Advocacy

Promoting changes in laws, regulations, and other government actions to advance the mission of ASIPP®.

In its relatively short history, ASIPP has accumulated an impressive list of major achievements from its work in our nation's capital and 50 states. These achievements have fostered patient access to pain-relieving techniques and services, while strengthening the specialty of interventional pain management.

ASIPP had a successful legislative trip in Washington D.C. Sept. 12-13, 2017. At no other time in the history of the American Society of Interventional Pain Physicians has it been more important to get involved in advocacy efforts. We are finally seeing the potential for change. After struggling with a deep regulatory tsunami for several years, there is a light at the end of the tunnel for IPM.

To reach our goals ASIPP has made it's presence known in Washington this week with approximately 70 ASIPP delegates representing 25 states.

 

The following are the 4 major issues discussed in the congressional visits:

  • Drastic cuts to ASC reimbursement
  • Medicare Advantage or Disadvantage Non-coverage Policies
  • Continued physician payment cuts for various interventional pain management procedures
  • Making MIPS more friendly with the elimination of meaningless use and any penalties

ASIPP had speeches and meetings with members of Congress. Scheduled speakers were Representative John Shimkus (R-IL), Vanila Singh, MD and Chief Medical Officer, HHS, Representative Cathy McMorris-Rodgers (R-WA), Senator Bill Cassidy, MD (R-LA), and Representative Larry Buschon, MD (R-IN). ASIPP members very surprised and excited to welcome Surgeon General Jerome Adams! There was also a successful fundraiser for Chairman Kevin Brady, Ways and Means Committee (taxes, health care, Social Security, Medicare, international trade and welfare). He is a Republican U.S. Representative for the Texas 8th district. He has been a champion in helping put forth multiple issues related to interventional pain management.


ASIPP Recently Met With Legislators on Topics Important to Interventional Pain Physicians

A Delegation of ASIPP representatives met with Congressional leaders to discuss issues which are of concern for Interventional Pain Physicians. ASIPP members discussed 'Inappropriate Reimbursement Patterns of Medicare Advantage Plans' and 'AHRQ Technology Assessment for Low Back Pain Therapies: Intellectual Bias and Conflicts'.


Final Voyage of FDA and MPW Epidural Saga: Victory for Practicing Interventional Pain Physicians

On October 5, 2015, the Center for Drug Evaluation and Research, the U.S. Food and Drug Administration (FDA), and the Department of Health and Human Services, notified the American Society of Interventional Pain Physicians (ASIPP) of the status of the citizen's petition concerning the rejection of the 17 recommendations developed by the Multisociety Pain Workgroup (MPW). See Letter 

The rejection was in response to the FDA citizen’s petition filed by ASIPP and the letter sent to the FDA from 1,040 practicing pain physicians to amend the April 23, 2014, Drug Safety Communication regarding epidural corticosteroid injections for pain urging the rejection of the 17 recommendations developed by MPW.

The letter signed by 1,040 interventional pain physicians was sent on June 26, 2014, and ASIPP filed a citizen petition on September 3, 2014. The FDA held hearings on November 24-25, 2014  on the safety of epidural steroid injections. On March 4, 2015, the FDA informed ASIPP that they were unable to reach a decision on our petition because it raised complex issues requiring extensive review and analysis by agency officials.

The FDA has now determined that they will not amend the drug safety communication; however, they will not adopt the 17 recommendations made by the MPW. This ruling by the FDA is a major victory for practicing interventional pain physicians that avoids micromanagement and the additional bureaucracy created by the MPW. The FDA also published an article in the New England Journal of Medicine which essentially alludes to the same facts as described, and in no uncertain terms, they emphasize the fact that they are not withdrawing the issued warning, but they also were not endorsing the standards from MPW, even though they facilitated the discussion.

It is sad that despite the FDA's and other agencies’ inability to identify what patients are receiving, ASA, ISIS, and other organizations on the CPT Committee blocked our CPT codes specifying the epidural approach, such as caudal or interlaminar, and the use of particulate steroids or nonparticulate steroids or other agents.

Sadly, ISIS has issued a practice advisory stating how they protected the performance of epidural steroid injections and they are standing by the 17 standards refused to be adopted by the FDA.

Consequently, the epidural saga continues even though this may be the final chapter.


Change Your Specialty Designation

Use the CMS Form to Change your Specialty Designation to 09 - Interventional Pain Management

We are faced with the need to increase our 09 Interventional Pain Management specialty designation. Currently CMS claims there are too few IPM physicians, which negatively affects our reimbursement. Interventional Pain Physicians can now change their specialty code designation to 09 utilizing the CMS form CMS855I - see page 8, section D.