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American Society of Interventional Pain Physicians | August 28, 2019
Inaugural Midsouth Meeting in Memphis Next Month – Register Today!
We invite you to the first meeting of the Midsouth Societies of Interventional Pain Physicians September 20-22 in Memphis at the Historic Peabody Hotel.
IPM: Issues, Pitfalls and Opportunities is for physicians and midlevel practitioners for the following states: Alabama, Arkansas, Indiana, Kentucky, Mississippi, Missouri, and Tennessee.
The meeting will address regulatory aspects of opioid therapies while also bringing in the DEA’s perspective. Learn about advances in the field and bring your staff for sessions on billing and coding and denials and appeals.
The Institute for Medical Studies designates the Midsouth 2019 Annual Meeting live activity for a
maximum of 17 AMA PRA Category 1 Credits™ .
Click here for meeting registration.
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Docs Brace for Medicare 'Appropriate' Imaging Rule
With the deadline just 4 months away, fears of unreadiness and unintended consequences abound
As the medical community braces for implementation of the Protecting Access to Medicare Act (PAMA) by the Jan. 1, 2020 deadline, some wonder if it's even feasible or if another program delay is on the horizon.

The policy, aimed at reducing unnecessary testing, mandates that all advanced diagnostic imaging orders go through an algorithm that provides key confirmation codes required when Medicare is billed later on for the service.

Dubbed a "clinical decision support mechanism" (CDSM), this software processes each CT, MRI, nuclear medicine, and PET order before spitting out its verdict to the ordering professional: "appropriate," "maybe appropriate," or "rarely appropriate," according to a certain set of appropriate use criteria (AUC).

Related Story
Electronic Attachment Rule Still Going Begging at CMS
Proposed rule now slated for a December release according to Unified Agenda

WASHINGTON -- "Standards for healthcare attachments." Those four words, contained in this year's Unified Agenda from the Office of Management and Budget, belie a long and unfinished struggle to get the federal government to help with one of physicians' biggest hassles: getting prior authorization from insurers for certain tests and procedures.

Electronic attachments -- test results, x-rays, or anything else that could be sent electronically as part of a prior authorization request -- have long been a hassle for providers because there is no standard format for including them with a prior authorization. Lack of a standard for electronic attachments was one of six barriers to improving the prior authorization process listed in a recent report from the Committee on Operating Rules for Information Exchange (CORE), a division of the Council for Affordable Quality Healthcare (CAQH).

AHA Endorses Prescription Fish Oil for High Triglycerides
High dose recommended in science advisory
Prescription omega-3 fatty acids are an "effective and safe option" to cut down triglycerides, according to a science advisory released by the American Heart Association (AHA).
However, over-the-counter omega-3 supplements are not reviewed or approved by the FDA and should not be used in place of prescription medication for the long-term management of high triglycerides, cautioned writing group chair Ann Skulas-Ray, PhD, of the University of Arizona, Tucson, in a press release.

Join the AMA to help us keep our seat in the House of Delegates

The American Medical Association (AMA) requires all societies to requalify for membership in the AMA House of Delegates (HOD) every five years. In order for ASIPP to retain our seat, the AMA requires that 20% of ASIPP’s physician members also be members of the AMA. Unfortunately, ASIPP is at risk of losing representation in the AMA because we have fallen below the 20% membership minimum threshold.

Membership in the AMA gives us a voice in shaping policy that affects our practice and patients.
We encourage you to join or renew your membership in the AMA. Joining the AMA will further strengthen our specialty’s representation at the national level through the AMA House of Delegates, the AMA’s policymaking body, and strengthen our ability to meet the challenges in health care today with thoughtful, well-organized responses.

We strongly encourage you to join the AMA today to help us keep our seat at the table. Right now, you can become a member and pay only half the dues.

The stronger our membership, the more we can advance issues that are important to our specialty including improving the Medicare Quality Payment Program, reducing administrative burdens and ensuring accurate coding and reimbursement of our services.

Thank you for supporting ASIPP!

Click HERE to join today and pay only half price! 
Johnson & Johnson ordered to pay $572 million for its role in Oklahoma’s opioid crisis

NORMAN, Okla. — A judge Monday found Johnson & Johnson responsible for fueling Oklahoma’s opioid crisis, ordering the health-care company to pay $572 million to remedy the devastation wrought by the epidemic on the state and its residents.

Cleveland County District Judge Thad Balkman’s landmark decision is the first to hold a drugmaker culpable for the fallout of years of liberal opioid dispensing that began in the late 1990s, sparking a nationwide epidemic of overdose deaths and addiction. More than 400,000 people have died of overdoses from painkillers, heroin and  illegal fentanyl  since 1999.

“The opioid crisis has ravaged the state of Oklahoma and must be abated immediately,” Balkman said, reading part of his decision aloud from the bench Monday afternoon.

Blocking key protein could treat chronic pain

New research in mice suggests that targeting a particular protein in the spinal cord could form the basis of a new pain relief medication that could relieve chronic pain for thousands of people.

Approximately 20% of adults in the U.S. are currently living with chronic pain.
About  one-fifth  of adults in the United States are living with chronic pain, which is a pain that lasts for longer than 3 months. However, one specific type of chronic pain is of particular concern — neuropathic pain.

Neuropathic pain results from nerve injury and around  10%  of the U.S. population may be living with it. Due to rising life expectancy and contributory lifestyle factors, estimates suggest that this figure will increase.

Association of Restless Legs Syndrome With Risk of Suicide and Self-harm

Key Points

Questions Is restless legs syndrome associated with a high risk of suicide and self-harm? Questions   Is restless legs syndrome associated with a high risk of suicide and self-harm?

Findings   In a cohort study that included 169 373 participants, individuals with restless legs syndrome had a higher risk of suicide and self-harm compared with age- and sex-matched participants without restless legs syndrome, and the increased risk was independent of common diseases and conditions.

Meaning   Restless legs syndrome was associated with an increased risk of suicide and self-harm.

Importance   Restless legs syndrome (RLS) is a common neurologic disorder that has been previously found to be associated with higher odds of suicidal ideation. In the context of the increasing suicide rate in the United States, the evidence regarding the association between RLS and the risk of suicide and self-harm is limited.

Objective   To investigate the association between RLS and risk of suicide and self-harm.

Design, Setting, and Participants   This cohort study was performed using Truven Health MarketScan national claims data from 2006 to 2014; the baseline data were from 2006 to 2008, and the follow-up data covered 6 years (January 1, 2009, to December 31, 2014). Included were 24 179 nonpregnant participants with RLS and 145 194 age- and sex-matched participants without RLS at baseline (2006-2008), who were free of suicide, self-harm, cardiovascular disease, or cancer at study baseline. Data analysis was performed from February 1, 2018, to January 1, 2019.

Exposure   Diagnosis of RLS, as identified by the  International Classification of Diseases Ninth Revision  code.

Main Outcomes and Measures   Incident suicide and self-harm event, identified by the  International Classification of Diseases Ninth Revision  diagnosis code.

Results   Among 169 373 participants in the current analysis, the mean (SD) age was 49.4 (9.1) years; 53 426 (31.5%) participants were men. During a mean (SD) follow-up duration of 5.2 (2.2) years, 119 incident suicide and self-harm cases were identified. Individuals with RLS had a higher risk of suicide or self-harm compared with those without RLS (adjusted hazard ratio, 2.66; 95% CI, 1.70-4.15), after adjusting for lifestyle factors (eg, alcohol and obesity), presence of chronic diseases (eg, depression, insomnia, diabetes, chronic kidney disease, peripheral neuropathy, iron-deficiency anemia, and Parkinson disease), and use of medications. Excluding those with depression, insomnia, obstructive sleep apnea, and other common chronic conditions, the significant association between RLS and suicide or self-harm persisted (adjusted hazard ratio, 4.14; 95% CI, 2.17-7.92).

Conclusions and Relevance   Restless legs syndrome was associated with a high risk of suicide and self-harm, and the risk was independent of most identified diseases and conditions.

Drugmakers Endo, Allergan agree to $15 million in settlements in major opioid case

Reuters) - Endo International Plc and Allergan Plc have agreed to pay $15 million to avoid going to trial in October in a landmark case by two Ohio counties accusing various drug manufacturers and distributors of fueling the U.S. opioid epidemic.

The tentative deals disclosed on Tuesday came ahead of the first trial to result from 2,000 lawsuits pending in federal court in Cleveland largely by local governments seeking to hold drug companies responsible for the deadly epidemic.

Endo announced said it had reached an agreement-in-principle to pay Cuyahoga and Summit counties $10 million to and provide them up to $1 million worth of two of its of its drug products free of charge.
Allergan has tentatively agreed to pay $5 million to resolve claims involving its branded opioids, though the deal does not resolve claims involving generic painkillers, said Frank Gallucci, a lawyer for Cuyahoga County.

The Health 202: Fewer Americans are abusing opioids. But the improvements vary dramatically by state
A new government survey shows opioid abuse is declining by double digits — welcome data to public health advocates and policymakers who are wrestling with an epidemic that has crippled communities across the nation.

And the improvements come as more people gain access to addiction-fighting medication, despite the Trump administration’s attempts to discourage Medicaid expansion and pull back on the Affordable Care Act.

Eleven percent fewer Americans reported pain reliever misuse in 2018 compared with the year prior, according to an annual survey released yesterday by the Substance Abuse and Mental Health Services Administration. Heroin use is declining among adults under age 26 and holding steady among those older. The survey also showed declines in the use of other drugs including cocaine, methamphetamine and hallucinogens.
HHS proposes rule to reform substance abuse confidentiality regs
The Department of Health and Human Services wants to ease decades-old regulations preventing physicians from knowing patients’ histories of addiction treatment.

Congress passed Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) more than 40 years ago because of concerns about the potentially negative consequences—including discrimination—that could come from disclosing the patient records of individuals with substance use disorders.

The proposed rule modifies several sections of 42 CFR Part 2 to “encourage care coordination among providers, including updating the definition of what constitutes a Part 2 record and its applicability,”
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
ABIPP Part I  
Combined CSM/CCPM Exam for ABIPP Path
Competency Exam in Controlled Substance Management
Competency Exam in Coding, Compliance, and
Practice Management

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

June 14
ABIPP Competency Exam

939 Ridge Lake Blvd. | Memphis, TN 38120
Progress Against Cardiometabolic Death Stalls in U.S.
"Very concerning" and persistent racial disparities seen in population-based study

Long-running trends toward improved survival for patients with diabetes, stroke, and heart disease essentially stalled in the past decade, researchers found, while deaths related to hypertension continued their climb extending back to at least 1999.

Age-adjusted mortality rates (AAMRs) per 100,000 people decreased from 1999 to 2017 for the following conditions, reported Sadiya Khan, MD, MSc, of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues:

  • Heart disease: from 266.5 to 165.0
  • Stroke: from 61.6 to 37.6
  • Diabetes: from 25.0 to 21.5

Amgen Shows Price Is Still Right for Blockbuster Drug Deals

U.S. stocks have been wobbly lately, but the health-care deal market is still vibrant.
Amgen   AMGN +0.82%  said Monday  it plans to purchase  the anti-inflammatory drug Otezla from  Celgene   CELG +0.13%  for $13.4 billion in cash. Shares of  Bristol-Myers Squibb  , BMY +0.58%  which is planning to acquire Celgene for $74 billion in cash and stock, rallied in response.

There was a good reason for that. Bristol-Myers did so well despite not operating from a position of strength. The company said back in June that  Celgene would sell Otezla  to satisfy Federal Trade Commission scrutiny over the deal. Bristol-Myers has a drug in its pipeline that could potentially compete with Otezla.

Amgen is paying more than eight times last year’s sales for the drug. Thanks to the high price, Bristol-Myers is increasing its planned stock-buyback program, scheduled for when the deal closes, to $7 billion from $5 billion.

Access to this article may be limited.
Feds: PainMD's abandoned medical records at risk of being burned, shredded

  • PainMD and Rinova clinics shut down, stranding ex-patients without medical records.
  • Thousands of records have been abandoned in locked storage units.
  • Prosecutors worry the records — potential evidence — will be burned or shredded.

Federal and state prosecutors have asked a judge to halt the destruction of thousands of  medical records abandoned by PainMD , a Nashville-area pain clinic company that shut down earlier this year in the midst of a fraud investigation.

The medical records, which could be evidence against PainMD or important to former patients, are currently stuck in storage units spread across Tennessee, Virginia and South Carolina.

Where Are Nurses Needed Most?
Six things to know about the nursing shortage

It's no secret that the U.S. is in desperate need of nurses. The nursing shortage is a growing problem that's putting pressure on nursing staff around the country, and that's because of patients living longer, educational bottlenecks, and a staggeringly high turnover rate< https://dailynurse.com/3-reasons-many-nurses-leaving-profession/> in the healthcare industry.

As a nursing student, you're probably well aware of these issues. In fact, it may even be one of the primary reasons you're pursuing a nursing career in the first place. After all, what could be more fulfilling than providing care and support for patients who desperately need it?

There are several areas -- both physical and occupational -- where the need for nurses is at an all-time high. If your true calling is to make a difference in the lives of your patients, here are six nursing shortage facts that may influence where you end up after graduation.

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

Hospital appointments cancelled 10 times in a row amid NHS chaos

Andrew Marsden's NHS hospital appointment was cancelled four times, despite fears he had suffered a second stroke.

Hospital patients are having vital appointments cancelled more than 10 times in a row, amid growing chaos across the NHS. 

A Daily Telegraph investigation reveals soaring numbers of patients - many elderly - are suffering repeated cancellations, with notice only given in some cases the night before via letters dispatched by taxi. 

Blog: Insurers Win and Patients Lose… Again
While insurers grow more powerful, patients and doctors are losing control of medicine, says Kevin Campbell, MD

The country's biggest health insurers earned more than $11 billion in profit in Q2 this year, and Kevin Campbell, MD, has had enough of the industry continuing to grow without a fight from patients and physicians.

The opinions expressed in this commentary are those of the author. The following transcript has been edited for clarity.

In an era where many Americans are not able to afford high-quality healthcare due to rising healthcare costs, I find it interesting that health insurers' profits are growing -- by billions of dollars just in the last year.

This week, an article in FierceHealthcare highlighted the steep increase in earnings realized by many major insurers over the second quarter of 2019. Much of this profit increase is thought to be due to the benefits of creating a much smaller competitive market through mergers and acquisitions.
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

DC Physician Indicted for Almost $13M in Medicare Fraud

A physician who has a practice in the District of Columbia has been charged with participation in an alleged $12.7 million healthcare fraud scheme that involved submitting false claims to Medicare for complicated procedures that were never performed, according to a Department of Justice (DOJ) news release.

In an indictment filed July 30 in the District of Columbia, physiatrist Frederick Gooding, MD, aged 68, of Wilmington, Delaware, was charged with 11 counts of healthcare fraud. He was arrested on August 1.
According to the indictment, from January 2015 to August 2018, Gooding participated in a healthcare fraud scheme in which he submitted Medicare claims for injections and aspirations that were not medically necessary, not provided, or both.

Northern Nevada Doctor Sentenced To Prison For Illegally Writing Opioid Prescriptions

RENO, Nev. – A northern Nevada doctor specializing in family medicine was sentenced today to one year and one day in federal prison and ordered to pay a $125,000 fine for overprescribing highly addictive pain pills Oxycodone and Hydrocodone not for a legitimate medical purpose, announced United States Attorney Nicholas A. Trutanich for the District of Nevada, Special Agent in Charge Aaron C. Rouse for the FBI’s Las Vegas Field Office, and Special Agent in Charge Timothy B. DeFrancesca for the Office of Inspector General of the United States Department of Health and Human Services.

Dr. Shouping Li, 57, the former Vice Chief of Staff for Humboldt County General Hospital in Winnemucca, Nev., pleaded guilty in February 2019, to distribution of a controlled substance, specifically Oxycodone and Hydrocodone. In addition to the imprisonment, United States District Judge Miranda Du sentenced Dr. Li to three years of supervised release.

According to court documents, the investigation into Dr. Li, who specialized in family medicine with a concentration in cardiovascular disease, began in March 2018, after the FBI received reports of several deaths related to opioid pain medication overdoses and allegations that Dr. Li may have illicitly been prescribing narcotics not for a legitimate medical purpose. Dr. Li admitted that, between August 2015 and February 2018, he prescribed Oxycodone and Hydrocodone at a high dosage rate to his patients outside the usual course of his professional practice and without a legitimate medical purpose. He further admitted that several of his patients passed away while he actively attended to them.


Charges Filed Against Dozens in Trafficking Network Responsible for Diverting Over 23 Million Oxycodone, Hydrocodone and Carisoprodol Pills
DEA Also Takes Administrative Action and Immediately Suspends Seven Pharmacies and Two Providers; DOJ Announces Expansion of Health Care Fraud Strike Force into Rio Grande Valley and San Antonio

A total of 41 individuals have been charged in nine indictments for their alleged involvement in a network of “pill mill” clinics and pharmacies. Those charged include medical providers, clinic owners and managers, pharmacists, pharmacy owners and managers as well as drug dealers and traffickers. Their actions allegedly resulted in the diversion of approximately 23 million oxycodone, hydrocodone and carisoprodol pills. 

In addition, federal law enforcement agents executed 36 search warrants including 15 pharmacies and six “pill mill” clinics, as well as other offices and residences, aimed at disrupting networks of opioid diversion. The Drug Enforcement Administration (DEA) also served immediate suspension orders on seven pharmacies and two providers involved in dispensing controlled substances without legitimate medical purpose.


State Society News 
October 25-27, 2019

California Society of Interventional Pain Physicians 10 th annual meeting
The Resort at Squaw Creek, Lake Tahoe.

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