July 3, 2013
Hospitals to Pay U.S. More Than $34 Million to Resolve False Claims Act
Allegations Related to Kyphoplasty
located throughout twenty-one states have agreed to pay the United States a
total of more than $34 million to settle allegations that the health care
facilities submitted false claims to Medicare for kyphoplasty procedures, the
Justice Department announced today. Kyphoplasty is a minimally-invasive
procedure used to treat certain spinal fractures that often are due to
In many cases, kyphoplasty
can be performed safely and effectively as an outpatient procedure without any
need for a more costly hospital admission. The settlements announced today
resolve allegations that the settling hospitals frequently billed Medicare for
kyphoplasty procedures on a more costly inpatient basis, rather than an
outpatient basis, in order to increase their Medicare billings.
US Dept. of
Room Block Ends
Sunday: Register Today for Board Review Course
Make plans today to attend the2013 Board Review Course set
for July 29-Aug. 2 at the Chase Park Plaza in St. Louis, MO. The next board
review course will not be held until 2015.
This intensive and
comprehensive high-quality review will 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
* Extensive educational
* Extensive evaluation
sessions with daily pre-test, post-test, and review
You can earn up to 44.25 AMA PRA
Category 1 credits.
Click HERE to
Click HERE for Chase Park Plaza.
Special ASIPP room rate through July 7, 2013.
Click HERE to view
ASIPP Offers Pain
and Addiction Management Review Course: Register NOW!
The brochure for the Pain and
Addiction Management Comprehensive Review Course is now available.
Register today to attend the Pain
and Addiction Management review course set for July 29-30 in St. Louis, MO.
This innovative course embraces
the issues of pain and addiction. It is a "must attend" training event for not
only interventional pain physicians, but also all other medical specialites. The
course will cover controlled substance abuse as well as addiction.
Click HERE to view the
Here is the link for Registration:
ASIPP Special Room Rates
through July 7
Costs Set for a Jolt
Healthy consumers could see
insurance rates double or even triple when they look for individual coverage
under the federal health law later this year, while the premiums paid by sicker
people are set to become more affordable, according to a Wall Street Journal
analysis of coverage to be sold on the law's new exchanges.
The exchanges, the
centerpiece of President Barack Obama's health-care law, look likely to offer
few if any of the cut-rate policies that healthy people can now buy, according
to the Journal's analysis. At the same time, the top prices look to be within
reach for many people who previously faced sky-high premiums because of chronic
illnesses or who couldn't buy insurance at all.
|Congress Eyes Part
B Drug Program Changes
Congress is looking at several changes to Medicare's Part B drug program, and
its efforts could result in legislation tied to reforming the program's
sustainable growth rate (SGR) physician reimbursement formula.
The House Energy and
Commerce Health Subcommittee held a hearing late last week
on three bills that address various issues in the Part B drug
program. While Part D covers prescription drugs, Part B pays for drugs -- such
as oncology drugs -- that are administered in physician offices or outpatient
Specifically, the three
- H.R. 1416, which would eliminate the sequestration's effect on
physician-administered drugs under Part B
- H.R. 1428, which would provide coverage for immunosuppressive drugs
for kidney transplant recipients
- H.R. 800, which would exclude prompt-pay discounts from manufacturers
to wholesalers from the calculation of a drug's average sale
Cut Employers' Health Cost
As companies seek ways to
curb health-care spending, insurer WellPoint Inc. WLP +0.17% is rolling out a program that lets
employers pay only a set amount for a medical service, asking workers who select
costlier care to pay the difference.
The idea has been tested
for years by a limited number of large employers. But the new option from the
second-biggest U.S. insurer, which will be available for coverage that kicks off
next January, will be offered broadly to any client with at least 100
Under the approach, workers
are supposed to be given choices among hospitals, doctors or other providers to
be used for a procedure-such as an imaging scan or even a surgery-each with
pricing and quality information. If they pick one that costs more than the
employer offers, they pay the difference. If workers opt for a provider that
costs less than the employer's price, an employer could choose to offer them a
credit, WellPoint said.
Generated by Cardiologists Continues to Drop
Average annual hospital
revenue generated by invasive cardiologists dropped 3.2% from 2010 to 2013,
while the revenue generated by noninvasive cardiologists dropped 6.6%, according
to a survey by physician job placement firm
"In the last several years,
some services provided by cardiologists have been considered reimbursement
'outliers' by Medicare and have been targeted for significant" cuts, the survey
authors noted, adding that "revenues generated by invasive cardiologists for
hospitals can be expected to decline in coming years."
Physicians in ACOs Say They've Not Benefited Financially
A new survey suggests
that what many doctors have feared all along about accountable care organizations may be true -
that ACOs won't create any financial benefit for physicians.
More than two-thirds
(67%) of physicians who participated in an ACO last year reported no personal
financial benefit, such as a bonus or shared savings agreement, as a result of
their participation, according to a survey of about 3,500 physicians from
staffing firm Jackson
Doctors Will Have
To Take A Pay Cut Under Obamacare
For Obamacare to succeed,
American doctors need to earn less money.
Last week, Washington took
a step in that direction. One of Medicare's influential advisory boards
recommended that payment rates to providers be sanded down.
At present issue are the
rates paid to doctors working as part of hospital-owned clinics versus
physicians working in their own, independent offices.
Right now, when a doctor
works as part of hospital owned practice, and bills Medicare, she's paid more
money than what she'd receive for providing the same services in her own
independent medical office. That's because of an arbitrage between Medicare's
inpatient (Part A) and outpatient (Part B) billing schemes.
Test Driving the
All the outreach in the
world won't count for much if the Obamacare ticket counter doesn't work. Behind
the campaign to educate the uninsured about the Affordable Care Act (ACA) is the
assumption that software to sell the plans will be ready and
user-friendly by Oct. 1, when enrollment is supposed to start. That assumption is not universally shared. Some wonder
if systems will be tested and finished on time. Others worry the programs will
lead consumers to make dumb insurance choices.
Kaiser Health News got an
early look at Obamacare software that will be deployed in Minnesota, Maryland,
and the District of Columbia. Connecture is developing the
Web interface for consumers under 65 who don't have employer-based
health coverage to shop and sign up for a plan in those states. Connecture isn't
handling the software that qualifies you to buy under the health act or verifies
your eligibility for subsidies. Other companies are doing those. Connecture's
piece is the point-of-sale program, the one that steers you through insurance
choices and closes the deal.
Faults Medicare for Not Tracking 'Extreme' Prescribers
More than 700 doctors
nationwide wrote prescriptions for elderly and disabled patients in highly
questionable and potentially harmful ways, according to a
critical report of Medicare's drug program released today.
The review by the inspector
general of the U.S. Department of Health and Human Services flags those doctors
as "very extreme" in their prescribing - and says that Medicare should do more
to investigate or stop them.
Patient Responsibility Leads to Greater Hassle
- Administrative hassles are taking too much time and money away from physician
practices and the burden is likely to grow as employers ask workers to pay for
more of their health care.
That's the message in
the most recent edition of the American Medical Association's National Health Insurer Report
Card, released at the organization's annual House of Delegates
Why More Kids are Facing Chronic Pain
Chronic pain in children
and teenagers is a dramatically growing problem, with hospital admissions for
youngsters with the condition rising ninefold between 2004 and 2010, a new study
The most common type of chronic pain among kids in the study was abdominal
pain, which was reported in 23 percent of cases, according to the
Other conditions included
reflex sympathetic dystrophy syndrome, a condition that brings nerve pain
affecting the limbs, which affected 9.2 percent of children in the study, and
chronic pain syndrome, a condition that involves being in pain for longer than
six months (6.4 percent). Children also reported headaches
and migraines , limb pain and back pain.
Copyright © 2008
American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394