American Society of Interventional Pain Physicians | August 29, 2018
6.75 A MA PRA Category 1 Credits™
11 AMA PRA Category 1 Credits

Neuromodulation Cadaver Workshop will be
limited to 4 physicians per station.
Minimum attendance of 4 physicians required thirty days prior to meeting or
course and workshop is subject to cancellation. Register early!

1 Day Review Course and 1.5 Day Cadaver Workshop.
1. Trial lead placement for low back pain
2. Trial lead placement for neck pain
3. Spinal cord stimulator permanent implant placement (conventional)
4. Wireless trial and permanent placement
5. Transforaminal trial and permanent placement
6. Placement of intrathecal infusion system
7. Intercostal nerve stimulation
8. Sacroiliac stimulation
9. Suprascapular nerve stimulation
10. Free forum

Procedures are subject to change.

18 A MA PRA Category 1 Credits™

6.75 A MA PRA Category 1 Credits™

11 AMA PRA Category 1 Credits

7 AMA PRA Category 1 Credits™
(Plus Free Online Lectures)
11 AMA PRA Category 1 Credits™
Senate Passes Historic Health Spending Bill

WASHINGTON -- A spending bill that boosts funding for medical research while also taking aim at the opioid epidemic and maternal mortality passed the Senate on Thursday in a vote of 85-7.
The $857-billion "minibus" package bundled funding for Department of Health and Human Services (HHS) as well as for the Defense, Labor, and Education departments.

Attention now turns to the House of Representatives, which has not yet acted on a bill to fund HHS. Congress faces a Sept. 30 deadline to enact a funding package to avoid shutdown of the affected departments.

Pain Scores After Total Knee Arthroplasty May Predict Chronic Opioid Use

Acute postoperative pain scores were found to be associated with chronic opioid use after total knee arthroplasty (TKA) in patients taking opioid medications prior to intervention, according to a study published in  Regional Anesthesia and Acute Pain .
The preoperative and perioperative characteristics of 32,874 veterans who used  opioid analgesics  prior to TKA were examined. Study participants were categorized according to the acute pain scores they reported before surgery over a 3-day period (ie, ≤4 or >4 on a 0-10 scale). Rates of chronic opioid use (ie, mean >30 mg/day dose in morphine equivalents) starting 3 months after treatment,  prescriptions at discharge , and postoperative vs preoperative dose category changes were examined.

Interventional Pain Management Reports is an Open Access online journal, a peer-reviews journal dedicated to the publication of case reports, brief commentaries and reviews and letters to the editor. It is a peer-reviewed journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. 

Interventional Pain Management Reports is an official publication of the American Society of Interventional Pain Physicians (ASIPP) and is a sister publication of Pain Physician . Interventional Pain Management Reports Interventional Pain Management Reports is an open access journal, available online with free full manuscripts.  

The benefits of publishing in an open access journal that has a corresponding
print edition journal are:  
  • Your article will have the potential to obtain more citations.
  • Your article will be peer-reviewed and published faster than other journals.
  • Your article can be read by a potentially much larger audience compared with traditional subscription-only journals.  
  • Open Access journals are FREE to view, download and to print.

So submit today your:
  • Case Reports
  • Technical Reports
  • Editorials
  • Short Perspectives

Specialty Physicians Ready to Push Back

Some physicians are probably not very happy with  recently proposed changes to the Medicare Physician Fee Schedule .
The Centers for Medicare & Medicaid Services (CMS) designed the changes to reduce paperwork and enable physicians to spend more time with patients. Those seem like good ideas. However, CMS may face pushback from specialty physicians who will see significantly lower reimbursements for their most complex patients under the new fee schedule.
The proposed changes affect evaluation and management (E&M) coding for office and outpatient visits. CMS proposed to chang the reimbursement schedule for new patients and established payments from five separate levels to two. Although the new reimbursements are higher for levels 1-3, they are lower for levels 4-5, which represent more complex cases commonly seen by specialty physicians

Researchers Question DEA Hydrocodone Schedule Change in Light of Postoperative Prescribing Practice Data

Despite the best intentions, the 2014 US Drug Enforcement Administration (DEA) change of hydrocodone-containing analgesic products from schedule III to the more-restrictive schedule II has been linked with an increase in the quantity of opioids filled by patients in a postoperative setting, according to research published in  JAMA Surgery . 1
The DEA initiated the scheduling change as a response to the ongoing opioid crisis. Although recent studies 2,3  suggest that this shift in policy did lead to a reduction of overall hydrocodone fills, the impact of the policy change in the postoperative setting is, according to researchers, “not understood.”

Call to Better Investigate the Associations Between Sleep Disturbances and Chronic Pain

Although literature indicates bidirectional associations between sleep disturbances and pain, few longitudinal studies have examined the role of  sleep disturbances in contributing to chronic pain , according to a review published in  Chest .
In this review, the investigators focused on studies that assessed whether sleep disturbances could predispose individuals to pain conditions. Insomnia was found to predispose patients to chronic pain or to contribute to the worsening of pain conditions, prompting the study authors to recommend that clinicians managing patients with chronic pain assess them for insomnia.
In studies examining the association between common sleep disturbances and chronic pain, some evidence was found linking short sleep duration, sleep apnea, narcolepsy, and sleep bruxism to chronic pain. The small number of studies and limitations in study design prevented the researchers from defining the directionality of these associations.

Pain Physician
July/August 2018 Issue Features

Health Policy Review
  • Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic
Systematic Reviews
  • Is Unilateral Percutaneous Kyphoplasty Superior to Bilateral Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures? Evidence from a Systematic Review of Discordant Meta-Analyses
  • Prevalence of Recurrent Herniation Following Percutaneous Endoscopic Lumbar Discectomy: A Meta-Analysi
Randomized Trials
  • Thermal Versus Super Voltage Pulsed Radiofrequency of Stellate Ganglion in Post-Mastectomy Neuropathic Pain Syndrome: A Prospective Randomized Trial
  • Evaluation of an Experimental Pain Model by Noncompartmental Analysis of Results from a Randomized Placebo Controlled Trial
  • Transforaminal vs Interlaminar Epidural Steroid Injection for Acute-Phase Shingles: A Randomized, Prospective Trial

Health Insurer Shuns Amniotic-Tissue Product From MiMedx
United Healthcare won’t reimburse patients for use of ‘unproven’ product

United Healthcare, one of the nation’s largest insurance companies, has determined that amniotic tissue products made by  MiMedx Group Inc.  MDXG +0.73%  and other manufacturers are “unproven and/or not medically necessary for any indication,” and won’t reimburse patients for their use, according to the insurer’s most recent medical policy update bulletin.
The updated policy at United Healthcare, which goes into effect Oct. 1, came about because of “insufficient clinical evidence of safety and/or efficacy in published peer-reviewed medical literature” about the products, the bulletin said.

Access to this article may be limited.

NIH research program to explore the transition from acute to chronic pain

The National Institutes of Health has launched the Acute to Chronic Pain Signatures (A2CPS) program to investigate the biological characteristics underlying the transition from acute to chronic pain. The effort will also seek to determine the mechanisms that make some people susceptible and others resilient to the development of chronic pain. A2CPS is part of the NIH-wide  HEAL (Helping to End Addiction Long-term) Initiative , an aggressive, trans-NIH effort to speed scientific solutions to stem the national opioid public health crisis. The high prevalence of chronic pain in the United States, and the reliance on opioids for its management, has created an urgent need for safer, more effective pain control. Though A2CPS is part of the HEAL Initiative, its anticipated $40.4 million four-year budget is supplied by the NIH Common Fund, and is an additional investment to enhance research on pain and opioid addiction beyond funds already allocated to HEAL.
A major challenge in pain care is to prevent chronic pain from developing after an initial painful event. For most people, pain goes away as an injury heals. For many others, the pain persists beyond healing of the initial event, and can last for years or even a lifetime. Changes that occur in the body and brain during the development of chronic pain are poorly understood.


DOJ News

Co-Owners of Miami Pain Management Clinic Plead Guilty to Conspiracy to Distribute Medically Unnecessary Opioid Prescriptions
The husband and wife co-owners of a Miami pain management clinic and a patient recruiter pleaded guilty today to conspiracy to distribute controlled substances for their participation in a scheme to unlawfully distribute thousands of pills of oxycodone.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division; U.S. Attorney Benjamin G. Greenberg for the Southern District of Florida; Special Agent in Charge Robert Lasky of the FBI’s Miami Field Office; Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); Special Agent in Charge Brian Swain of the U.S. Secret Service (USSS), and Special Agent in Charge Adolphus P. Wright of the U.S. Drug Enforcement Administration (DEA) Miami Field Division made the announcement.  
“The so-called ‘pain clinic’ owned by David Bosch and Tania Sanchez traded oxycodone prescriptions for cash, resulting in bogus, medically unnecessary prescriptions for at least 7,500 tablets of oxycodone,” said Assistant Attorney General Benczkowski. “Pill mills like this must be shut down. The Department of Justice is committed to reducing the staggering number of opioid overdoses in this country, and holding accountable all responsible parties, from owners of illegal clinics to patient recruiters, for their roles in this deadly scourge.”


California Doctor Convicted of Medicare Kickback Conspiracy
A federal jury in Los Angeles, California found a Lancaster, California doctor guilty today of conspiracy for his role in a Medicare kickback conspiracy involving a Los Angeles-area home health agency. 
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Nicola T. Hanna of the Central District of California, Special Agent in Charge Christian J. Schrank of the U.S. Department of Health and Human Services
Office of Inspector General’s (HHS-OIG) Los Angeles Regional Office and Assistant Director in Charge Paul D. Delacourt of the FBI’s Los Angeles Division made the announcement.
Kanagasabai Kanakeswaran, M.D., 65, was convicted of one count of conspiracy to pay and/or receive kickbacks for Medicare referrals and four counts of receiving kickbacks for Medicare referrals after a six-day trial. Sentencing has been scheduled for Jan. 7, 2019 before U.S. District Judge Philip S. Gutierrez of the Central District of California, who presided over the trial. 


State Society News 

July 12-14, 2019
GSIPP 2019 - 15th Annual Meeting & Pain Summit
The Cloister Hotel at Sea Island
Sea Island, GA
For more information, contact Karrie Kirwan at or Tara Morrison at or 770-613-0932.

Send in your state society meeting news to Holly Long,
ASIPP | Pain Physician Journal | Phone | Fax | Email