" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

December 31, 2013


Happy New Year! As the New Year rings in, we would like to forget all our problems replacing them with tons of hope, peace, and success in every sphere. Whether we can do this or not, let us remember that while there has been a lot of bad news this past year, there have also been many things to celebrate. Today, we would like to share with you this year-end update covering the major changes in IPM during the past year.  
10 Years after Intense Lobbying by ASIPP, NASPER Receives its Final Recognition

As we all know, we waged an intense lobbying effort along with many of the other issues to create a National All Schedules Prescription Electronic Reporting (NASPER) program based on Kentucky All Schedule Prescription Electronic Reporting (KASPER). This passed the House of Representatives on 2 occasions, however, because of the intense opposition from some legislators and some organizations, lackluster support from some organizations, and an entitlement philosophy of many we had to compromise into a state prescription monitoring program. Interestingly enough, this week American College of Physicians has published their policy position paper indicating the need for a national prescription monitoring program. Until then they suggest that NASPER can be utilized.


It is ironic that the American College of Physicians is finally supporting such an endeavor for which ASIPP was originally criticized. With so much opposition and disingenuous support by various factions, today we have prescription monitoring programs in 49 states (with the Missouri program pending legislation), giving us the ability to connect with other states in many programs, as well as physician accessibility in all states.


This is progress for which we can celebrate, indeed making it a good New Year.

American College of Physicians Urges Stricter Controls to Address Prescription Drug Abuse Epidemic


Prescription drug abuse is a serious public health problem in the US. Now a major doctors' organization is urging its members to practice greater caution and restraint when prescribing such medications.


In a recent policy paper, The American College of Physicians (ACP), recommended both important procedural and clinical changes that will hopefully make it more difficult for those who abuse common prescription drugs-such as Percocet, Oxycontin or Vicodin or sell them on the street-to continue this dangerous and unethical practice.



Opioid abuse a priority for CDC in 2014


Abuse of prescription opioids and antibiotic resistance are two of the five biggest health care challenges facing the United States in the coming year, according to the Centers for Disease Control and Prevention.


The other three areas the CDC announced that it will be concentrating on 2014 are increasing the rates of HPV vaccination, eradicating polio, and improving global health.



Internal Medicine News

Threats Continue, Time to Action and Participate in the Campaign to Save IPM with Grassroots and Financial Contributions 


Another issue we hoped to would be resolved by the year end is the draconian 2014 reimbursement cuts. However, we can share the good news that we have a 3-month reprieve, giving us additional time to keep up the letter writing and advocacy efforts. Through ASIPP's intense advocacy efforts and your help, we will continue to work to reverse the cuts.


Through this major grassroots effort, we have obtained the support thus far from 5 senators and 3 members of the Congress and are expecting many others to give support within the next week. We have received letters of support from Arkansas Senators John Boozman, Mark Pryor; Connecticut Senators Richard Blumenthal, Christopher Murphy; and Kentucky Senator Rand Paul. In the House we have received letters from Kentucky Representatives Ed Whitfield, and Brett Guthrie, and Texas Representative Pete Olson.


We are also holding multiple meetings with key committees in the Congress and have learned that they are talking to CMS about this issue. These draconian cuts based on flawed methodology and flawed analysis. They must go - hopefully New Year will ring in this good news.



Cigna Issue Continues to Loom with Some Progress 


In 2012 Cigna issued policies severely limiting interventional pain management for only one year in a majority of the cases with many onerous restrictions. Recently we sent a letter outlining the issues and the solutions with evidence-based advocacy with an impressive 684 signatures. Read letter to Cigna 


We have received strong support from Congress. In fact, Senator Blumenthal from Connecticut on live TV called on them for an open discussion. In addition, several members of the Congress have sent the inquiries asking them for details and why this policy should not be reversed. ASIPP continues to work for a resolution to this issue through meetings with members of Congress and Cigna.


Cervical Epidural and Facet Joint Interventions 


We are in the preliminary stages of negotiations with Cigna on this issue. Once again we would like to resolve this issue as soon as possible into the New Year as we did this year with in preventing the denial of coverage for cervical epidural injections and facet joint interventions in Tennessee (Letter to BCBS) (Letter to TennCare).

ASIPP Publishes Evidence-Based Guidelines of Interventional Techniques in Management of Chronic Spinal Pain Now Listed on AHRQ Website 



This past year both the opioid and interventional pain management guidelines are now posted on the Agency for Healthcare Research and Quality (AHRQ) National Guidelines Clearinghouse.


American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: part 2 - guidance. 2006 (revised 2012 Jul). NGC:009284
American Society of Interventional Pain Physicians - Medical Specialty Society.


See guidelines 


An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. 2003 (revised 2013 Apr). NGC:009842
American Society of Interventional Pain Physicians - Medical Specialty Society



Evidence-Based Advocacy Continues with LCDs


As you know, early this year ASIPP was invited to participate on a Multi-Specialty Pain Workgroup. led by Noridian Healthcare Solutions to revise several interventional pain managment LCDs. After finding that the process was not the best and unable to find a resolution, ASIPP withdrew from the MPW committee. Since then, in conjunction with the state societies, ASIPP has submitted multiple comment letters, revisions, and also held high level meetings with Contractor Medical Director, Bernice Hecker of Noridian.


Once again we would hope that the issue will be resolved soon in the New Year.

President Obama Signs the Pathway for SGR Reform Act of 2013


On December 26, 2013, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on January 1, 2014. The new law provides for a 0.5 percent update for such services through March 31, 2014. President Obama remains committed to a permanent solution to eliminating the Sustainable Growth Rate (SGR) reductions that result from the existing statutory methodology. The Administration will continue to work with Congress to achieve this goal.


The new law extends several provisions of the Middle Class Tax Relief and Job Creation Act of 2012 (Job Creation Act) as well as provisions of the Affordable Care Act. Specifically, the following Medicare fee-for-service policies have been extended. We also have included Medicare billing and claims processing information associated with the new legislation. Please note that these provisions do not reflect all of the Medicare provisions in the new law, and more information about other provisions will be forthcoming.



Update on Obamacare 


The arrival of Jan. 1 will be a big event for President Barack Obama's health care law - the day when Americans across the country can use their new health insurance for the first time. It could be a day of badly needed success stories, if people have a smooth time and sing the praises of their new private health insurance or Medicaid coverage. Read more...


A very nervous New Year's for Obamacare


White House looks to spread good Obamacare news 

Thank you and  Happy New Year!



Lax and Hans



Laxmaiah Manchikanti, MD

Chairman of the Board and Chief Executive Officer, ASIPP and SIPMS

Medical Director, Pain Management Center of Paducah

Clinical Professor, Anesthesiology and Perioperative Medicine

University of Louisville, Kentucky

2831 Lone Oak Road

Paducah, KY 42003

270-554-8373 ext. 101




Hans Hansen, MD

President, ASIPP

Medical Director

The Pain Relief Centers, LLC

1224 Commerce Street

Conover, NC 28613

(828) 261-0467










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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