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American Society of Interventional Pain Physicians News  | April 27, 2016
IN THIS ISSUE
  1. CMS Releases Proposed MIPS Payment Structure
  2. ICD-10 Book Now Available: Order Your Copy Today! 
  3. ASIPP to Courses on Disc Decompression, Imaging, Controlled Substance, Practice Management, Interventional Techniques in Memphis in June
  4. Physician Revenue Generation for Hospitals Stays Strong
  5. Special deals, circumstances propel healthcare CEO pay
  6. The cost of fighting over whether to use drugs to treat addiction
  7. Long-Term Data Favorable on Percutaneous Lumbar Decompression for Spinal Stenosis
  8. United Health Dumps Out of Obamacare Exchanges
  9. State Society News 
  10. Physician Wanted 
CMSCMS Releases Proposed MIPS Payment Structure
                            
Today, April 27, 2016, CMS released the anticipated proposed rule concerning the new Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule. The agency had released a request for information (RFI) in late 2015 to gather input from stakeholders before writing the proposed rule.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced the Medicare Sustainable Growth Rate (SGR) formula with the new MIPS methodology. MIPS is intended to consolidate components of the Physician Quality Reporting System (PQRS), the Physician Value-Based Purchasing (VBP) Program and the Medicare Electronic Health Record (EHR) Incentive Program. The proposed rule also establishes incentives for physicians to participate in APMs; CMS has set a goal of moving 50% of Medicare payments to physicians to APMs by 2018.

Comments on the rule are due by 5:00 pm ET on June 27, 2016. We will send more information as it is available.

book
ICD-10 Book Now Available: Order Your Copy Today!

 
The initial impression of ICD-10 implementation was that it went well for both providers and CMS, however, shortly after the October 1, 2015 date when Medicare claims began processing, providers found out otherwise. In some cases, Interventional Pain Management providers continue to struggle with "finding the right code" to report for their patient's condition.

CMS released a publication "Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities" http://tinyurl.com/CMS-ICD-10-ClarifyQ-A that provided additional details as to how this ICD-10 family of codes "free pass" was going to work.
 
In short, CMS stated, "The recent Guidance does not change the coding specificity required by the NCDs and LCDs. Coverage policies that currently require a specific diagnosis under ICD-9 will continue to require a specific diagnosis under ICD-10. It is important to note that these policies will require no greater specificity in ICD-10 than was required in ICD-9, with the exception of laterality, which does not exist in ICD-9. LCDs and NCDs that contain ICD-10 codes for right side, left side or bilateral do not allow for unspecified side."
What this means is that:
  • Interventional Pain Management providers are still being held responsible for reporting the correct ICD-10 code or risk Medicare claims denials.
  • Many Interventional Pain Management procedures are included in the various Medicare contractor's Local Coverage Policies (LCD) and include very specific lists of ICD-10 codes that meet medical necessity for the diagnostic and therapeutic procedures.
  • In some cases, Medicare contractors have separate LCD policies for each type of interventional pain procedure and often multiple pages in length.
Don't be one of the providers that have the misunderstanding if they report a valid ICD-10-CM code in the same family of codes, Medicare will accept that.
 
Busy Interventional Pain Management providers don't have time to check the Medicare LCD each time they perform a procedure.
 
Make your medical practice easier and use the ASIPPĀ® new ICD-10-CM Pocket Guide for assistance navigating through the complexity of ICD-10 coding.

  
This book is 5.25 x 8.25 and can easily be placed in your jacket or any carrying case. For only $400 you will receive both the electronic and paper versions. You can recover your cost by avoiding mistakes in just one single case.
  
Order immediately to avoid any future losses. Get it for yourself and get copies for all your partners and staff. Multiple copies can be transferred to your EMR and save you money.
  
Also take a 10% discount for 5-9 copies or a 20% discount for 10 copies or more.


memphisASIPP Courses on Disc Decompression, Imaging, Controlled Substance, Practice Management, and Interventional Techniques in Memphis in June


Here is an overview of the June schedule of meetings that ASIPP has in store for you! Meeting Brochures and Registration will be available soon!

Lumbar Endoscopic Spinal Decompression Hands-on Cadaver Workshop and Online Lectures
Jun. 11-12

Click HERE  to register

Comprehensive Review of Interventional Techniques and Hands on Cadaver Workshop
Basic, Intermediate and Advanced Interventional Techniques
Jun 9-12

Two days of didactics and 1 1/2 days of hands-on training in the cadaver lab. New and revised content!

Click HERE  to register

Comprehensive Imaging Review in Interventional Pain Management and Competency Examination
Course - Jun. 9-10
Examination - June 11

Click HERE to register
 
Comprehensive Review Course of Controlled Substance Management and Practice Management and Competency Examinations
Course - June 9-10
 
Examinations - June 11
Take CSM, CCPM, or a combined examination

Take one or both! Click HERE to Register
 
ABIPP Part I Examination - June 11        

250 North Main Street
Memphis , TN, 38103

PaySpecial deals, circumstances propel healthcare CEO pay
                                                      
Joe Kiani founded and built his company on sales of pulse oximetry equipment. He's a philanthropist who launched the Patient Safety Movement Foundation and a campaign contributor who hobnobs with Democratic and Republican party elites. 

And last year he vaulted to the top of the list of healthcare's highest paid executives through an unusual golden parachute built into his stock option plan. Fully $111.9 million of his whopping $119.2 million compensation package in 2015 came in the form of 2.7 million shares of restricted Masimo Corp. stock that Kiani will receive if he is fired, if control of the company changes or he's asked to relocate from Southern California to stay with the company.

The year before, Masimo paid Kiani just $4.5 million, according to a Modern Healthcare analysis of executive compensation at investor-owned healthcare companies. 
 
CostThe cost of fighting over whether to use drugs to treat addiction
                           
A rift among addiction-medicine providers about the role of medication-assisted recovery treatment may be hampering efforts to address the growing epidemic of addiction to heroin and prescription opioid painkillers.

Many experts see the use of naloxone and other medications as the most effective way to mitigate the health risks and address the social stigma of drug addiction. But substance abuse treatment has traditionally been the realm of non-medical professionals whose expertise is often drawn from their own experiences with addiction.

The divide may stand in the way of greater integration of addiction treatment into mainstream medicine, and the increased reimbursement that would come with it.
  
StudyLong-Term Data Favorable on Percutaneous Lumbar Decompression for Spinal Stenosis
                                                      
Six-month data from a randomized controlled study for the Medicare Coverage with Evidence Development program appear to show that a percutaneous decompression procedure is beneficial for people with neurogenic claudication due to lumbar stenosis (Pain Physician  2016;19:25-37). The minimally invasive lumbar decompression (MILD) technique is used for percutaneous lumbar decompression with a dorsal approach.

The results of the MiDAS (MILD Decompression Alternative to Open Surgery) ENCORE (Evidence-based Neurogenic Claudication Outcomes Research) study indicated that MILD was associated with lower Oswestry Disability Index (ODI) scores compared with epidural steroid injections (ESIs). MILD also produced lower scores on the Numeric Pain Rating Scale (NPRS) and the Zurich Claudication Questionnaire (ZCQ). The study was approved by the Centers for Medicare & Medicaid Services as a continued evidence development study and paid for by Vertos Medical, the company that teaches the MILD technique and manufactures the equipment for it.


UnitedUnited Health Dumps Out of Obamacare Exchanges
                                                      
U.S. health insurer UnitedHealth said Tuesday it would largely exit the Obamacare individual insurance market in 2017, citing expectations for mounting losses from the program.

UnitedHealth is the largest U.S. health insurer and one of the biggest sellers of plans on the exchanges, which were created as part of President Barack Obama's national healthcare law. UnitedHealth sells these plans in 34 states this year, up from 25 states last year.

"Next year, we will remain in only a handful of states," UnitedHealth CEO Stephen Hemsley said in prepared remarks as part of the company's first-quarter earnings report.
  
Hyatt 
     
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State Society News

FSIPP Annual Meeting
May 20-22, 2016
The Florida Society of Interventional Pain Physicians will hold its annual meeting in 2016 on May 20-22. 
The 2016 Annual Meeting, Conference and Trade Show Interventional Pain Management: 
A Diagnostic and Therapeutic Pathway to Restoration of Function
 will be held at the  Orlando World Center Marriott,
8701 World Center Drive, Orlando, FL 32821
 
FSIPP is also offering 2 concurrent programs:
  • Safe Opiate Prescribing Course - no charge, but you need to be registered for the annual meeting.
  • The Business of Pain Course on Saturday, May 21 - $150.00 
Registration:

 

 




CASIPP Annual Meeting
November 11-13, 2016
Early Bird Registration is Open for the California Society of Interventional Pain Physicians annual meeting. T he meeting is set for Friday, November 11 - Sunday, November 13, 2016  at the exquisite Bacara Resort & Spa,  Santa Barbara , California. 


 
Please send your State Society meetings and news to: Holly Long at hlong@asipp.org

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