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American Society of Interventional Pain Physicians News  | June 22, 2016
IN THIS ISSUE
  1. Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment
  2. Registration now Open! ASIPP To Offer 3 courses in August: Regenerative Medicine, Interventional Techniques and Controlled Substance and Practice Management
  3. ABIPP Certification Made Simple
  4. Trustees' report says Medicare will be insolvent by 2028, two years earlier than previous estimates
  5. KY Gov. Matt Bevin Unveils Proposal for Medicaid Transformation 
  6. Employers Cut Down on Wellness Benefits
  7. CMS Updates Medicare Reimbursement Schedule for Lab Tests  
  8. Even Cheap Meals Influence Doctors' Drug Prescriptions, Study Suggests 
  9. Leading Health Insurance Provider Changes Policy on High-Frequency Spinal Cord Stimulation
  10. Listen to ASIPP's Newest Podcast
  11. ICD-10-CM Book Now Available: Order Your Copy Today!
  12. Zika and the Olympics: The Games Must Go on
  13. State Society News
  14. Physicians Wanted
mipsMerit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment
  
CMS has proposed a rule concerning the Merit-based Incentive Payment System (MIPS). More than likely we will be receiving a final rule in November or so. We will have only one month to implement this program or else we will all face cuts of 4% in 2019 and rising to 9% in 2021.
 
This program is extremely onerous and penalizes small practices and solo physicians. It is especially onerous for interventional pain management physicians since they did not consult us as a specialty and all the primary specialties are interested in their primary specialty rather than interventional pain management. However, we understand that other societies are also working on it, which is encouraging.
 
It is essential to show a great response from interventional pain physicians and all other physicians and providers who sympathize with us.
 
You do not have to be a member of ASIPP to sign onto the letter (See Letter).You do not have to be an interventional pain physician and you do not even have to be a physician. All providers involved in MIPS, including PAs, nurse practitioners, nurses, and various other providers involved in taking care of our patients, including medical assistants, data collectors and medical students, can sign on.
 
For your name to be included, please send your name and the names of all your associates and those who are willing to sign on, including staff, to Savannah Gold at sgold@asipp.org by the end of the day on Sunday, June 26.
 
We will also be sending a copy of this letter, along with a separate letter to Congress, asking them to repeal, delay, or provide an exemption for our interventional pain management specialty. The signatures will be used for both letters.
 
Please do not delay. Please agree to sign your name  onto the letter immediately and work to get others to sign onto the letter as well. We need at least 500 signatures in 2 days and 2,000 by June 26.
 
Thank you again for your help in saving our specialty, not only for our patients and ourselves, but also for future generations of patients and IPM physicians.
august



This comprehensive four day Regenerative Medicine Review Course. will run August 18-21, 2016 in Las Vegas, Nevada at The Caesars Hotel and the state-of-the-art Oquendo Center.

These unique courses meets the continuing needs of interventionalists, based on input and needs assessment over the years and are cutting edge educational programs. It entails two days of didactic courses and two days of hands-on workshops covering various aspects of regenerative medicine. The first two days involve comprehensive review courses in regenerative medicine and hands-on with live models.

This two day course is an essential component for interventional pain physicians and provides education opportunities to assist you in providing high-quality, competent, safe, accessible, and cost-efficient services to your patients. The next two days will be a Cadaver Workshop fashioned to techniques of regenerative medicine.
                           
 


This Hands-On Cadaver Workshop in Interventional Techniques, including online lectures will run August 20 through August 21, 2016 in Las Vegas, Nevada at Caesars Palace Las Vegas and the state-of-the-art Oquendo Center. These unique courses meets the continuing needs of interventionalists, based on input and needs assessment over the years and are cutting edge educational programs. It entails the equivalent of two days of online lectures and two days of hands-on workshops covering various interventional techniques.

The 2 day Cadaver Workshop involves comprehensive review of interventional techniques. This two day 2 day Cadaver Workshop is an essential component for interventional pain physicians and provides education opportunities to assist you in providing high-quality, competent, safe, accessible, and cost-efficient services to your patients. Online Lectures from a recent Interventional Techniques couse are supplied for viewing prior to the cadaver workshop and will be available indefinitely after the meeting.

The Cadaver Workshop is fashioned to accommodate training levels and capacity of participants. Physicians can choose from basic, intermediate, or ABIPP examination preparation course levels to mirror your needs and skill level. it registration
                           
  

The ASIPPĀ®Comprehensive Review Courses and Competency Examination in Controlled Substance Management and Practice Management will be held in Las Vegas, NV, on August 18-20, 2016. These unique courses meet the continuing needs of interventionalists, based on input and needs assessment over the years and are cutting edge educational programs. They entail two days of didactic courses and a competency examination. Only physicians on the track to meet ABIPP requirements may take the combined examination. Others may take the single examination. The Practice Management course is so beneficial to practices, both officebased and ASCs, that many physicians send their staff early to keep them current on the cutting edge aspects of practice management.

These intensive review courses are designed to present interventional pain management specialists and other health care providers an in-depth review of multiple areas of interventional pain management-the areas we were never taught, yet are crucial for our survival. In addition to the review course, the American Board of Interventional Pain Physicians (for physicians) and the American Association of Allied Pain Management Professionals (for non-physicians) offers the opportunity for examination in order for physicians to obtain competency certification to and non-physicians to obtain associate certificates in Controlled Substance Management and/or Practice Management. Only physicians on the ABIPP track wanting to fulfill the ABIPP requirements may take the combined examination.
abippABIPP Certification Made Simple
 
The American Board of Interventional Pain Physicians (ABIPP) has developed certification programs that recognize accepted levels of knowledge and expertise in the interventional pain management profession, with the goal of improved patient care. Hundreds of qualified physicians have made the commitment to become ABIPP certified. ABIPP is recognized in 11 states. Ten states have no statutes governing specialty boards. Approval is pending in remaining states.
 
ABIPP is a Specialty Board providing certifications in the following areas:
Board Certification in Interventional Pain Management
Either with ABMS pain medicine board certification or  ABMS primary certification only

Competency Certification in:
* Interventional Pain Management
Regenerative Medicine
Controlled Substance Management
Coding, Compliance, and Practice Management
Fluoroscopic Interpretation and Radiological Safety
Endoscopic Spinal Decompression
 
Click HERE to view Pathway to ABIPP Certification

More information  www.abipp.org
trusteesTrustees' report says Medicare will be insolvent by 2028, two years earlier than previous estimates
 
The Medicare trust fund will be insolvent by 2028, according to the 2016 Medicare trustees' report released Wednesday.

The prediction is a departure from the 2030 date the Obama administration outlined in the previous two reports. The estimate is still later than the timeline released by the Congressional Budget Office in January, which estimated the program would be solvent only until 2026.

The updated estimate is the result of a projected decrease in payroll taxes and a slower-than-expected decrease in inpatient utilization, Andy Slavitt, acting CMS administrator, said at a news briefing Wednesday.

Like last year, the report does not include alternative payment models now being tested by the Center for Medicare and Medicaid Innovation. The only alternative pay model included in the insolvency estimate is the Medicare Shared Savings Program for ACOs, which was also included in last year's report.
  

                           
KYKY Gov. Matt Bevin Unveils Proposal for Medicaid Transformation
  
As a first step towards the implementation of the plan, the Cabinet for Health and Family Services announced a comprehensive Section 1115 waiver application proposal for Kentucky that is "Helping to Engage and Achieve Long Term Health" (HEALTH).
  
"We have given the preparation of this proposed waiver the highest priority due to the health challenges confronting the Commonwealth and the unsustainability of the Medicaid program as currently constructed," said Gov. Bevin. "This proposal is modeled after the very same health plan offered to Kentucky state employees including incentives to promote healthy lifestyles. This plan offers common sense strategies to help our citizens gain employment or prepare for employment through community engagement, including volunteer activities and job training programs."
  
  

wellnessEmployers Cut Down on Wellness Benefits
  
In the past few years, workplace wellness programs like health coaching were hot. Now they are not.
A big new survey of benefits from the Society for Human Resource Management found that employers are cooling toward certain wellness benefits. Originally designed to cut employers' health costs, benefits like on-site flu shots, 24-hour nurse hot lines, health coaching and insurance-premium discounts for weight loss all have declined over the past year, the study found.

As employers begin to analyze return-on-investment and participation data, they "may be taking a step back," said Evren Esen, director of survey programs at SHRM, the world's largest society for human-resources professionals.
  
  
Access to this article may be limited.
lab
CMS Updates Medicare Reimbursement Schedule for Lab Tests
  
A new methodology for calculating Medicare reimbursement rates for laboratory tests is on the horizon, according to a  fact sheet   from the Centers of Medicare and Medicaid Services (CMS).

According to a final rule issued this week, Medicare reimbursement rates for clinical diagnostic laboratory tests will be calculated using the weighted median of private payer rates for each test. The rule defines "private payers" as group health plans, health insurance issuers, Medicare Advantage plans under Part C, and Medicaid managed care organizations.

Eligible laboratories will be required to report private payer rates for specific tests, which CMS will use to update the Clinical Laboratory Fee Schedule (CLFS).


cheapEven Cheap Meals Influence Doctors' Drug Prescriptions, Study Suggests
  
It doesn't take much to get a doctor to prescribe a brand-name medication, a new study suggests.

The study found that U.S. doctors who received a single free meal from a drug company were more likely to prescribe the drug the company was promoting than doctors who received no such meals. Meals paid for by drug companies cost less than $20 on average.

The findings, published online Monday by JAMA Internal Medicine, were based on an analysis of U.S. government data tracking both industry payments to doctors and physicians' prescriptions of drugs paid for by the Medicare Part D drug benefit for the elderly. Researchers examined payments and prescriptions in 2013 associated with three brand-name cardiovascular drugs and one antidepressant, each of which had lower-cost alternatives.
  
  
Acces to this article may be limited.
scsLeading Health Insurance Provider Changes Policy on High-Frequency Spinal Cord Stimulation
  
High frequency (10 kHz) spinal cord stimulation (SCS) has proven effective for the management of chronic leg and back pain. 1   In a statement issued in 2008, the Neuromodulation Therapy Access Coalition declared it to be "critical that patients with chronic, intractable pain have access to SCS because, for appropriate candidates, no other treatment options exist, and their condition is often partially or completely disabling. SCS provides a means to relieve pain, restore function, and improve the quality of life for these patients". 2  In addition, unlike alternative surgical procedures to relieve pain, SCS is reversible and preserves pain pathways.

The FDA also recognizes SCS "as an aid in the management of chronic intractable pain of the trunk or limbs," points the document. This statement gathered support from leading pain medicine organizations, including the American Society of Interventional Pain Physicians and the American Academy of Pain Medicine. Yet, Blue Cross Blue Shield of Tennessee and Pennsylvania modified their policy earlier this month, dubbing SCS for the treatment of pain associated with conditions including multiple sclerosis, spinal cord lesions, acute peripheral nerve injuries, postherpetic neuralgia and cancer 'investigational'. 3,4
  
  
  
podcastListen to ASIPP's Newest Podcast
 
In this month's ASIPP Podcast we take a look at some of the content of ASIPP's ICD-10-CM pocket book; learn about the amazing life of Dr. John Bonica, a pioneer of pain medicine; in the news segment we have a story about a pill that could prevent tooth decay, a spider that could hold the key to a new type of pain medication, the reason NSAIDs have such a cardiac risk, and much more.
 
Click HERE to access Podcast
 
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.


zikaZika and the Olympics: The Games Must Go on
  
While a number of experts believe the Olympics should be postponed or cancelled or moved from Brazil, there are others who feel that the threat of Zika virus is not enough to delay the Olympic games in Rio de Janeiro this August.

MedPage Today   asked experts from a variety of specialties ranging from public health, infectious disease, obstetrics and gynecology, and family medicine, who all agreed that the Olympics should go forward as planned.
  
  

Hyatt 

     
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State Society News




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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