" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

September 11, 2013 


  1. Spotlight Case: The Pains of Chronic Opioid Usage
  2. FDA Tightens Opioid Labeling
  3. IBM to Move Retirees Off Health Plan
  4. Time Warner Joins IBM in Health Shift for Retirees
  5. Retirees Become the Guinea Pigs Health-Insurance Exchanges
  6. No Standard Pay for Doc Services
  7. CMS Asks For Physician Feedback On Release of Reimbursement Data
  8. Conflicts of Interest Often Under-reported in Clinical Trials
  9. Opinion: Stopping ObamaCare Fraud
  10. Pharma firms rethink marketing strategies under the Sunshine Act
  11. Hundreds of thousands of US teens smoke pot each day




spotlightSpotlight Case: The Pains of Chronic Opioid Usage


Dr. Laxmaiah Manchikanti and R. Joshua A. Hirsch were fetured on the Agency for Healthcare Research and Quality website hosted by the US Department of Health and Human Services.


The invited commentary fulfilled the following objectives:

  • Describe the appropriate initial assessment of patients with chronic non-cancer pain.
  • List the most common errors made in prescribing opioids for non-cancer pain.
  • Outline appropriate monitoring for patients prescribed opioids for non-cancer pain.
  • Appreciate the need to risk stratify patients on opioids for non-cancer pain. 

Read the spotlight case .




fdaFDA Tightens Opioid Labeling


  The FDA has ordered a class-wide label change for long-acting opioids such as OxyContin (oxycodone) aimed at limiting use of these drugs to patients with severe, refractory pain.


The move, announced at press briefing Tuesday, is part of a handful of changes that the agency hopes will curb an ongoing prescription painkiller epidemic, including a label clarification about the risks of abuse and death with the drugs, a requirement for additional postmarketing studies, and a boxed warning about the risks of neonatal opioid withdrawal syndrome.


"Opioids are important pain relieving medications that provide significant benefits when used appropriately," Douglas Throckmorton, MD, deputy director of the FDA's Center for Drug Evaluation and Research (CDER), said during a press briefing. "But they have significant risks associated with inappropriate patient selection and improper use, whether accidental or intentional."



MedPage Today


ibmIBM to Move Retirees Off Health Plan


International Business Machines Corp. IBM -0.61% plans to move about 110,000 retirees off its company-sponsored health plan and instead give them a payment to buy coverage on a health-insurance exchange, in a sign that even big, well-capitalized employers aren't likely to keep providing the once-common benefits as medical costs continue to rise.


The move, which will affect all IBM retirees once they become eligible for Medicare, will relieve the technology company of the responsibility of managing retirement health-care benefits. IBM said the growing cost of care makes its current plan unsustainable without big premium increases.


IBM's shift is an indication that health-insurance marketplaces, similar to the public exchanges proposed under President Barack Obama's health-care overhaul, will play a bigger role as companies move coverage down the path taken by many pensions, paying employees and retirees a fixed sum to manage their own care.



Wall Street Journal



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timeTime Warner Joins IBM in Health Shift for Retirees


Insurance exchanges are the health-care experiment du jour. Retirees are the test case.


The latest indication: Media-company Time Warner Inc. TWC +0.16% plans to move its U.S. retirees from company-administered health plans to private exchanges, according to a person familiar with the matter. The company will allocate funds in special accounts that retirees can use to go shop for coverage, the person said.



Wall Street Journal



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guineaRetirees Become the Guinea Pigs Health-Insurance Exchanges


Insurance exchanges are the health-care experiment du jour. Retirees are the test case.


President Barack Obama's health-care overhaul calls for such exchanges, which will go live next month, and employers are looking at similar, privately administered exchanges as an alternative to offering their own health plans.


Yet while these efforts are just ramping up-and creating anxiety in the process-hundreds of thousands of retirees already are using exchanges to pick Medicare plans.



Wall Street Journal



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payNo Standard Pay for Doc Services


Private insurers pay some doctors almost twice as much for routine office visits as other doctors, a retrospective analysis published Monday in Health Affairs showed.


An assessment of 21 office-based services showed that for 18 services, the allowable payable amount for the highest-paid doctors was more than twice what it was for the lowest-paid doctors, according to Laurence Baker, PhD, of Stanford University, and colleagues.


"We found substantial variation in payments for common physician services both across and within [metropolitan statistical areas], with very little variation explained by patient or physician characteristics," the authors wrote.


MedPage Today

cmsCMS Asks For Physician Feedback On Release of Reimbursement Data


 CMS is inviting physicians to respond to their proposal to make physician payment data accessible to the public to try to balance price transparency with privacy interests


In May 2013, a federal district court ruling struck down a rule that prohibited CMS from publicly releasing reimbursement data for physicians. Following that ruling, CMS released a proposal to make individual physician payment data accessible to the public. According to a story on cancernetwork.com, CMS is now inviting physicians to share their input on the proposal. Physicians are able to share their input, via email, until September 5, 2013.


As the situation stands now, outside parties have to file a Freedom of Information Act in order to request access to the physician payment database. CMS, however, is trying to figure out how to make the data more accessible to the public. The cancernetwork.com article says that the American Medical Association never supported lifting the rule that prohibits the release of the data. According the AMA, doing so violated rights physicians hold under the Privacy Act.



Healthcare Technology Online

conflictConflicts of Interest Often Under-reported in Clinical Trials


CHICAGO -- At least half of clinical trial study authors fail to report relevant conflicts of interest, according to an analysis of papers presented here Monday at the Peer Review Congress.


Kristine Rasmussen, of the Nordic Cochrane Centre in Copenhagen, and colleagues took advantage of the fact that Danish physicians are required to apply for permission for paid collaboration with industry, and then publicly disclose all of their conflicts, to look at 100 consecutive drug trials with at least one Danish author.


About half -- 48% -- of researchers with conflicts related to the trial sponsor or manufacturer failed to disclose some or all of them. That number rose to 88% when the authors looked at conflicts related to competing manufacturers, and 89% for any drugmaker at all.



MedPage Today

fraudOpinion: Stopping ObamaCare Fraud


Every politician claims to hate fraud in government, and the House of Representatives will have a chance to prove it Wednesday when it votes to close a gigantic hole for potential abuse in the Affordable Care Act.


The Health and Human Services Department announced in July that it won't verify individual eligibility for the tens of billions in insurance subsidies the law will dole out. Americans are supposed to receive those subsidies based on income and only if their employer doesn't provide federally approved health benefits. But until 2015 the rule will be: Come on in, the subsidy is fine.


HHS will let applicants "self attest" that they are legally eligible. No further questions asked. The new ObamaCare exchanges will also be taking applicants' word on their projected household income. It seems that what it calls "operational barriers" continue to prevent HHS from checking applications against IRS income data.



Wall Street Journal


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pharmaPharma firms rethink marketing strategies under the Sunshine Act


With penalties to pharma companies for violating the Physician Payments Sunshine Act potentially ranging into the millions of dollars, adhering to the act is a priority. But when it comes to marketing materials, achieving compliance is not simple, resulting in tentative strategies.


Healthcare and pharmaceutical marketing agency Traffik Health created a tip sheet for its pharmaceutical clients, said Shane Kimsey, director of accounts. The California-based company recommended its clients create a central reporting database to ensure a uniform reporting structure that allows for appropriate monitoring; the establishment of quarterly audits; and providing training to staff so they understand the rules of the act - a simple thing to do that is crucial for marketing to be compliant yet effective.



Healthcare Finance News


potHundreds of thousands of US teens smoke pot each day


Despite recent gains against substance abuse by American teens, hundreds of thousands of them use marijuana and alcohol on a given day, U.S. health officials reported Thursday.


On a typical day, an estimated 881,684 kids aged 12 to 17 smoke cigarettes, 646,707 use marijuana and 457,672 drink alcohol, according to a report by the U.S. Substance Abuse and Mental Health Services Administration, or SAMHSA.


The number of teens smoking pot on a given day could almost fill the 250,000-seat Indianapolis Speedway two and a half times, the report pointed out.







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