October 27, 2010
Opinion: ObamaCare's Incentive to Drop Insurance |
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One of the principles of game theory is that you should view the game through your opponent's eyes, not just your own.
This past spring, the Patient Protection and Affordable Care Act (President Obama's health reform) created a system of extensive federal subsidies for the purchase of health insurance through new organizations called "exchanges." The details of these subsidies were painstakingly worked out by members of my own political party to reflect their values: They decided who was to benefit from the subsidies and what was to be purchased with them. They paid a lot of attention to their own strategies, but what I believe they failed to consider properly were the possible strategies of others.
Our federal deficit is already at unsustainable levels, and most Americans understand that we can ill afford another entitlement program that adds substantially to it. But our recent health reform has created a situation where there are strong economic incentives for employers to drop health coverage altogether. The consequence will be to drive many more people than projected-and with them, much greater cost-into the reform's federally subsidized system. This will happen because the subsidies that become available to people purchasing insurance through exchanges are extraordinarily attractive.
By Phillip Bredesen, a Democrat, the governor of Tennessee and the author of "Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System," just out by Atlantic Monthly Press.
To order the book: http://www.amazon.com/Fresh-Medicine-Reform-Sustainable-Health/dp/0802119387
The Wall Street Journal |
In Medicare's Data Trove, Clues to Curing Cost Crisis |
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Somewhere in the New York City area there is a family-practice doctor who, government records suggest, pocketed more than $2 million in 2008 from Medicare, the federal insurance program for the elderly.
That made her one of the best-paid family-medicine physicians in the Medicare system. But more noteworthy than the sum is her pattern of billing, which strongly suggests abuse or even outright fraud, according to experts who have examined her records.
The Wall Street Journal |
Alabama Board of Medical Licensure Proposes IPM Scope of Practice Regs |
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Good news for IPM! ASIPP learned this week that the Alabama Board of Medical Examiners (ABME) has issued a proposed rule to regulate the practice of interventional pain management.
There is still time to send a comment letter in support of the approval of this important rule. The deadline to comment on this rule is November 4 (please note the attached rule gives an earlier date for comments but it has been extended to Nov. 4). Comments in support of this proposed rule would be helpful in assuring this rule is approved and added to the Alabama regulations.
Comments may be made via email or USPS mail: Patricia E. Shaner, Esq. Office of General Counsel Alabama State Board of Medical Examiners P.O. Box 946 848 Washington Avenue (36104 Montgomery, AL 36101-0946 tshaner@albme.org
Obviously time is limited - please show your support by sending your comment of support today.
Proposed Rule |
Key Tax Breaks at Risk as Panel Looks at Cuts |
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Sacrosanct tax breaks, including deductions on mortgage interest, remain on the table just weeks before the deficit commission issues recommendations on policies to pare back with the aim of balancing the budget by 2015.
The tax benefits are hugely popular with the public but they have drawn the panel's focus, in part because the White House has said these and other breaks cost the government about $1 trillion a year. At stake, in addition to the mortgage-interest deductions, are child tax credits and the ability of employees to pay their portion of their health-insurance tab with pretax dollars. Commission officials are expected to look at preserving these breaks but at a lower level, according to people familiar with the matter.
The Wall Street Journal |
Physician Panel Prescribes the Fees Paid by Medicare |
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Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars.
The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement. Yet the influence of the secretive panel, known as the Relative Value Scale Update Committee, is enormous.
The Wall Street Journal |
Opioid Safety is Focus of $1 Million-A-Year Educational Initiative |
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A group that represents patients living with pain has launched an initiative aimed at educating physicians and patients on how to prescribe and use opioids and other pain treatments safely.
The $1 million-a-year project is called Pain Safety & Access for Everyone, or PainSAFE. It comes in response to a striking rise in deaths and overdoses related to opioid abuse and controversy over how the drugs are marketed.
Fatal opioid overdoses tripled to nearly 14,000 deaths from 1999 to 2006, according to Centers for Disease Control and Prevention data reported in September 2009. In June, the CDC estimated that 305,885 emergency department visits in 2008 were related to opioids, more than double the 2004 estimate of 144,644.
AMA |
Medical Malpractice Claims Frequency Declining, Report Says |
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SCHAUMBURG, IL - A new report reveals that healthcare organizations are seeing slightly fewer medical malpractice claims - and those they are seeing aren't any more expensive than in past years.
According to the fifth annual benchmarking report on malpractice claims trends released by Zurich, a Schaumburg, Ill.-based insurer of hospitals and healthcare organizations, claims severity - or the average amount per claim - has stabilized over the past several years. The average annual increase over the past 11 years is 4 percent.
Zurich collected data from 1,600 hospitals in report years 1997 through 2007.
"It's interesting to note that severity does continue to rise among claims valued under $1 million, which are the claims considered more typical within an institution's loss experience," said Leo Carroll, head of healthcare-specialty products at Zurich North America Commercial. "While the most severe claims (those valued above $1 million and $5 million) have stabilized overall, the frequency of those large losses has increased slightly."
On Saturday evening, November 20th, we offer the opportunity for you to sit for the American Board of Interventional Pain Physicians' Competency Examination. By successfully completing the coding, compliance and practice management competency examination, you are demonstrating to your colleagues, patients, insurers, payors, etc. that you understand the complexities of this aspect of our unique specialty. This examination will not be offered again until August 5, 2011.
Healthcare Finance News |
Only a Few Spots Remain in Nov. Comprehensive Review and Cadaver Workshop |
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Register today to secure one of the few remaining oepn spots in the Comprehensive Review Course and Cadaver Workshop in Interventional Pain Management on November 19-21 in Memphis, Tenn.
This course offers basic, intermediate, and comprehensive interventional pain management examintion levels to assure a focused learning experience.
With our excellent participant/instructor ratio, you will have the opportunity for personal interaction with our highly distinguished faculty of renowned teachers and lecturers, creating a thorough and compelling educational experience.
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. Click HERE to register.
The course will take place at the Memphis Peabody on Friday and at the Medical Education and Research Institute (MERI) on Saturday and Sunday.
Secure your place by registering today! |
CCPM Review Course Won't Be Offered Again Until Aug. 2011 |
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Register today to attend the Billing, Coding and Practice Management Review Course on November 19-20 in Memphis, TN. This will be the last time this year this course will be offered and it will only be offered one time next year (August 3-4 in St. Louis).
The course is designed to meet the unique billing, coding and practice management needs of interventional pain physicians, health care professionals, and their staff. experience.
The Comprehensive Review Course in Coding, Compliance and Practice Management is not only an essential element in Interventional Pain Management, but also beneficial to you as a physician and to your practice. Coding, Compliance and Practice Management is an area which is critical to our field yet one in which few have adequate training. In today's environment of ever-changing regulations and litigations, we cannot afford to ignore this important and complex subject.
Click HERE to register.
Register Online |
CVS to Pay Largest Ever Civil Penalty Under Controlled Substances Act |
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In an agreement finalized October 13, CVS Pharmacy, Inc., the biggest operator of retail pharmacies in the United States, has admitted that it unlawfully sold pseudoephedrine to criminals who made methamphetamine. As part of the agreement with federal prosecutors, CVS has agreed to pay $75 million in civil penalties and to forfeit the $2.6 million in profits the company earned as a result of the illegal conduct.
CVS Pharmacy, a subsidiary of CVS Caremark Corporation, failed to ensure compliance with laws limiting sales of pseudoephedrine, which allowed criminals to obtain a key ingredient used in the manufacture of methamphetamine from CVS stores located primarily in Los Angeles County; Orange County, California; and Clark County, Nevada. Between September 2007 and November 2008, CVS supplied large amounts of pseudoephedrine to methamphetamine traffickers in Southern California, and the company's illegal sales led directly to an increase in methamphetamine production in California. CVS eventually changed its sales practices to prevent these illegal sales, but it did so only after it became aware of the government's investigation.
DEA |
Insurers, Employers Talk Quality While Targeting Physician Pay |
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Health insurers and employers are pushing what they call "physician payment reform" in an effort to keep costs down and quality up.
Simply put, "physician payment reform" is a catch phrase that refers to paying physicians based on quality measures and episodes of care, rather than a fee-for-service system. It's not a new idea. But physician payment reform -- intended to be a step up from terms such as "pay-for-performance" -- is gaining traction as more authorities in the health industry declare that no improvements in quality or costs will come without fundamentally changing how doctors are reimbursed.
AMA |
Reduce Practice Disruptions Caused by Cell Phone Use |
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Cell phones have become both the bane and boon of modern life. Experts say medical practices need policies to make it less likely that a patient taking a call during an office visit will throw a physician's schedule off track, or that text messages and Facebook postings will distract employees.
"It's an issue of respect," said Jennifer Souders, administrator of Hilltop Family Physicians in Parker, Colo. "Patients should give undivided attention to physicians or staff. Staff should be giving undivided attention to patients."
amednews.com |
Maryland Society of Interventional Pain Physicians to Hold Meeting |
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The Maryland Society of Interventional Pain Physicians will meet at 6:30 p.m., Nov. 1 at the Greystone Grill in Columbia, MD.
This an informative and entertaining evening gathering will serve as a Maryland Society of Interventional Pain Physicians chapter meeting and an opportunity to socialize with new members.
The event sponsor, Forest Laboratories, will provide a brief presentation on pain medicine, followed by dinner.
To RSVP, please respond to Dr. Francisco Ward at poem@verizon.net
Click here for more information about the Greystone Grill. Click here for directions. |
Physicians Wanted |
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Visit the ASIPP Web site to find available positions for IPM physicians.
Physicians Wanted |
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Copyright © 2008
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
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