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American Society of Interventional Pain Physicians | July 17, 2019
2019 ASIPP Washington Legislative Meeting and
Capitol Hill visits set for October 15-16, 2019  
Now is our chance! Let your voices be heard!  
At no other time in the history of the American Society of Interventional Pain Physicians has it been more important for you, as members, to get involved in our advocacy efforts. Despite o ur ongoing, tireless efforts, with some improvements, our specialty continues to be affected by coverage and reimbursement issues. These issues continue to hurt more than just our bottom lines; some practices and surgery centers have been forced to close their doors or sell to others.
Our legislative issues include:
  •  Non-coverage by Medicare Advantage
  •  Dual eligibility with Medicaid not paying 20%
  •  Centene acquisition of Well Care
  •  Onerous audits and investigations
  • Incorporation of best practices in Pain Management
  • Support for preauthorization for Medicare Advantage
  • Support for H.R.3107 - Improving Seniors' Timely Access to Care Act of 2019 (preauthorization bill)

We have scheduled a legislative conference for October 15-16, 2019. To participate in this conference, you must to be in Washington DC on Tuesday, October 15 in order to attend the preparation session Tuesday evening. Then, on Wednesday, October 16, we will head to Capitol Hill for breakfast and congressional speeches. You will be able to fly out late on Wednesday evening. Please do not plan on leaving before 6 pm.  
Each member is expected to visit two senators and one member of Congress for a total of three visits.  
ASIPP has booked a block of rooms at the beautiful Melrose Georgetown Hotel, less than a mile from the Hill. You will be responsible for travel expenses.  Please let us know as soon as possible if you will be attending so that we can begin making the appointments. Please bring your family, friends and employees.
It will be fun! If you have never participated before, just ask those who have. Not only is this a necessary and important meeting, but it is also an exciting and fun experience.
Please contact Melinda Martin, ASIPP Director of Operations, at mmartin@asipp.org if you are interested in attending.
Purchase Your Cincinnati Reds-Chicago Cubs Suite Tickets When Registering for OH-KY SIPP Meeting

The Ohio and Kentucky Societies of Interventional Pain Physicians have planned a great agenda over 2.5 days on August 9-11. The committee has reserved a suite for the Cincinnati Reds-Chicago Cubs game Saturday evening. Enjoy a fun and relaxing evening as you watch these two clubs play while networking with your peers. Tickets are just $83 and can be purchased when you register for the meeting. IF you’ve already registered and would like to purchase tickets, email your order to kavery@asipp.org

Click here to view the program.
We will accept abstracts for the poster presentations until Aug. 1, 2019.
To submit proposals, click here .

Register Now for First Midsouth Meeting to be Held September 20-22 in Memphis
The first meeting of the Midsouth Societies of Interventional Pain Physicians will be September 20-22 in Memphis. IPM: Issues, Pitfalls and Opportunities is for physicians and midlevel practitioners for the following states: Alabama, Arkansas, Indiana, Kentucky, Mississippi, Missouri, and Tennessee.
Click here for meeting registration and hotel booking information. 

Click Below to view:
Pain Management Task Force Releases Final Report
The Task F,orce Final Report was given to Congress, federal government agencies and the public on May 30, 2019.

These recommendations will help the health and lives of patients with acute and chronic pain throughout the Nation. The Task Force received close to 10,000 comments and incorporated what was possible provided  the charge of the CARA legislation, time, resources and other factors.

U.S. Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force. Final Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations. May 9, 2019.

June 13 - June 14, 2020 | Memphis, TN
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 now offers the only competency certification program for regenerative medicine.
For complete information about the examination requirements and to obtain an application packet, visit www.abipp.org or call 270-554-9412 x4217 or by email at summer@asipp.org.
June 13
June 13
June 13-14
June 14
ABIPP Competency Exam
June 13
Combined CSM/CCPM Exam for ABIPP Path
June 13
Competency Exam in Controlled Substance Management

June 13
Competency Exam in Coding, Compliance, and
Practice Management
June 13-14
Regenerative Medicine Competency Exam
June 13-14
Endoscopic Lumbar Decompression Competency Exam
939 Ridge Lake Blvd. | Memphis, TN 38120
Price Controls Best Way to Cut Health Costs, Economists Say
Market-based methods have been tried but don't seem to work

WASHINGTON -- Are price controls really the best solution to lower healthcare costs?
"I'm a card-carrying economist -- my card may be revoked, [but] I'll just say 'Yes,'" said Dan Polsky, PhD, professor of health economics at Johns Hopkins University in Baltimore, speaking Monday at an event on U.S. health spending sponsored by the Robert Wood Johnson Foundation and Altarum, a health policy think tank.
"We've tried market-based methods," said Polsky. "The assumptions one makes in economics class about how a market functions -- none of them exist in healthcare ... it's not working. I'm all for giving price controls a try."

What Can Be Done About 'Pay for Play'?
Kevin Campbell, MD, calls for an overhaul of the U.S. pharmaceutical and device industries

In this video, Kevin Campbell, MD, takes a look at pharmaceutical industry influence on physician prescribing and lobbying on Congress, and says both are in need of a fix. The opinions expressed in this commentary are those of the author.
The following transcript has been edited for clarity:
This week, an article in JAMA Internal Medicine addressed the issue of industry payments to physicians and how these payments affect doctor's prescribing practices. In this particular investigation, researchers at the University of Toronto examined the frequency of brand name biologic drug use for Crohn's disease by physicians who are paid by manufacturers to provide industry sponsored lectures or have received other industry-directed payments. Not surprisingly, those physicians who received payments prescribed these name brand biologics at a much higher rate.

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

Medicare for All: Would Patients and Physicians Benefit or Lose?
Milton Packer issues an urgent call for practitioners to join the debate

Anyone listening to the discourse among presidential candidates has heard about a new proposal for healthcare delivery, Medicare for All.
No two people define Medicare for All in the same way. Is "Medicare for All" the same as "socialized medicine"? (I do not know what "socialized medicine" means.) Is the concept identical to a "single payer" system? Is it akin to the healthcare systems in Canada or Europe? Does it abolish private insurance?
This post addresses two simple questions: Would "Medicare for All" benefit patients? And would it benefit physicians? (This is a relevant question, since physicians represent a majority of the readers of this blog.)

2019 MIPS Reporting? Start Now.
MIPS-eligible clinicians must report a full year of data. Don’t fall behind – keep up with NIPM-QCDR.
MIPS 2019 has brought larger payment adjustments and greater reporting requirements, including a 365-day performance period for the Quality and Cost categories. The sooner you start your MIPS reporting for 2019, the better.
Sign up today to use ASIPP’s NIPM-QCDR for MIPS.
This powerful tool makes MIPS reporting easy through the use of our new patient-reported outcomes measures for 2019, which ease the burden on providers and reduces costly EMR integration.

Get started today at ASIPP.ArborMetrix.net

America to face a shortage of primary care physicians within a decade or so
Despite hospital systems and health officials calling out the need for more primary care doctors, graduates of U.S. medical schools are becoming less likely to choose to specialize in one of those fields.
A record-high number of primary care positions was offered in the 2019 National Resident Matching Program — known to doctors as “the Match.” It determines where medical students will study in their chosen specialty after graduation. But this year, the percentage of primary care positions filled by fourth-year medical students was the lowest on record.

Opioid Use Decreased in Medicare Part D, While Medication-Assisted Treatment Increased

The Nation has been grappling with an opioid crisis for several years. In 2017 alone, there were 47,600 opioid-related overdose deaths in the United States. It continues to be a public health emergency. OIG has been tracking opioid use in Medicare during this crisis, particularly since 2016. OIG has identified beneficiaries at serious risk of misuse or overdose and has identified prescribers with questionable prescribing for these beneficiaries. These types of analyses are crucial to understanding and addressing the national opioid crisis. Building on past OIG work, this data brief details opioid use in Medicare Part D in 2018 and trends in drugs used to treat opioid use disorder.

We based this data brief on an analysis of Part D prescription drug event records for opioids received in 2018. We determined beneficiaries' morphine equivalent dose, which is a measure that converts all of the various opioids and strengths into one standard value.

  • Nearly 3 in 10 Medicare Part D beneficiaries received opioids in 2018, a significant decrease from the previous 2 years.
  • At the same time, the number of beneficiaries receiving drugs for medication-assisted treatment for opioid use disorder has steadily increased and reached 174,000 in 2018.
  • In addition, the number of beneficiaries receiving prescriptions through Part D for naloxone-a drug that can reverse the effects of an opioid overdose-more than doubled from 2017 to 2018.
  • About 354,000 beneficiaries received high amounts of opioids in 2018, with about 49,000 of them at serious risk of opioid misuse or overdose; this was fewer than in the previous 2 years.
  • About 200 prescribers had questionable opioid prescribing for beneficiaries at serious risk.

White House Cedes Battle, but Not War, Against Drug Rebates
HHS Secretary said he hopes Congress will consider taking action

WASHINGTON -- The Trump administration isn't giving up on getting rid of drug rebates to pharmacy benefit managers or insurers to instead give negotiated discounts directly to consumers, Health and Human Services (HHS) Secretary Alex Azar said Thursday.
"The president is deeply committed to protecting America's seniors," Azar said at a press briefing with reporters at HHS headquarters. "He does not want any risk that our actions could cause seniors' premiums to increase."
Shortening trainee doctor hours hasn't harmed patients
Capping hours at 80 per week led to no differences in patient deaths, readmissions or costs.

When reforms shortened working hours for U.S. doctors-in-training, some worried: Was that enough time to learn the art of medicine? Would future patients suffer?
Now a study has answers, finding no difference in hospital deaths, readmissions or costs when comparing results from doctors trained before and after caps limiting duties to 80 hours per week took effect.
"Some still long for the old days of 100-hour work weeks, but most of the world has moved on and realized there are better ways to train residents," said Dr. Karl Bilimoria of Northwestern University Feinberg School of Medicine, who was not involved in the research published Thursday in the  journal BMJ .

ASIPP Guidelines Selected for ECRI Guidelines Trust

The have also identified the guidelines below that we will review for inclusion in the ECRI Guidelines Trust:

  • Responsible, safe, and effective use of antithrombotics and anticoagulants in patients undergoing interventional techniques: American Society of Interventional Pain Physicians (ASIPP) guidelines. (2019)
  • Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. (February 2017)

ECRI Guidelines Trust™ is a publicly available web-based repository of objective, evidence-based clinical practice guideline content. Its purpose is to provide physicians, nurses, other clinical specialties, and members of the healthcare community with up-to-date clinical practices to advance safe and effective patient care. This centralized repository includes evidence-based guidance developed by nationally and internationally recognized medical organizations and medical specialty societies.

ASIPP members interested in accessing the Guidelines Trust can do so at: https://guidelines.ecri.org/register.

Humor Blog: Dilaumorfentanylocet Approved for 11/10 Pain and Above
Pain scores dropped to between zero and "I'm in la-la land"

Disclaimer: This post is from GomerBlog , a satirical site about healthcare.
In an exciting development for doctors and nurses around the country, the FDA has approved a powerful new drug for the treatment of resistant pain, defined as pain of 11 and above on a scale of 10.
Dilaumorfentanylocet was tested in a large multicenter clinical trial and used to treat a broad range of pain sources -- pancreatitis, multi-level spinal fusion, open abdominal aortic aneurysm repair, stubbed toe, bruised knee, paper cuts, and band-aid removal. The agent will be marketed as SpinalTapenan, and carries the tag line: "For when your pain goes to 11."
Excited lead study investigator Opie Yates, MD, reported that the average pretreatment pain score was 68 out of a possible 10, but after just a single dilaumorfentanylocet dose, pain scores came down to between zero and "I'm in la-la land." The effect was robust, long-lasting, and resistant to such interventions as naloxone (Narcan) and CPR.
Portsmouth doctor reprimanded for treatment of chronic pain patient

CONCORD — A Portsmouth doctor has been reprimanded and fined by the New Hampshire Board of Medicine after he cut back a chronic pain patient’s prescription opioid painkillers — and then dropped him as a patient altogether after the man threatened suicide.
Joshua Greenspan, who is board certified in pain management and anesthesiology, signed a settlement agreement in May to resolve allegations of professional misconduct. Greenspan did not respond to a message left at his office at the American Pain Institute on Friday.
According to a settlement agreement, the Board of Medicine received a complaint from a patient in June 2018, alleging that Greenspan, “after treating him for years and prescribing the same dosages of pain medication, suddenly reduced his medications, which led to increased pain and anxiety, and suicidal ideations.”

Justice Department Obtains $1.4 Billion from Reckitt Benckiser Group in Largest Recovery in a Case Concerning an Opioid Drug in United States Histor y

Global consumer goods conglomerate Reckitt Benckiser Group plc (RB Group) has agreed to pay $1.4 billion to resolve its potential criminal and civil liability related to a federal investigation of the marketing of the opioid addiction treatment drug Suboxone. The resolution – the largest recovery by the United States in a case concerning an opioid drug – includes the forfeiture of proceeds totaling $647 million, civil settlements with the federal government and the states totaling $700 million, and an administrative resolution with the Federal Trade Commission for $50 million.
Suboxone is a drug product approved for use by recovering opioid addicts to avoid or reduce withdrawal symptoms while they undergo treatment. Suboxone and its active ingredient, buprenorphine, are powerful and addictive opioids. 
“The opioid epidemic continues to be a serious crisis for our nation, and I’m proud of the work the Department of Justice and our partners are doing to address this epidemic,” said Principal Deputy Associate Attorney General Claire Murray.

State Society News 

July 26-28, 2019
PAIN 2019
West Virginia Society of Pain Physicians
Loews Miami Beach, FL

August 9-10, 2019
Ohio and Kentucky Annual Meeting
Westin Cincinnati
Cincinnati, OH

Send in your state society meeting news to Holly Long, hlong@asipp.org
ASIPP | Pain Physician Journal | Phone | Fax | Email