Health Policy


Letters to Insurers












Healthcare Update Articles

PPJ Articles:

Survival Strategies for Tsunami of ICD-10-CM for Interventionalists: Pursue or Perish!

Interventional Pain Management at Crossroads: The Perfect Storm Brewing for a New Decade of Challenges

The Influence of Prescription Monitoring Programs on Chronic Pain Management Controlled Substances

ASIPP Docs:


Healthcare Policy Review

Metamorphosis of Medicine in the United States: Is Information Technology a White Knight or Killer Whale? 
Pain Physician November/December 2014: 17: E663-E670.

Metamorphosis of Medicine in the United States: A Carrot and Stick Policy of Electronic Medical Records
Pain Physician November/December 2014; 17:E671-E680

Ethical Perspectives on Urine Drug Screening for Pain Physicans
Alan D. Kaye, MD, PhD, Zwade J. Marshall, MD, Steven M. Lampert, MD, Andrea M. Trescot, MD, Amit Prabhakar, MD, Amir O. Elhassan, MD, and Richard D. Urman, MD
http://www.painphysicianjournal.com/2014/september/2014;17;E559-E564.pdf

Reversal of Epidural Cuts in 2015 Physician Payment Schedule: Two Steps Forward One Step Back
Laxmaiah Manchikanti, MD, Ramsin M. Benyamin, MD, Hans Hansen, MD, John Swicegood, MD, and Joshua A. Hirsch, MD
http://www.painphysicianjournal.com/2014/september/2014;17;E565-E573.pdf

Epidural Steroid Injections Safety Recommendations by Multi-Society Pain Workgroup (MPW): More Regulations Without Evidence and Clarification
Laxmaiah Manchikanti, MD, Frank J.E. Falco, MD, Ramsin M. Benyamin, MD, Christopher G. Gharibo, MD, Kenneth D. Candido, MD, and Joshua A. Hirsch, MD
http://www.painphysicianjournal.com/2014/september/2014;17;E575-E588.pdf

Patient Perception of Pain Care in the United States: A 5-Year Comparative Analysis of Hospital Consumer Assessment of Health Care Providers and Systems
Anita Gupta, DO, PharmD, Lisa K. Lee, MD, Jeffrey J. Mojica, BS, Ali Nairizi, MD, and Shelley J. George, MD
http://www.painphysicianjournal.com/2014/september/2014;17;369-377.pdf

Prevalence of Low Back Pain in Latin America: A Systematic Literature Review
Joao B.S. Garcia, PhD, John J.Hernandez-Castro, PhD, Rocio G. Nunez, MD, Maria A.R. Pazos, MD, Jorge O. Aguirre, PhD, Asisa Jreige, MD, Willian Delgado, MD, Manuel Serpentegui, MD, Maria Berenguel, MD, and Alberto F. Cantisani, MD
http://www.painphysicianjournal.com/2014/september/2014;17;379-391.pdf

Policies and Events Affecting Prescription Opioid Use for Non-Cancer Pain Among an Insured Patient Population (May/June 2014)
Brian K. Ahmedani, PhD, Edward L. Peterson, PhD, Karen E. Wells, MPH, David E. Lanfear, MD, MS, and L. Keoki Williams, MD, MPH
Pain Physician Journal 2014;17;205-216.

Economic Impact of Converting an Interventional Pain Medicine Physician Office-Based Practice into a Provider-Based Ambulatory Pain Practice (May/June 2014)
Jay S Grider DO, PhD, MBA, Kelley A. Findley, BS, Courtney Higdon, MBA, Jonathan Curtright, MBA, and Don P. Clark, PhD
Pain Physician Journal 2014;17;E253-E261.

 Assessment of the Trends in Medical Use and Misuse of Opioid Analgesics from 2004 to 2011 (March 2014)
Sairam Atluri, MD, Gururau Sudarshan, MD, and Laxmaiah Manchikanti, MD
Pain Physician Journal 2014;17;E119-E128.

Percutaneous Adhesiolysis Procedures in the Medicare Population: Analysis of Utilization and Growth Patterns from 2000 to 2011 (March 2014)
Laxmaiah Manchikanti, MD, Standiford Helm II, MD, Vidyasagar Pampati, MSc, and Gabor B. Racz, MD
Pain Physician Journal 2014;17;E129-E139.

 Declining Value of Work of Interventional Pain Physicians (January 2014)
Laxmaiah Manchikanti, MD, Hans Hansen, MD, Ramsin M. Benyamin, MD, Frank J.E. Falco, MD, Alan D Kaye, MD, PhD, and Joshua A. Hirsch, MD.
Pain Physician Journal 2014;17;E11-E19

 The Tragedy Of The Sustained Growth Rate Formula Continues Into 2014: Is There Hope or Repeal? (January 2014)
Laxmaiah Manchikanti, MD, Frank J.E. Falco, MD, Hans Hansen, MD, and Joshua A. Hirsch, MD.
Pain Physician Journal 2014;17;E21-E26

 Opioids In Chronic Noncancer Pain: Have We Reached A Boiling Point Yet? (January 2014)
Laxmaiah Manchikanti, MD, Sairam Atluri, MD, Hans Hansen, MD, Ramsin M. Benyamin, MD, Frank J.E. Falco, MD, Standiford Helm II, MD, Alan D Kaye, MD, PhD, and Joshua A. Hirsch, MD.
Pain Physician Journal 2014;17;E1-E10

 Utilization and Growth Patterns of Sacroiliac Joint Injections from 2000 to 2011 in the Medicare Population

 Assessment of the Escalating Growth of Facet Joint Interventions in the Medicare Population in the United States from 2000 to 2011

 Assessment of the Growth of Epidural Injections in the Medicare Population from 2000 to 2011

 Cost Utility Analysis of Caudal Epidural Injections in the Treatment of Lumbar Disc Herniation, Axial or Discogenic Low Back Pain, Central Spinal Stenosis, and Post Lumbar Surgery Syndrome

 Assessment of Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant Therapy in Interventional Pain Management

 Utilization of Interventional Techniques in Managing Chronic Pain in the Medicare Population: Analysis of Growth Patterns from 2000 to 2011

 Assessment of Infection Control Practices for Interventional Techniques: A Best Evidence Synthesis of Safe Injection Practices and Use of Single-Dose Medication Vials

 Proposed Physician Payment Schedule for 2013: Guarded Prognosis for Interventional Pain Management

 Obamacare 2012: Prognosis Unclear for Interventional Pain Management

 CMS Proposal for Interventional Pain Management by Nurse Anesthetists: Evidence by Proclamation with Poor Prognosis

 The Impact of Comparative Effectiveness Research on Interventional Pain Management: Evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient-Centered Outcomes Research Institute

 Medicare Physician Payment Systems: Impact of 2011 Schedule on Interventional Pain Management

 Patient Protection and Affordable Care Act of 2010: Reforming the Health Care Reform for the New Decade

 A Critical Review of the American Pain Society Clinical Practice Guidelines for Interventional Techniques: Part I Diagnostic Interventions

 Independent Medical Examinations: Facts and Fallacies

 Analysis of Growth of Interventional Techniques in Managing Chronic Pain in the Medicare Population: A 10-Year Evaluation from 1997 to 2006

 Obama Health Care for All Americans: Practical Implications

 Review of Occupational Medicine Practice Guidelines for Interventional Pain Management and Potential Implications

 Reassessment of Evidence Synthesis of Occupational Medicine Practice Guidelines for Interventional Pain Management

 Health Care Reform in the United States: Radical Surgery Needed Now More Than Ever

Evidence-Based Medicine Series

Evidence-Based Medicine, Systematic Reviews, and Guidelines In Interventional Pain Management: Part 7: Systematic Reviews and Meta-Analyses of Diagnostic Accuracy Studies

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 6. Systematic Reviews and Meta-analysis of Observational Studies

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 5. Diagnostic Accuracy Studies

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 4: Observational Studies

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 3: Systematic Reviews and Meta-Analyses of Randomized Trials

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 2: Randomized Controlled Trials

Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management, Part I: Introduction and General Considerations

Office of the Inspector General (OIG) posts report, "Medicare Payments for Facet Joint Injection Services"

A Critical Appraisal of 2007 American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines for Interventional Pain Management: An Independent Review Utilizing AGREE, AMA, IOM, and Other Criteria

Review of Occupational Medicine Practice Guidelines for Interventional Pain Management and Potential Implications

Therapeutic Opioids: A Ten-Year Perspective on the Complexities and Complications of the Escalating Use, Abuse, and Nonmedical Use of Opioids

Opioids in the Management of Chronic Non-Cancer Pain: An Update of American Society of the Interventional Pain Physicians’ (ASIPP) Guidelines

Physician Refer Thyself: Is Stark II, Phase III the Final Voyage?

Interventional Techniques in Ambulatory Surgical Centers: A Look at the New Payment System

 Physician Payment 2008 for Interventionalists: Current State of Health Care Policy

 Interventional Techniques in Ambulatory Surgery Centers: A Look at the New Payment System

 National Drug Control Policy and Prescription Drug Abuse: Facts and Fallacies

2007 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplemetary Medical Insurance Trust Funds

2006 National Survey on Drug Use & Health – September 6, 2007 Results

Issues in Health Care: Interventional Pain Management at the Crossroads - Pain Physician, 2007

Prescription drug abuse: What is being done to address this new drug epidemic? Testimony before the Subcommittee on Criminal Justice, Drug Policy and Human Resources - Pain Physician, 2006

  Health Spending Projections Through 2016: Modest Changes Obscure Part D’s Impact, Feb, 2007

  Medicare in Interventional Pain Management: A Critical Analysis - Pain Physician, 2006

  Do financial incentives in a globally budgeted healthcare payment system produce changes in the way patients are categorized? A five-year study. Am J Manage Care. 2007 Sep;13(9):513-22

  Moving research into practice: lessons from the US Agency for Healthcare Research and Quality's IDSRN program. Implement Sci. 2007 Mar 29;2:9

Health Policy Regulations

The Disastrous but Preventable Consequences of ICD-10 (March 2014)
Laxmaiah Manchikanti, MD, Frank J.E. Falco, MD, Alan D Kaye, MD, PhD, and Joshua A. Hirsch, MD
Pain Physician Journal 2014;17;E111-E118

Accountable Interventional Pain Management: A Collaboration Among Practitioners, Patients, Payers, and Government (November 2013)
Laxmaiah Manchikanti, MD, Standiford Helm II, MD, Vijay Singh, MD, and Joshua A. Hirsch, MD.
Pain Physician Journal 2013;16;E635-E670

Physician Response to Medtronic’s Position on the Use of Off-label Medications in the Synchromed Pump (September 2013)
Ali Rezai, MD, David S. Kloth, MD, Hans Hansen, MD, David M. Schultz, MD, Simon Thompson, MBBS, and Timothy R. Deer, MD.
Pain Physician Journal 2013;16;415-417

Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2009

Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009

2008 Medicare Physician Fee Schedule Payment Rates Effective for Dates of Service July 1, 2008 through December 31, 2008 

Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates

Physician Self-Referral and Hospital Ownership Disclosure Provisions in the IPPS FY 2009 Final Rule 
Final Rule - Physicians referrals to health care entities with which they have financial relationships (Phase III) – September 5, 2007

GAO-06-704 Medicare Physician Services: Use of Services Increasing Nationwide and Relatively Few Beneficiaries Report Major Access Problems

GAO-07-86 - Medicare: Payment for Ambulatory Surgical Centers Should Be Based on the Hospital Outpatient Payment System

DEA Practitioner’s Manual

Texas Workers' Compensation Regulations

How to Appeal Medicare Denial
Download a pdf step-by-step guide through the appeals process

Useful Links

Federal Register and Notices

Limit on Number of Buprenorphine Patients Per Physician

CMS Rulings

CMD Rulemaking - Electronic Comment Submission

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Pain Physician Journal

Centers for Medicare & Medicaid Services (CMS)

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CMS 855I - (to change your specialty designation code)

CMS Manual System

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