January 22, 2014
Comment Period of
Draconian Cuts is Ending: Only a Few More Days- Act Now or Never
The fight to reverse the
draconian cuts continues.
While we are making
progress, we must continue to act. We have until Monday, January 27th to comment
and be heard. Because of this, there is no longer time for mailing the letters.
They should now only be sent electronically through the ASIPP Capwiz
links.Many of the offices are saying that they have not heard from doctors
in their district. It is extremely important that they hear from you. All
politics are local, all lobbying is local.
It is an understatement to
say that the cuts are draconian and it will be devastating. Unless we act upon
the issue this may be the end of interventional pain management practice for
almost 40% of the physicians who base majority of their practices out of office
setting, reduce access to patient care, and increase Medicare expenses by $187
If we think it is
devastating that they are paying a doctor for doing a cervical epidural $42
without the SGR cut (which includes a 0.5% increase), consider what the
reimbursement will after March 31. With an SGR cut, if HHS has its way, it will
drop to $30. Imagine all the new Affordable Care and Medicaid contracts, with
some paying only 80% of $30, that will be $24 for doing a cervical epidural
injection in post laminectomy syndrome.
ASIPP has set up Capwiz
letters for physicians and patients. You should customize and describe your own
situation in physician letters. Make sure each and every physician writes a
letter and all of your patients sign a letter.
How to Implement a
Letter-Writing Campaign in Your Office
As of today, January 22,
2014, there have been 10,442 letters sent to CMS and 52,749 total letters to
multiple members of the Congress through the ASIPP Capwiz website.
We now have 11
letters of support from members of Congress:
Senators John Boozman, Mark Pryor, Rand Paul, Richard Blumenthal, Christopher
Murphy, Mary Landrieu,
and Minority Leader Mitch McConnell.
Representatives Ed Whitfield, Pete Olson, Renee Ellmers, and Brett
We expect several others
this week including a Doctor Caucus letter and an additional group letter lead
by Rep. Ed Whitfield.
Save IPM Fund
Like many people suffering
from chronic and debilitating pain, 28-year-old Cassie Winters has tried it all:
physical therapy, powerful pain killers, massage, energy healing and meditation.
She was even told that finding a new hobby or thinking happy thoughts would get
her mind off the pain.
"Nothing worked," she
But Winters refused to give
up. Though traditional therapies failed, she found a interventional pain
specialist, a doctor who can diagnose and treat acute and chronic pain using
targeted injections and minimally invasive therapies, often in conjunction with
other modalities. Today she says she's finding some relief with a spinal cord
stimulator, an implanted device that sends electrical signals to the brain to
help mask the pain.
CMS to Release
Physician Payment Data
The Centers for Medicare
and Medicaid Services announced Tuesday that it will start to evaluate requests
for individual physician payment information on a case-by-case
The driving force to replace the previous policy was
the more than 130 comments from over 300 organizations and individuals.
"Numerous of these comments identified ample benefits to releasing Medicare
physician payment data," Jonathan Blum, principal deputy administrator of CMS,
wrote in a blog post about the announcement.
Way for Doctors to Identify Substance Abuse?
Study supports asking a
simple question, rather than giving lengthy questionnaire
A single question may help
doctors determine whether a patient has a drug or alcohol problem and the level
of abuse, a new study suggests.
Keep it simple is the
message from the study of nearly 300 people recruited from the Boston Medical
Center primary care clinic.
"We found that single
questions may be useful in both screening and preliminary assessment" of
substance-use severity, lead author Dr. Richard Saitz, chair and professor of
community health sciences at Boston University School of Public Health, said in
a university news release.
Is Marijuana More
Dangerous than Alcohol?
Physicians and drug policy
groups are sharply at odds over President Obama's statement to a magazine that
marijuana is no more dangerous than alcohol "in terms of its impact on the
Obama's interview with The
New Yorker magazine will appear Jan. 27. In it he said that while he considers
marijuana "a bad habit and a vice," a waste of time and not very healthy, he
doesn't think it's more dangerous than alcohol.
The issue is in the news as
two states, Colorado and Washington, begin experiments with the legal sale of
recreational marijuana this year. Both passed laws legalizing its recreational
use on Nov. 6, 2012.
No ASC Pay Increase for 2015; 3.25-5.25% Increase for HOPDs
On Friday, the
Medicare Payment Advisory Commission approved a final recommendation for
Medicare pay rates in 2015, recommending that ambulatory surgery centers get 0
percent pay raise, according to an AHA News report.
At the same time, MedPAC
recommended increasing hospital inpatient and outpatient prospective payment
systems by 3.25 percent in the absence of sequestration cuts and 5.25 percent if
spending cuts continue. The sequestration that begun last April enacted
automatic 2 percent Medicare payment cuts for the next 10 years.
MedPAC did suggest reducing or eliminating pay differences between hospital
outpatient departments and physician offices for some procedures, as currently
hospital outpatient departments are paid significantly more.
to Spine Surgeons: Fluoroscopic Transforaminal vs. Caudal Lumbosacral
A report in the February edition of the Journal
of Spinal Disorders and Techniques evaluates radiation exposure during
fluoroscopy-guided transforaminal and caudal approaches of lumbosacral epidural
The study included 228
patients who received lumbosacral ESI; 181 patients received transforaminal ESI
and 47 received caudal ESI. Fluoroscopy time was 11 to 161 seconds for
transforaminal ESI and four to 78 second for caudal ESI.
The researchers found that
kerma-area product and fluoroscopy time were positively correlated for both
transforaminal and caudal ESI, and after correction for fluoroscopy time KAP was
less in transforaminal ESI than caudal ESI.
Will Physicians Be
Dropped From Managed Care Networks?
Insurers are dropping
thousands of physicians from their managed care networks in response to growing
pressures from the Affordable Care Act (ACA), leaving many doctors to wonder
what plans they will still participate in for 2014 and beyond. But that's not
all. If the insurer lets you stay, reimbursement rates may be cut so much that
you will wonder whether being dropped was the better outcome.
confirmed recently that it sent discontinuation letters to thousands of
physicians in 10 states that cited "significant changes and pressures in the
healthcare environment" as the cause. The company issued a statement saying that
it expected its Medicare Advantage network, which covers about 27% of people on
Medicare, to remain at about 85% of its 2013 size through the rest of 2014. The
insurer currently has more than 350,000 providers in the Advantage network. (See
the sidebar on p. 3 for UnitedHealth's explanation of why the cuts were
Why Aren't Doctors
Whenever I feel like taking
a trip back in time, I save myself the trouble of building a time machine and
instead just head over to a doctor's office. For a Millennial, or really anyone
who lives a modern lifestyle, getting medical care is a rare departure from an
otherwise technology-fueled existence.
First comes making the
appointment, which usually requires a phone call. My gynecologist's office, for
example, doesn't use online booking, so scheduling a visit means calling them
from my "open plan" office and describing what, if any, "the issue is." Layered
on top of this indignity, my last name is basically impossible to spell or
pronounce. "Yes, once again that's K-H-A-Z-as-in-zebra-A-N."
Filling out forms in
triplicate in the waiting room is, for me, relatively painless. By now, I've
perfected my ability write my address, insurance ID number, and the words
"allergies to most plants and animals" in about 15 seconds or less.
Copyright © 2008
American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394