American Society of Interventional Pain Physicians | March 27, 2019
Room Block Extended to April 8!
Time to Make Plans To Attend ASIPP 21 st Annual Meeting
Join Us in Vegas! Come to the Annual Meeting on May 3-5 and Meet the New ASIPP Board Members


The Annual ASIPP® meeting is one the most exciting and educational meetings in the world . We bring to you the most renown speakers who will deliver the highest caliber lectures. Th is year’s A nnual M eeting features 11 exemplary keynote speakers, more than 60 distinguished speakers, nearly 80 key topics – all related to interventional pain management .  


Chairman of the Board and CEO: Laxmaiah Manchikanti, MD 
 
Outgoing President: Hans Hansen, MD
 
Incoming President: Sudhir Diwan, MD 
 
President-Elect: Harold Cordner, MD 
 
First Executive Vice-President: Amol Soin, MD 
 
Second Executive Vice-President: Sheri Albers, DO 
 
Vice President-Strategic Affairs: Sukdeb Datta, MD 
 
Secretary: Frank Falco, MD 
 
Treasurer: Sanjay Bakshi, MD 
 
Lifetime Directors: Laxmaiah Manchikanti, MD; Cyru s Bakhit, MD; Vijay Singh, MD
 
Academic Directo rs: Joshua Hirsch, MD; Christopher Gharibo, MD; Sal Abdi, MD; Jay Grider, DO 
 
Young Physician Directors: Jessica Jameson, MD; Helen Blake, MD; Kunj Patel, MD; Kartic Rajput, MD 
 
Resident / Fellow Board member: Yu Chiu, MD 
 
Directors-at-Large: Devi Nampiaparampil, MD; Ricardo Buenaventura, MD; Dharam Mann, MD; Steve Aydin, DO; Deborah Tracy, MD 
 
Directors Emeritus: Ramsin Benyamin, MD; Standiford Helm, MD 
 
AMA House of Delegates/CPT/RUC: Lee Snook, MD, AMA Delegate 
Sachin "Sunny" Jha, MD; AMA CPT Advisory Committee, AMA Alternate Delegate
Michael Lubrano, MD; AMA RFS Representative, AMA RUC Member 
 
Pain Physician Journal: Alan David Kaye, MD , PhD, Editor-in-Chief
 
IPM Reports :  Kenneth Candido, MD, Editor-in-Chief
 
American Board of Interventional Pain Physicians (ABIPP): Mark Boswell, MD , PhD, Executive Director
 
We would like to thank the following outgoing board members, whose terms have expired, for their hard work and dedication the past two years.
Kaylea Boutwell, MD
George Chang Chien, DO
Scott Glaser, MD
Annu Navani, MD
Vikram Patel, MD
Francis Riegler, MD
Sanford Silverman, MD
Peter Staats, MD
Bradley Wargo, DO


Join us at the 21 st Annual Meeting on May 3-5 to welcome the new board and thank the outgoing members!
abipp logo
ABIPP Part 1 Chicago, June 9
June 9 | Chicago, IL
 
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
 
April 1 to April 15, 2019, fee is $2,000
 
April 16 to April 30, fee is total of $3,000
 
No registrations after April 30
 
 
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 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

May1 to May 15, 2019, fee is $2,000

May 16 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
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 Management

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.
REGISTRATION        HOTEL
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

Free-Market Advocate Slams Independent Practice for NPs

WASHINGTON -- The physician shortage will not be solved by allowing nurse practitioners and other advanced practitioners to practice independently without physician supervision, Nicole Johnson, MD, said Monday at a meeting sponsored by the Practicing Physicians of America, a free-market healthcare group.
"Twenty-three states [allow] nurse practitioners to practice unsupervised by physicians," said Johnson, a pediatrician in Cleveland. "Nurses are practicing medicine without a license to do so, and it's dangerous and unsafe for patients." In addition, "they have oversaturated their market and we still need physicians -- they haven't improved access to care and haven't improved affordability -- and this is in the face of a nursing shortage. They need to solve that problem [without] bleeding out the nursing population."
Instead, nurses "should be integrated into physician-led teams and [not act as] physician substitutes," Johnson said.


Accused: Surrogate Endpoints, Non-Inferiority Trials for Cancer Drugs

Researchers questioned the legitimacy of clinical trial designs used to gain FDA approval of new oncology drugs based on surrogate endpoints on the one hand and noninferiority endpoints on the other, in two JAMA Network journal publications.
Questioning the surrogate endpoint study design, researchers found that the use of progression-free survival (PFS) instead of overall survival (OS) as the trial endpoint was associated with a shorter study duration by a mean of 11 months (95% CI 5-17 months) on multivariate analysis, Emerson Chen, MD, Knight Cancer Institute, Oregon Health & Science University in Portland, Oregon, and colleagues reported in JAMA Internal Medicine .



Skip the Turf Wars, Improve Endovascular Stroke Therapy Access?

Faced with a shortage of specialized stroke neurologists in the U.S., some proposed that other interventionists get extra training so they can step in and perform endovascular stroke treatment in places that lack access to this therapy.
"In rural areas and in small- to medium-sized communities without CSCs [comprehensive stroke centers] or 'stroke-ready' teams, skilled extracranial interventionists can play a critically important role in stroke intervention," according to David Holmes, Jr., MD, an interventional cardiologist at the Mayo Clinic in Rochester, Minnesota, and L. Nelson Hopkins, MD, a neurosurgeon at the University at Buffalo, New York.


Federal Fix Needed for Surprise Billing, House Panel Told

WASHINGTON -- Patients aren't the only ones who have problems with surprise billing issues, Rep. Phil Roe, MD (R-Tenn.), said Tuesday at a hearing on the topic .
"I've been negotiated out of healthcare networks," said Roe, an ob/gyn and a member of the House Education and Labor Subcommittee on Health, Employment, Labor, and Pensions. "There are no innocents in this, when you look at insurers, at hospitals; everybody's culpable here."


4 things to know about orthopedic surgeons: 36% still in private practice

The 2018 American Academy of Orthopaedic Surgeons census report provides demographic and specialty information on its membership.
Here are four key trends from the report:
1. Thirty-six percent of the respondents were in private practice or an orthopedic group setting.
2. Seventeen percent of respondents were employed by a hospital while 14 percent of respondents received a salary from an academic institution.
3. Sixty percent of respondents were subspecialists, with 18.2 percent focused on sports medicine and 14.4 percent focused on total joints.
4. On average, the orthopedic surgeon respondents performed 30 procedures per month; just full-time orthopedists performed 32 procedures per month on average.



8 states with the highest, lowest share of surprise out-of-network medical bills

Florida had the highest share of surprise out-of-network medical bills during in-network hospital admissions in 2016 among 37 states and Washington, D.C., according to a report from the Health Care Cost Institute.
For the report, the institute used its commercial claims database to examine about 620,000 in-network inpatient admissions and associated professional claims (both in- and out-of-network claims filed by the physician or other healthcare professional who provided care) in the 37 states and the district in 2016.



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

Opinion: Medicare for All Means Hope for None

Medicare, as President Lyndon B. Johnson put it, is a “light of hope” for elderly Americans. Medicare for All proposals threaten to extinguish it. Medicare for All would break a sacred promise and harm seniors’ access to care by forcing a system designed to support them to take on every other American. They deserve a system that helps them get well, not get in line.
As for your taxes, the question isn’t whether Medicare for All would raise them, but by how many tens of trillions. The Mercatus Center at George Mason University and Emory University’s Kenneth Thorpe calculate 10-year price tags of $32.6 trillion and $24.7 trillion, respectively.


Access to this article may be limited

Related Article:
Verma: 'Medicare for All means hope for none'


Dueling healthcare policy proposals spark $40B stock sell-off

Competing healthcare policy proposals at the federal level have wiped out roughly $40 billion of market value from the largest health insurers, according to Bloomberg .
The sell-off in the S&P 500 Managed Care Index began in late February when some congressional Democrats began voicing support for "Medicare for All" proposals. It continued this week as the Department of Justice said it supports a judge's ruling that the entire Affordable Care Act should be invalidated.



UnitedHealthcare abruptly exits Iowa's Medicaid program

UnitedHealthcare will pull out of Iowa's managed Medicaid program, Republican Gov. Kim Reynolds said March 29.
The change, which will take place in the next few months, will affect more than 425,000 Medicaid recipients in Iowa. Ms. Reynolds said the departure came after Iowa officials ended negotiations with UnitedHealthcare that included terms the governor's office deemed "unreasonable and unsustainable."
 


Pain Physician
March/April 2019 Issue Features

Systematic Review
Ian D. Coulter, PhD, Cindy Crawford, BA, Howard Vernon, DC. PhD, Eric L. Hurwitz, DC. PhD, Raheleh Khorsan, PhD, Marika Suttorp Booth, MS, and Patricia M. Herman, ND, PhD

Systematic Review
Nitika Sanger, HBSc, Meha Bhatt, MSc, Nikhita Singhal, BHSc, Katherine Ramsden, MD, Natasha Baptist-Mohseni, BSc, Balpreet Panesar, BSc, Hamnah Shahid, BASc, Alannah Hillmer, BSc, Alessia D'Elia, BSc, Candice Luo, BHSc, Victoria Rogers, BSc, Abirami Arunan, HBSc, Lola Baker-Beal, BSc, Sean Haber, BSc, Jihane Henni, BSc, Megan Puckering, BSc, Sunny Sun, BSc, Kim Ng, BSc, Stephanie Sanger, MLIS, Natalia Mouravaska, MD, M. Constantine Samaan, MD, Russell de Souza, ScD, Lehana Thabane, PhD, and Zainab Samaan, PhD

Randomized Trial
Doo-Hwan Kim, MD, Myung-Su Lee, MD, Sookyung Lee, MD, Syn-Hae Yoon, MD, Jin-Woo Shin, MD, PhD, and Seong-Soo Choi, MD, PhD

Randomized Controlled Trial
Neerja Bharti, MD, John Sujith, MD, Navneet Singla, Mch, Nidhi B. Panda, MD, and Indu Bala, MD.


Judge blocks Trump's association health plan rule: 5 things to know

A federal judge ruled that the Trump administration's move to loosen regulations around association health plans doesn't comply with the ACA, according to The Wall Street Journal .
Five things to know:
1. U.S. District Judge John Bates struck down the rule March 28. The judge said the administration's association health plan rule was made to "end run" parts of the ACA.
2. The rule allowed groups or associations to join and obtain health insurance. About 4 million people were expected to enroll in association health plans by 2023, according to Department of Labor data cited by WSJ.
3. While the plans have a lower price tag, they don't cover all of the essential benefits required by the ACA. The Trump administration argued the plans give Americans more options, but opponents of the rule worried they would weaken insurance markets.
4. Kelly Laco, a spokesperson for the Justice Department, said, "We disagree with the district court's ruling and are considering all available options." She continued: "The administration will continue to fight for sole proprietors and small businesses so that they can have the freedom to band together to obtain more affordable, quality healthcare coverage."
5. The Trump administration can request a stay and appeal the judge's decision. The administration can also revisit the rule, according to WSJ.
 


How long does a joint replacement last?

Joint replacement surgery represents one of the biggest and most life-changing advances in modern medicine. It has meant the difference between disability from crippling arthritis and nearly normal mobility for millions of people in recent decades. The hip and knee are, by far, the most commonly replaced joints, and they have the most reliable results. In the US each year, more than 300,000 hips and 700,000 knees are replaced, and the results are generally good. But every time a joint is replaced, an important question looms: how long will it last?
It’s a fair question. After all, no one wants to go through the risk, discomfort, and recovery time required for a major operation only to need it again in a short time.



Dueling healthcare policy proposals spark $40B stock sell-off

Competing healthcare policy proposals at the federal level have wiped out roughly $40 billion of market value from the largest health insurers, according to Bloomberg .
The sell-off in the S&P 500 Managed Care Index began in late February when some congressional Democrats began voicing support for "Medicare for All" proposals. It continued this week as the Department of Justice said it supports a judge's ruling that the entire Affordable Care Act should be invalidated.


Diagnosis of Fibromyalgia: Disagreement Between Fibromyalgia Criteria and Clinician ‐Based Fibromyalgia Diagnosis in a University Clinic
 
Objective
Recent studies have suggested that fibromyalgia is inaccurately diagnosed in the community, and that ~75% of persons reporting a physician diagnosis of fibromyalgia would not satisfy published criteria. To investigate possible diagnostic misclassification, we compared expert physician diagnosis with published criteria.
Methods
In a university rheumatology clinic, 497 patients completed the Multidimensional Health Assessment Questionnaire (MD ‐HAQ) and the 2010 American College of Rheumatology preliminary diagnostic criteria modified for self‐administration during their ordinary m edical visits. Patients were evaluated and diagnosed by university rheumatology staff.
Results
Of the 497 patients, 121 (24.3%) satisfied the fibromyalgia criteria, while 104 (20.9%) received a clinician International Classification of Diseases (ICD) diagnosis of fibromyalgia. The agreement between clinicians and criteria was 79.2%. However, agreement beyond chance was only fair (κ = 0.41). Physicians failed to identify 60 criteria ‐positive patients (49.6%) and incorrectly identified 43 criteria‐negative pa tients (11.4%). In a subset of 88 patients with rheumatoid arthritis (RA), the kappa value was 0.32, indicating slight to fair agreement. Universally, higher polysymptomatic distress scores and criteria ‐based diagnosis were associated with more abnormal MD‐HAQ clinical scores. Women and patients with more symptoms but fewer pain areas were more likely to receive a clinician's diagnosis than to satisfy fibromyalgia criteria.
Conclusion
There is considerable disagreement between ICD clinical diagnosis and criteria ‐based diagnosis of fibromyalgia, calling into question ICD‐based studies. Fibromyalgia criteria were easy to use, but problems regarding clinician bias, meaning of a fibromyalgia diagnosis, and the validity of physician diagnosis were substantial .



Fibromyalgia May Soon Be Reliably Diagnosed By Blood Test
Researchers have identified a "metabolic fingerprint" of fibromyalgia, increasing the probability a reliable blood test may be designed.
Fibromyalgia is notoriously difficult to diagnose , but a study published in the Journal of Biological Chemistry suggests that may soon change.
In the absence of a blood test, clinicians rely on patient-reported symptoms and a physical evaluation of pain to diagnose fibromyalgia. Researchers from Ohio State University have identified a “metabolic fingerprint” of the disease that increases the probability a reliable blood test may be designed. 1
 


New heart-disease prevention guideline: What physicians must know

For decades, it was considered an easy way to prevent a heart attack, stroke or other cardiovascular event: take a low-dose aspirin daily. But for healthy older adults who want to cut their risk of cardiovascular disease, that course of prevention is no longer recommended, according to new advice from the American College of Cardiology (ACC) and the American Heart Association (AHA).  
The  2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease  highlights the need for patients to make healthy lifestyle changes to cut their risk for cardiovascular disease. It also reinforces the AMA and AHA’s commitment to ensuring patients and physicians have the tools they need to prevent cardiovascular disease.  

AMA

Physicians score overwhelming victory in bid to fix prior authorization

Kentucky patients—particularly those with chronic conditions on an established medication regimen—should have speedier access to treatment as a result of a new law reforming health insurance company prior authorization (PA) processes. And their physicians next year are expected to have a major administrative burden reduction.  
Gov. Matt Bevin signed the measure—Senate Bill 54—into law March 26 after it was approved by the Kentucky House of Representatives and Senate by votes of 97–1 and 37–0.  

AMA

Drug Prices on TV? They May Be Coming

WASHINGTON — The Trump administration is moving ahead with its proposal to require drug companies to disclose the often sky-high prices of their products in television commercials, despite strenuous objections and the threat of legal challenges by drug makers and TV broadcasters.
The White House is reviewing the text of a final rule to impose the requirement, contending that the disclosures “will provide manufacturers with an incentive to reduce their list prices by exposing overly costly drugs to public scrutiny.”
President Trump has rolled back dozens of Obama-era regulations affecting financial services, energy and the environment. But he has been willing to impose new rules to rein in what he describes as outrageously high drug prices, and administration officials say these efforts will be politically popular.


ER shift can require 4,000 EHR clicks

Depending on the EHR system physicians use, they can spend significant time clicking on their computer screen, 62 clicks specifically just to order Tylenol, according to Fox News .
For physicians working a full shift in the emergency room, more than 4,000 clicks are required throughout the day. With all that clicking, comes mistakes.


The Good News on Statin Hesitancy

Statin eligible patients who aren't on one were mostly willing to accept a prescription if offered, according to a survey of registry participants.
Among the 1,511 such adults surveyed, 59.2% said they had never been offered a statin, Corey Bradley, MD, of Duke Clinical Research Institute in Durham, North Carolina, and colleagues reported.
But 67.7% of those not offered a statin reported being willing to take one in the findings published in the Journal of the American Heart Association .




Senator: Give Patients Their Health Info, Please

WASHINGTON -- Patients need more access to their health data, Sen. Ron Wyden (D-Ore.), ranking member of the Senate Finance Committee, said here Wednesday at the annual Health Datapalooza meeting sponsored by Academy Health.
"The nation is practically drowning in a tsunami of healthcare consumer data," said Wyden. "Hospitals have it, pharmacies have it, the government's got it, and our smartphones have it. My sense is that what consumers want is something that's understandable and user-friendly to help them get better care, help them get more affordable care, and they want their data protected from thieves and ripoff artists and what they call spying eyes."


Why Isn't Interventional Radiology More Appealing to Women, Minorities?

AUSTIN, Texas -- Interventional radiology had an uneven reputation among medical students in a survey, especially for women and underrepresented minorities (URMs), who tend to choose other specialties for their careers.
The poll of 353 medical school students showed that while URMs were just as likely as other groups to be interested in pursuing interventional radiology, they were less likely to say that they know what interventional radiologists do (OR 0.53, 95% CI 0.35-0.85) nor when to consult the service (OR 0.52, 95% CI 0.30-0.91).


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