patient relationship when lawmakers draft measures regulating health care.


Some states have adopted statutes interfering with the care provided by doctors, the American College of Physicians said in its "Statement of Principles on the Role of Governments in Regulating the Patient-Physician Relationship." Some laws and regulations require doctors to offer care that is not supported by evidence-based guidelines.



AMA news


sellWhat Physicians Should Know Before Selling Their Practice to a Hospital


For a long time, third-party reimbursement allowed most private practice physicians to go it alone and earn a decent living from insurance carriers and government-sponsored health programs; regrettably, that is no longer the case.


In today's ever-changing world of healthcare reform, bundled payments, and Accountable Care Organizations, many private practitioners have come to the stark realization that private practice may soon be a thing of the past. Most are convinced that the best way to stay ahead of the pack is to sell out to a hospital, health network, or other alternative healthcare system.



Physicians News Digest


californiaCalifornia Bill AP 369 on Governor's Desk


Pain Step Therapy/Fail First bill that prohibits a health plan from requiring a patient to try and fail on more than two medications, before allowing the patient to have the medicine prescribed by their provider. AB 369 also allows the provider to determine the duration of a treatment, not the health plan. Evidently the health plans are vehemently opposing this bill still and trying to get Governor Brown to veto it.


AB 369 will not result in costs to health plans or the state:

· According to the CHBRP report on AB 369, most health plans currently require one to two trials for step therapy. AB 369 will only impact the few outlier plans that require more.

· The bill specifies plans do not have to pay for medicine which is not included in their formulary.

· Plans can still manage their costs by charging patients a copay or coinsurance on medicines not covered by their formulary.

· There is no cost to the state for Medi-Cal patients in managed care. The state pays the managed care plans a set capitated amount to cover all services.


AB 369 will not result in an increase in the misuse of addictive pain medicines:

· The protections in current law that regulate how physicians prescribe opioids are not changed by the bill. Plans use step therapy as a way to control costs, not to combat opioid abuse.

AB 369 does not include any mandates, so it does not impact how federal health reform will be implemented in California:

· The bill does not require plans to cover any pain medicine.


Send support letters sent to Governor Brown and Lark Park urging them to sign AB 369, telling them what it means to get proper care as a pain patient, you can send all letters to the following address:

Governor Jerry Brown

State Capitol, Suite 1173

Sacramento, CA 95814

Fax: (916) 558-3160

Please copy all letters to Lark Park in the Governor's Office and to Assemblyman Jared Huffman:


finalizedFinalized ICD-10 Deadline Sparks Relief Across Industry


HHS finalized October 1, 2014 as the deadline for ICD-10 compliance on Friday. In so doing, the agency sparked widespread relief across the industry.


"We had a number of clients hesitate after the initial announcement of a delay by CMS," said Michael Arrigo, managing partner of consultancy No World Borders healthcare practice. "Now that the final rule has been published it removes uncertainty from the market place about ICD-10."


Arrigo is not alone in finding that keeping the C-suite engaged in such a massive and expensive project - one that nonetheless had an unsolidified deadline - has been quite challenging. In early August, Healthcare Finance News reported the same, in Smart CFOs keep focus on ICD-10.



Healthcare Finance News


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 recenlty published works listed.  Please email in notification of any published article that was not published in Pain Physician journal and that was published in the current year and we will ist in the weekly enews.


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





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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