American Society of Interventional Pain Physicians | February 20, 2019
ASIPP Gearing up
for Orlando Meetings!


Just a few spots remain at some levels, so if you are interested in attending, register right now!

 
Feb. 22-24,  2019 
Interventional Techniques Review Course and Cadaver Workshop  

Regenerative Medicine Review Course and Cadaver Workshop

Neuromodulation Review Course and Cadaver Workshop
Abstract Submission Deadline Extended to March 4

Abstract submissions are now being accepted for the 2019 ASIPP Annual Meeting Abstract and Poster Contest. The top 10 abstracts selected by our panel will be presented at the annual meeting. The top 25 abstracts will be presented as electronic posters in view for all our attendees.

Click HERE to submit. Deadline is March 4
JULY ABIPP EXAMS
AND COMPETENCY EXAMS
July 13 - July 14 | 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.

Register before March 30, 2019. Fee only $1,000.

April 1 to May 30, 2019, fee is $2,000

May 1 to May 30, fee is total of $3,000

No registrations after May 30.

 
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.

July 13
ABIPP Part I
 
July 13-14
ABIPP Part II
 
July 14
ABIPP Competency Exam

July 13
Combined CSM/CCPM Exam for ABIPP Path
July 13
Competency Exam in Controlled Substance Managemen

July 13
Competency Exam in Coding, Compliance, and
Practice Management

July 13-14
Regenerative Medicine Competency Exam
 
July 13-14
Endoscopic Lumbar Decompression Competency Exam

939 Ridge Lake Blvd. | Memphis, TN 38120
 
The cut-off date for our room block with discounted rates is on June 10, 2019 or until sold out, whichever occurs first.

Medicare Administrative Contractors (MACs) will host a multi-jurisdictional Contractor Advisory Committee (CAC) via WebEx on March 20, 2019

Medicare Administrative Contractors (MACs) will host a multi-jurisdictional Contractor Advisory Committee (CAC) via WebEx on March 20, 2019, 1-4 pm EST.
The purpose of the meeting is to obtain advice from CAC members and subject matter experts (SMEs) regarding the strength of published evidence on Percutaneous Vertebral Augmentation (PVA) for osteoporotic Vertebral Compression Fracture (VCF). In addition to discussion, the CAC and SME panel will vote on pre-distributed questions. The public is invited to attend as observers.
Ever since two high profile, methodologically controversial, randomized controlled trials (RCTs) found no benefit of percutaneous vertebroplasty over sham in 2009, there has been a lack of consensus on the appropriate management of osteoporotic VCF, particularly the role of PVA. After several recent publications further question the value of PVA, Contractor Medical Directors (CMDs) thought it appropriate to reassess current Medicare coverage. CAC panels do not make coverage determinations, but MACs benefit from their advice.
A participant Disclosure Statement, background material, and tentative questions will be posted by 2/22; the agenda (including final questions and WebEx details) will be posted 3/13/19.

Regenerative Medicine and Antithrombotic Guidelines Now Available


Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines


Responsible, Safe, and Effective Use of Antithrombotics and Anticoagulants in Patients Undergoing Interventional Techniques: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Methylprednisolone May Provide Short-Term Relief From Acute Diskogenic Sciatica

The study’s primary outcome was change in the intensity of leg pain, assessed at baseline, and daily for 5 days after treatment.
Intravenous (IV) administration of methylprednisolone may be associated with short-term pain relief in patients with acute diskogenic sciatica, according to a study published in Pain Medicine .
In this multicenter double-blind controlled trial, individuals with confirmed acute diskogenic sciatica and leg pain (with an intensity >40 mm on a 0 to 100 mm visual analog scale), but without neurologic deficits, were randomly assigned to receive IV methylprednisolone 60 mg at 8:00 am and a 0.9% saline solution at 6:00 pm (n=17), IV ketoprofen 100 mg at 8:00 am and 6:00 PM (n=19), or placebo (0.9% IV saline at 8:00 am and 6:00 pm; n=17). The study's primary outcome was change in the intensity of leg pain assessed at baseline and daily for 5 days after treatment. Secondary outcomes included lumbar pain at day 5, Straight Leg Raise Test and lumbar flexion index at day 5, oral morphine consumption at day 5, need for lumbar spine injections or surgery during the study.


Patients With Chronic Pain Found to Continue Opioids Despite Little Clinical Improvement

Patients with chronic noncancer pain were followed for 24 months at 4 multidisciplinary chronic pain clinics.
Patients initially prescribed opioids for chronic noncancer pain were found to continue the treatment over long periods of time, despite poor clinical improvement, according to the results of a 2-year prospective study published in Pain Medicine .
In this cohort study, patients with chronic noncancer pain were followed for 24 months at 4 multidisciplinary chronic pain clinics. Study participants had pain that lasted ≥3 months and patients were recruited at the first clinical consultation. The investigators collected demographic data, pain characteristics, and opioid prescription information at baseline and at 3, 6, 12, and 24 months. The International Association for the Study of Pain Taskforce on Pain Classification for the International Classification of Diseases-11 was used to classify pain.

Does Opioid Tapering in Chronic Pain Result in Controlled Pain at Taper Completion?
All studies examined had a type 3 or 4 level of evidence, but reported pain levels before and after taper.
Opioid tapering may result in an alleviation of chronic pain , but this notion is based on low-level evidence, according to a systematic review published in Pain Medicine .
For this systematic review, a total of 20 studies — published in Embase, Medline, Psychological Abstracts, PsycINFO, CINAHL, Science Citation Index, or the National Library of Medicine Physician Data Query database — in which the effects of opioid tapering were examined in alleviating pain in patients with chronic pain (n=2109) were examined. All studies had a type 3 or 4 level of evidence (ie, studies were not controlled) and reported pain levels before and after taper.


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

FDA Committees Vote on Esketamine Nasal Spray for Treatment-Resistant Depression

The Food and Drug Administration (FDA)’s Psychopharmacologic Drug Advisory Committee and Drug Safety and Risk Management Advisory Committee voted in favor (14 yes, 2 no, 1 abstain) of the approval of esketamine nasal spray (Spravato; Janssen) for the treatment of adult patients with treatment-resistant depression (TRD).
The decision was based on data from five Phase 3 studies assessing the safety and efficacy of esketamine, a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist; patients in these studies had a history of inadequate response to least 2 prior antidepressants and generally had more severe symptoms than those who participated in antidepressant studies for previously approved drugs.
Results from 2 of these Phase 3 studies (1 short-term, 1 long-term), which primarily provided the evidence to support effectiveness, showed that treatment with esketamine nasal spray plus a newly initiated oral antidepressant was associated with a statistically significant, clinically meaningful, rapid, and sustained improvement of depressive symptoms vs placebo nasal spray plus a newly initiated oral antidepressant.

Fish Oil Dietary Supplement Use Examined Among Cardiac Patients

A recently published study found that the majority of cardiac patients utilizing fish oil dietary supplements did so without the recommendation of a healthcare professional and without proper medical supervision.
In order to determine and better understand misconceptions regarding fish oil dietary supplements, the study authors assessed patient’s patterns of use and knowledge surrounding these products. During the study, an anonymous survey was presented to 1000 consecutive patients in the in-patient cardiology service at the Creighton University Medical Center between January 2015 and March 2017.
The survey included 10 multiple choice questions inquiring about reasons for use, active ingredients in and brand of the product, prescriber recommendations, purchase place, cost, pill burden, and the use of supplements versus prescription omega-3 fatty acids. Of the total patients who received the survey, 71% (N=711) completed it.


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

Pain Physician
January/February 2019 Issue Features

Sjors H. Wagemakers, MD, Joanne M. van der Velden, MD, PhD, A. Sophie Gerlich, MD, Alinde W. Hindriks-Keegstra, MD, Jacqueline F.M. van Dijk, PhD, and Joost J.C. Verhoeff, MD, PhD.
Cui Zhiyong, MD, Tian Yun, MD, Feng Hui, MD, Yang Zhongwei, MD, and Liu Zhaorui, MD.

Zung Vu Tran, PhD, Anna Ivashchenko, MPH, and Logan Brooks, BA.
Peng-Fei Wu, BD, Ya-Wei Li, MD, Bing Wang, MD, Bin Jiang, BD, Zhi-Ming Tu, BD, and Guo-Hua Lv, MD.

Parisa Nejati, MD, Afsaneh Safarcherati, MD, and Farshid Karimi, MD.


Academy of Integrative Pain Management to Cease Operations

Lenexa, KS, January 29, 2019 – After thirty years as the nation’s leading voice for integrative pain management, the Academy of Integrative Pain Management (AIPM) will cease operations and solicit members’ permission to dissolve as an organization in the coming weeks. AIPM’s Board of Directors voted unanimously on January 26 to take this action. The last day of active business operations for AIPM will be Thursday, January 31.
“This is an incredibly difficult and sad decision,” said Bob Twillman, Ph.D., AIPM’s Executive Director. “Our message has never been more relevant than now, amid the nation’s opioid crisis, yet we have found it increasingly difficult to maintain the resources needed to sustain our efforts. We are proud of our message and of what we have accomplished, especially over the last several years. We hope that others will step into the void we will leave in the pain field and carry on this vital work.”



Tobacco Users More Likely to Be Co-Prescribed Opioids With Benzodiazepines, Muscle Relaxants

Tobacco users accounted for 25.7% of visits for non-cancer pain.
Patients with non-cancer back or neck pain who use vs do not use tobacco may be more likely to be concurrently prescribed opioid analgesics with muscle relaxants and/or benzodiazepines , according to a study published in The American Journal on Addiction .
Investigators analyzed data from a cross-sectional survey conducted between 2006 and 2009 of visits to office-based outpatient physicians, which included 114,199,536 weighted visits from adult patients presenting with non-cancer neck and back pain. During the survey period, the annual rates of prescription or co-prescription were muscle relaxants, 9.9%; benzodiazepines, 2.5%; opioid analgesics, 20.6%; muscle relaxants plus benzodiazepines, 0.5%; muscle relaxants plus opioid analgesics, 9.1%; benzodiazepines plus opioid analgesics, 3.6%; muscle relaxants plus opioid analgesics plus benzodiazepines, 1.3%; none of the three drugs, 52.6%. Tobacco users accounted for 25.7% of visits for non-cancer pain. Of these, 25.6% were prescribed opioid analgesics and 14.7% were prescribed muscle relaxants plus opioid analgesics.

Pain Patients to Congress: CDC's Opioid Guideline Is Hurting Us

WASHINGTON -- Patients with chronic pain are suffering from ham-handed efforts to curb opioid overdoses, a series of witnesses told the Senate Health, Education, Labor and Pensions (HELP) Committee on Tuesday.
In particular, the  CDC's 2016 guidelines for opioid prescribing  came under heavy fire, as even a self-described supporter of its recommendations admitted the evidence base was weak.

In 2018, Congress passed the  SUPPORT for Patients and Communities Act , which included billions of dollars in funding aimed at curbing the overdose epidemic and expanding access to treatment for those with substance use disorders.


Baton Rouge Doctor and His Medical Billing Supervisor Plead Guilty to Fraudulent Billing Scheme
A Baton Rouge, Louisiana-based doctor pleaded guilty yesterday and his medical billing supervisor pleaded guilty today for their roles in a scheme to defraud Medicare and other health care insurers.  
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Brandon J. Fremin of the Middle District of Louisiana, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Field Office, and Special Agent in Charge Eric J. Rommal of the FBI’s New Orleans Field Office made the announcement. 
John Eastham Clark M.D., 66, of Baton Rouge, pleaded guilty on Feb. 13 to count one of an indictment charging him with conspiracy to commit health care fraud. His sentencing has not been scheduled yet by U.S. District Judge Shelly D. Dick of the Middle District of Louisiana, who accepted his plea. Charlene Anita Severio 56, of Walker, Louisiana, pleaded guilty today to one count of an indictment charging her with conspiracy to commit health care fraud and wire fraud and two counts of the indictment charging health care fraud. Her sentencing has not been scheduled yet by Judge Dick, who accepted her plea.

DOJ


Florida Compounding Pharmacy and Its Owners to Pay at Least $775,000 to Resolve False Claims Act Allegations
The Department of Justice announced today that Vital Life Institute LLC (formerly known as AgeVital Pharmacy LLC), located in Sarasota, Florida, and owners Jenny and William Wilkins have agreed to pay at least $775,000 to resolve claims that they violated the False Claims Act by engaging in an illegal kickback scheme to induce the referral of compounded drug prescriptions for TRICARE and Medicare beneficiaries. AgeVital and the Wilkinses have agreed to pay additional amounts in the event certain contingencies are triggered. 
The settlement resolves allegations that AgeVital, at the direction of the Wilkinses, paid kickbacks to a third-party marketing company to solicit prospective patients for compounded drug prescriptions regardless of patient need. The marketing company arranged for prescribers to sign those prescriptions, which were then referred to AgeVital to be filled. The kickbacks to the marketing entity allegedly consisted of a substantial share of the pharmacy’s TRICARE and Medicare reimbursements. The Anti-Kickback Statute prohibits, among other things, the knowing and willful payment of any remuneration to induce the referral of services or items that are paid for by a federal health care program. Claims submitted to federal health care programs in violation of the Anti-Kickback Statute can subject the violator to liability under the False Claims Act.

DOJ

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 karrie@theassociationcompany.com or Tara Morrison at tara@theassociationcompany.com or 770-613-0932.

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


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