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" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary
 

November 2, 2011

 

·  Published Trial Finds Caudal Epidural Injections to Be Effective

·  Lumbar Facet Blockade Service Specific Review Starts November 1, 2011

·  CMS Adopts Policy and Payment Changes for Outpatient Care in Hospitals and Ambulatory Surgical Centers

·  Still Time to Sign Up for November Comprehensive Review Course and Cadaver Workshop

·  CMS Announces Policy, Payment Rate Changes for the Physician Fee Schedule in 2012

·  A Statement from U.S Department of Health and Human Services Secretary Kathleen Sebelius

·  CMS Redesigns Medicare ACOs to be More Appealing to Physicians

·  New CMS Notification Rule Applies to All Patients, Regardless of Scheduling Date

·  Few Healthcare Providers Are Prepared for ICD-10 Despite Ticking Clock

·  RX Drug Deaths Triple in Decade

·  Supplemental New Drug Application Submitted to FDA for NUCYNTA® ER (Tapentadol) Extended-Release Tablets for Diabetic Peripheral Neuropathic Pain

·  Decline in Doctor Office Visits Could be Permanent

·  State Society News

·  Physicians Wanted


Published Trial Finds Caudal Epidural Injections to Be Effective


An article written by Laxmaiah Manchikanti, MD, Vijay Singh, MD, Kimberly A. Cash, RN, Vidyasager Pampati, MSc, Kim S. Damron, RN and Mark V. Boswell, MD, PhD is featured in this week's Spine.

The article, titled "A randomized, controlled, double-blind trial of fluoroscopic caudal epidural injections in the treatment of lumbar disc herniation and radiculitis" shows that there is significant improvement in both groups of patients with or without steroids at the one-year follow-up with potential superiority of steroids.

The article has also been selected as a focus article on "The Spine Blog," and will appear on the online blog on November 11.

Spine journal


Lumbar Facet Blockade Service Specific Review Starts November 1, 2011


CMS is required by the Social Security Act to ensure that payment is made only for those medical services that are reasonable and necessary. To meet this requirement, NAS Part B Medical Review (MR) analyzes national and local data in conjunction with the findings from the OIG and other CMS contractors such as CERT and RAC to identify atypical billing.

A service specific review will be initiated for Lumbar Facet Blockade and associated services for the states of AK, OR, and WA. NAS MR will review documentation submitted to support claims suspended during this review and post findings on the NAS website.

The service specific review will be initiated on November 1, 2011 for surgical claims with the following criteria:

  • * CPT codes: 64493-64495 and 64622-64623

Noridian


CMS Adopts Policy and Payment Changes for Outpatient Care in Hospitals and Ambulatory Surgical Centers


The Centers for Medicare & Medicaid Services (CMS) today issued a final rule with comment period (final rule) that will update payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning Jan. 1, 2012. In addition to establishing payment rates for calendar year (CY) 2012, the final rule expands the measures to be reported under the Hospital Outpatient Quality Reporting Program, creates a new quality reporting program for ASCs, and strengthens the Hospital Value-based Purchasing (Hospital VBP) program that will affect payments to hospitals for inpatient stays beginning Oct. 1 2012.

CMS projects that total payments to more than 4,000 hospitals - which includes general acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term acute care hospitals, children's hospitals, and cancer hospitals - paid under the Outpatient Prospective Payment System (OPPS) in CY 2012 will be approximately $41.1 billion. CMS also projects that payments to approximately 5,000 Medicare-participating ASCs paid under the ASC Payment System will be approximately $3.5 billion for CY 2012.

The final rule also provides:

  • * Provisions affecting payments to Hospital Outpatient Departments
  • * Provisions affecting payments to Ambulatory Surgical Centers
  • * Provisions affecting the Hospital Value-Based Purchasing program

The final rule with comment period for the OPPS and the ASC payment system can be downloaded from: http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1

CMS


Still Time to Sign Up for November Comprehensive Review Course and Cadaver Workshop


Register today to attend the Nov. 11-13 Comprehensive Review Course and Cadaver Workshop for Basic, Intermediate, and Comprehensive Interventional Pain Management Examination Preparation course review.

This 2½-day review course and workshop is designed for interventional pain physicians, for a review, skills improvement or to assist in preparation for Comprehensive Interventional Pain Management Examination qualifications.

ASIPP offers the most in-depth, comprehensive, and individualized programs available in interventional pain management, featuring maximum hands-on training with cadavers in a state-of-the-art facility and maximum ability to interact with other participants.

The meeting will be held at the Hilton Memphis and the MERI Center in Memphis, TN.

Click HERE to view brochure.

Register now!


CMS Announces Policy, Payment Rate Changes for the Physician Fee Schedule in 2012


The Centers for Medicare & Medicaid Services (CMS) today issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012. More than 1 million providers of vital health services to Medicare beneficiaries - including physicians, limited license practitioners such as podiatrists, and NPPs such as nurse practitioners and physical therapists - are paid under the MPFS. CMS projects that total payments under the MPFS in CY 2012 will be approximately $80 billion.

CMS is required to issue a final rule that reflects current law. Under current law, providers will face steep across-the-board reductions in payment rates, based on a formula- the Sustainable Growth Rate (SGR) - that was adopted in the Balanced Budget Act of 1997. Without a change in the law from Congress, Medicare payment rates to providers paid under the MPFS will be reduced by 27.4 percent for services in CY 2012-less than the 29.5 percent reduction that CMS had estimated in March of this year because Medicare cost growth has been lower than expected. This is the eleventh time the SGR formula has resulted in a payment cut, although the cuts have been averted through legislation in all but CY 2002. The Obama Administration is committed to fixing the SGR and ensuring these payment cuts do not take effect.

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CMS


A Statement from U.S Department of Health and Human Services Secretary Kathleen Sebelius


On the need to fix the Sustainable Growth Rate issue upon release of the final Medicare physician fee schedule rule

America's physicians are the backbone of our health care system. Physicians are there for us throughout our lives, helping us improve our health and fight off disease. Unfortunately, while Medicare remains strong, physicians are facing steep payment cuts as a result of a flawed 1997 law. Almost every year for more than a decade, doctors have faced this annual threat and the Congress has in turn acted to temporarily prevent these deep reductions from taking effect. We have not and will not let deep cuts to doctors' payments occur. The Obama Administration is 100 percent committed to fixing the flawed Medicare payment system and protecting Medicare beneficiaries' access to doctors.

Earlier this year, President Obama presented a deficit reduction plan in which he once again called for a permanent fix to the sustainable growth rate (SGR) provision so that our nation's physicians would no longer have to face the threat of draconian cuts year after year. Today we again call on the Congress to quickly and permanently pass the so-called 'doc fix' and we pledge to work with legislators on both sides of the aisle to address this issue once and for all. The pattern of threatened SGR cuts and last-minute Congressional rescues is in itself not a sustainable solution and must be remedied. Patients and physicians will both benefit when we take the action recommended by the President and permanently address this issue.

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HHS


CMS Redesigns Medicare ACOs to be More Appealing to Physicians


Washington -- The Obama administration's final rule on Medicare accountable care organizations removes several proposed conditions on participants in an effort to make the new shared savings payment model more enticing to physicians and other key players.

As many as 270 ACO networks are expected to participate in the Medicare pay

model that encourages physicians and hospitals to coordinate patient care in a way that improves quality and saves the program money. From 2012 through 2015, Medicare could save an estimated $1.8 billion and let groups share in $1.3 billion in bonuses for hitting savings targets, thus saving Medicare a net of about $500 million.

AMA news


New CMS Notification Rule Applies to All Patients, Regardless of Scheduling Date


CMS announced last week that it will repeal its requirement that surgery centers notify patients of certain information prior to surgery, according to an ASCA release.

Since the announcement, several ASCs have asked whether this applies to all patients or only those whose surgeries are scheduled the day they are performed. The rule indicates that starting on Dec. 23, ASCs will be allowed to provide patients with information concerning their rights, physician ownership and advance directive policies on the day of surgery without limitation.

The rule, therefore, applies to all patients, regardless of when the surgery was scheduled.

Becker's ASC Review


Few Healthcare Providers Are Prepared for ICD-10 Despite Ticking Clock


Less than ten percent of healthcare providers are over halfway there in terms of being fully prepared for ICD-10, according to the KLAS report, ICD-10: Preparing for October 2013. While providers know a lack of preparation could result in a halt to reimbursements and a revenue cycle disaster when ICD-10 comes, KLAS found that most organizations are still in the strategy/planning phase of their preparation.

This is significant given that providers further down the path of preparation told KLAS that ICD-10 readiness is a complex and costly initiative-one that will require significant time and resources. One patient accounting director said, "We know there is a lot of work to be done. In our opinion, meaningful use is a cakewalk compared to ICD-10."

This research found that many providers have not yet established an ICD-10 budget. That said, feedback from more progressive organizations indicate ICD-10 won't be cheap. Some large health systems are planning to spend tens of millions of dollars on their ICD-10 preparation, while some mid-size hospitals are planning to spend several million. Some of the internal steps these providers have taken are developing a steering committee;creating a comprehensive ICD-10 readiness strategy; developing training plans for coders, physicians, nurses and other staff; assessing compliance and technology needs; and formulating a detailed budget.

Mercom HIT Report


RX Drug Deaths Triple in Decade

 


Inappropriately used prescription pain medications kill 15,000 people in the United States each year, according to a new report released by the Centers for Disease Control and Prevention. "We're in the midst of an epidemic," says CDC Director Dr. Thomas Frieden. "Narcotics prescribed by physicians kill 40 people per day."

Deaths due to prescription painkiller overdoses now exceed the number of heroin and cocaine overdose deaths combined, says Frieden, who is joining Gil Kerlikowske, the director of National Drug Control Policy, also known as the nation's drug czar, to raise awareness about how prescription drug abuse deaths have tripled since 1999.

According to the data released Tuesday, 1 in 20 or 12 million Americans age 12 and older has misused prescription painkillers like oxycodone (Oxycotin), methadone or hydrocodone (Vicodin) and middle-aged adults have the highest overdose rates.

CNN


Supplemental New Drug Application Submitted to FDA for NUCYNTA® ER (Tapentadol) Extended-Release Tablets for Diabetic Peripheral Neuropathic Pain


Johnson & Johnson Pharmaceutical Research & Development, L.L.C. (J&JPRD) announced today that it has submitted a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) for NUCYNTA® ER (tapentadol) extended-release tablets, an oral analgesic, for the management of neuropathic pain associated with diabetic peripheral neuropathy (DPN) in adults.

The FDA approved NUCYNTA® ER on August 25, 2011, for the management of moderate to severe chronic pain in adults when a continuous, around-the-clock opioid analgesic is needed for an extended period of time.

Market Watch


Decline in Doctor Office Visits Could be Permanent


The number of visits patients make to physicians in a given month -- a vital sign for the whole health care economy -- has been declining consistently, according to multiple tracking studies, companies and researchers.

Analysts say those numbers may not bounce back, even with health system reform. That's because a struggling economy, higher insurance deductibles, and the efforts by health plans and others to reduce utilization have altered patient patterns, perhaps permanently. Patients now often seek office visits -- or any interaction with the health system -- only when a problem can't be ignored.

AMA news


State Society News


FSIPP Annual Meeting Dates May 18-20, 2012


The Florida Society of Interventional Pain Physicians has set the date for their next annual meeting for May 18-20, 2012 at the Gaylord Palms, Orlando, FL.

Read more about the meeting and other activities going on in the state of Florida in their newsletter. Click HERE to read latest issue.

For a complete look at the May meeting schedule and CME information, click HERE

 


Physicians Wanted


Visit the ASIPP Web site to find available positions for IPM physicians.

Physicians Wanted


 

 

 


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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