RELATED LINKS

NASPER

Carrier Advisory Committee

The 'unsustainable' Sustainable Growth Rate formula

Medical malpractice reform

ASC and HOPD Medicare reimbursement

Capwiz

ASC Alert Information

United States House of Representatives

United States Senate

At ASIPP's 2005 Annual Meeting in Washington, Representative Frank Pallone, Jr. (D-NJ) and Representative Ed Whitfield (R-KY), present ASIPP CEO Laxmaiah Manchikanti, MD (far right) with the pen used by President Bush to sign the NASPER law.

 NASPER Electronic Prescription Reporting Bill Moves Forward

Hailed as Key Way to Save Lives and Millions of Dollars in ‘Doctor Shopped’ Prescriptions

The American Society of Interventional Pain Physicians (ASIPP) announced this month that National All Schedules Prescription Electronic Reporting (NASPER) has received preliminary funding to begin implementation. The Omnibus Appropriations Bill (H.R. 1105) includes $2 million in appropriated funds for NASPER in 2009.

The National All Schedules Prescription Electronic Reporting, or NASPER, was a bill proposed by ASIPP, with the support of ASA, AMA and other organizations, to protect patients and physicians from the deleterious effects of controlled substance misuse, abuse and trafficking while maintaining patient access with quality care. The ultimate goal of NASPER is to have a coordinated prescription monitoring program in all 50 states, which could save hundreds of millions of dollars in prescriptions in the Medicaid and Medicare programs and also save countless numbers of lives.

NASPER was signed into law on August 11, 2005 by President George W. Bush, and was authorized a total of $52 million to be appropriated over a five year period. Since 2005, ASIPP has worked to gain the authorized and necessary appropriations to begin implementation. Currently, there are 38 states that individually fund their own prescription monitoring programs based on requirements originally set by NASPER. With NASPER’s new appropriated support, states can now save money by funding these programs with the federal grant as well as create a universal monitoring program.

“The initial $2 million is an encouraging start that will allow individual states to put NASPER into motion; however, in order to realize NASPER’s full potential, it is imperative to secure full funding,” said Dr. Laxmaiah Manchikanti, ASIPP CEO and Chairman of the Board. “ASIPP will work tirelessly to see that funding not only continues in 2010, but that it is funded for the full authorized amount of $10 million for that fiscal year.”

 Court Upholds Injunction In CRNA Scope of Practice

We are pleased to announce that the Louisiana Supreme Court has denied the writs filed by the Louisiana State Board of Nursing (LSBN), Louisiana Association of Nurse Anesthetists (LANA) and the American Association of Nurse Anesthetists (AANA). This means that the permanent injunction issued by the 1st Circuit Court of Appeal is now final.

In December 2008, the LSBN with the support of the LANA/AANA appealed the December 23, 2008 favorable ruling for the Spine Diagnostics Center of Baton Rouge by the Louisiana Court of Appeals. The case has been in the courts since 2005.

J. Michael Burdine on behalf of the Spine Diagnostics Center of Baton Rouge first brought the case to the courts in an effort to halt the the practice of interventional pain techniques by non-physicians, specifically in this case by CRNAs.

Over the years many organizations and individuals have supported the case through testimony, filing of Amicus Briefs, financial support , and time. Thanks to all who have worked tirelessly to see this case to the end.

The American Society of Interventional Pain Physicians is pleased to have had the opportunity to work with the many dedicated individuals in the fight to preserve interventional pain management and most importantly, to uphold patient safety

 Medicare 10.1% Cut averted

The final Medicare Extenders package passed the Senate and House and has been sent to the President for him to sign.

The bill summary indicates a .05% increase rather than the proposed 10. 1% cut. Thank you to all the ASIPP members for the many letters sent and contacts made to reach Congress.

Extender Package Summary

ASIPP has created a new Capwiz letter campaign to assist you contacting Congress. We have created a link for physicians as well as a link for staff, family, friends and patients. Please take the time to not only send a letter today. Additionally, we urge you to have your patients sign the letter and support this effort as well.

1. Customize and print off copies of the sample letter
2. Identify patients' state
3. As your patients sign out, ask them to fill out and sign the bottom of their state appropriate letter
4. Using the patient Capwiz link assign a staff member to submit the patients' letters

5. Also you can print off the Patient Information Page and post it in your office to provide Web site information.

The Key to a successful lobbying campaign is awareness, information, and action.

Send ASC Comment Letter

If you are interventional pain physician who owns or works in an ASC, it is very important that you send a comment letter to CMS addressing the many disparities which exist between ASC setting and HOPD setting. These disparities coupled with the new proposal by CMS are of great concern to SIPMS.

The cut-off for comment letters is Jan. 28, 2008 but please customize and send your letter(s) as soon as possible. If you send you letter via USPS you must send one original and two copies (3 total should be mailed). You may also send your comment letter electronically by clicking on the following link: Submit comment letter. We ask that you also get your staff involved as they may also send comment letters.

The docket number and titel is: CMS-1392-FC - Medicare and Medicaid Programs: Changes to the Hpsoital Outpatient Prospective Payment System and CY 2008 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2008Payment; Changes to Hospital Conditions of Participation; Changes Affecting Necessary Provider Designations of Critical Access Hospitals Rates

To assist you in sending your letter electronically, we have provided step-by-step instructions.

• Click on the link to access the sample letter
• Save the file to your computer
• Edit the letter as you desire adding your name and address to the letter
• Click on the following  CMS link to submit
• Click on the "Submit Comment" button
• Fill out the personal information screen and click "Continue"
• Scroll down to the bottom of the screen and type "attachment" in the text box
• Click on "Continue"
• Click on "browse," choose the Word file containing the saved comment letter
• Choose the appropriate file type and click and click on "Save Comments"

Sample Letters

It is also helpful to send your letter on your personal letterhead. If you choose to send letters via USPS or fax, the following links to sample Word files will be helpful. Please feel free to edit the letters to make them unique from your view point.  To find the names, addresses, phone and fax numbers of your elected officials click here

Sample Physician Letter

Sample Patient Letter

Sample Staff Letter

Sample Citizen Letter

 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.

NEWS AND UPDATES

RACs Free to Make the Call on Medical Necessity Rules
Though you may consider the RACs to be like bounty hunters, the RACs are certainly NOT pirates - CMS will be holding them to the same rules that apply to current reimbursement administrators, carriers, Fiscal Intermediaries (FIs) and Medicare Administrative Contractors (MACs). Healthcare Finance News, May 4, 2009)

Medicare Advantage Comes Under More Scrutiny
Private health insurance plans serving Medicare beneficiaries will be paid $11.4 billion more in 2009 than the traditional Medicare fee-for-service program, a new Commonwealth Fund study finds (Manos,, Healthcare Finance News, May 6, 2009). The study comes as stakeholders debate the value of Medicare Advantage, a program that offers an HMO- type coverage for Medicare beneficiaries. President Barack Obama's 2010 fiscal year budget proposes to pay for health reform by slashing reimbursement to health plans participating in Medicare Advantage.

Stimulus Package Alters

HIPAA Rules
The American Recovery and Reinvestment Act, better known as the stimulus bill, is notable for the $19 billion it offers for incentives to adopt and use health information technology. But it also expands the reach of the Health Insurance Portability and Accountability Act (Harris, American Medical News, May 4, 2009). Specifically, the stimulus bill expands the reach of privacy and security rules implemented under HIPAA to cover business associates and covered entities.

Sen Baucus Seeks Overhaul Of Medicare Payments To Doctors
Senate Finance Chairman Max Baucus, D-Mont., said Monday he's eyeing changes to the Medicare payment system for physicians that would in future years avoid short-term fixes to prop up the payments (The Wall Street Journal, May 4, 2009).. Baucus, speaking in a conference call with reporters, said he expected the current payment system to stay in place for three years under his proposal to overhaul the U.S. health system. After that, Baucus said, Congress should allow payments under the system to drop, with the payments to be replaced by a new compensation system.

ASIPP ADVOCACY EFFORTS

ASIPP-PAC

Through the American Society of Interventional Pain Physicians-PAC, the organization is able to offer significant presence and influence in Washington. ASIPP members who wish to contribute may contact ASIPP Meeting Coordinator Paula Reynolds at paula@thepainmd.com or phone 270.554.8373, ext. 149.

CARRIER ADVISORY COMMITTEE

After a four-year effort, ASIPP was successful in March 2005 in getting the Centers for Medicare and Medicaid Services to mandate the inclusion of an interventional pain management physician on each state’s Carrier Advisory Committee. See full details, including the representatives in many states and sample letters for those states still needing to nominate representatives.