American Society of Interventional Pain Physicians | September 27, 2017
Physician-owned practices spend $19k per physician on health IT:
4 key statistics

The  National Interventional Pain Management – Qualified Clinical Data Registry (NIPM-QCDR), a new resource from ASIPP®, is specifically tailored for interventional pain physicians. Your practice can use the NIPM-QCDR to fulfill the 2017 requirements of the Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS). Specifically, you can meet MIPS mandates for  Qualityand  Improvement Activities, and receive credit toward  Advancing Care Information.
The NIPM-QCDR combines rich CMS reporting capabilities with the first-ever set of measures specifically designed for interventional pain medicine. Participating in the NIPM-QCDR will make quality reporting more meaningful to your everyday practice, and help you improve care and optimize results.
Upcoming deadlines:
Full reporting: Sign up before November 3 to avoid a downward payment adjustment (penalty), and potentially earn a neutral or positive payment adjustment (bonus), by submitting a partial year or a full year of data.
Minimal reporting: Sign up before December 15 to avoid a downward payment adjustment (penalty) by submitting the minimum amount of data (one measure).

To learn more and get started, visit .

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. 

We would like to invite you to submit research case reports, brief commentaries and reviews to Interventional Pain Management Reports Journal . Your article will be published FREE’ of charge. 

Led by Editor in Chief: Kenneth Candido, MD, Chairman and Professor, Department of Anesthesiology , Advocate Illinois Masonic Medical Center in Chicago, IPM Reports focuses on the promotion of excellence in the practice of interventional pain management and clinical research. 

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
Short Perspectives

Click HERE to submit
Start Planning NOW! ASIPP Abstract Submission for 2018 Annual Meeting is Open
The American Society of Interventional Pain Physicians will hold its 20th Annual Meeting March 15-17, 2018 in Orlando, Florida at Marriott Orlando World Center.
This year, we will be making significant changes to the Abstract and Poster Sessions. Submissions will be in two categories: Resident/Fellow and Physician.  Selected posters will be on display for all meeting participants during all breaks and meal times.
The Abstract Committee will select the top 25 for publication in Pain Physician and of those 10 will be selected for Abstract presentation and judging during the Annual Meeting. The top 3 will receive cash prizes.
Tenet CEO to exit with $22.9M in severance pay

Dallas-based Tenet Healthcare's longtime CEO Trevor Fetter is set to receive a $22.9 million severance package when the company secures a new leader.
Tenet announced in August it was replacing Mr. Fetter, who has led the 77-hospital chain since 2003. He will step down by March 15, 2018, or when Tenet appoints a successor, whichever occurs first.
According to proxy materials filed earlier this year, Mr. Fetter will receive a $22.9 million severance package when he leaves the company. That amount includes: $10.85 million in cash payments; accelerated equity awards of $8.29 million; $3.74 in supplemental executive retirement plan and executive retirement account benefits; health and welfare benefits of $42,273; and $25,000 in outplacement services.

Disclosure of Pre-Referral Medical Errors: Attitudes and Practice Patterns
Disclosing errors to patients can be difficult for clinicians. Fears of litigation and professional embarrassment can be barriers in these situations. But disclosing the medical errors in diagnosis or previous treatment committed by a referring physician or institution adds another layer of complexity.
To determine what those barriers might be and how they might be addressed to improve patient care, Lesly A. Dossett, MD, MPH, of the University of Michigan Institute for Health Policy and Innovation in Ann Arbor, and colleagues conducted semi-structured interviews of 30 cancer specialists from 2 cancer care centers who described having a greater than 50% reliance on external referrals. A thematic analysis of interview transcripts, published in the  Annals of Surgery,  was then performed to determine physician attitudes towards disclosing errors and barriers to providing full disclosure.

$2B in DSH payment cuts set to kick in Oct. 1

Disproportionate Share Hospital payments — allotments established under Medicaid and Medicare to offset a portion of uncompensated care at hospitals that serve a disproportionate share of low-income patients — will be cut by $2 billion Oct. 1 without legislative action, according to STAT.
With the expectation of lower uninsured rates and lower levels of hospital uncompensated care, the ACA adjusted the available amounts of DSH funding. With the Supreme Court ruling that threw out the mandate for Medicaid expansion and the uncertainty regarding the ACA's future, safety-net hospitals are stuck in an unintended policy gap, according to STAT.
The ACA calls for aggregate reductions to DSH payments annually from fiscal year 2014 through fiscal year 2020. Subsequent legislation delayed the start of the reductions until fiscal year 2018, which begins Oct. 1, and pushed the end date back to fiscal year 2025. DSH payments would be  gradually reduced by a total of $43 billion over the eight-year period.

Physician practices examine risk adjustment coding in wake of federal lawsuits
Doctors need to carefully and properly use the HCC codes, which indicate the expected costs for a patient.
A federal lawsuit claims that UnitedHealth Group, the largest Medicare Advantage insurer in the country, is coding medical claims inappropriately for monetary gain. But while the lawsuit doesn't involve physician practices, many practices are now paying more attention to risk adjustment coding than ever.
At the heart of the UnitedHealth lawsuit is the claim that the insurer inflated its Medicare Advantage risk scores, which are determined by the level of services required by each beneficiary. Higher risk scores translate into higher payments from the government, and the contention is that this dynamic has created an incentive for plans to squeeze the maximum  reimbursement  possible.
FDA conducts major global operation to protect consumers from potentially dangerous prescription drugs sold online
The U.S. Food and Drug Administration, in partnership with international regulatory and law enforcement agencies, recently took action against more than 500 websites that illegally sell potentially dangerous, unapproved versions of prescription medicines, including opioids, antibiotics and injectable epinephrine products to American consumers.
These actions were part of a major global operation that the FDA participated in to target illegal drugs being marketed online, and shipped and distributed through the postal system, directly to American consumers. Among other actions, the FDA also issued warning letters to the operators of a majority of the illegal websites that were targeted in the operation and worked with internet registrars to confiscate certain websites. Patients who buy prescription medicines from illegal online pharmacies may be putting their health at risk because the products, while being passed off as authentic, may be counterfeit, contaminated, expired, or otherwise unsafe.
Failure of ACA Repeal Brings ‘Momentary Relief’ for Hospitals and Insurers
The failure of Senate Republicans’  latest attempt to roll back the Affordable Care Act  relieves health companies, but hospitals and insurers will quickly pivot back to worries about implementation of the existing law as the crucial open-enrollment season looms.
The bill, from Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, had drawn widespread opposition from hospitals, doctors and health insurers. The industry broadly condemned cutbacks to the Medicaid program, as well as a redistribution of ACA funding through block grants that would have left many states with less federal health-care support. Insurers and health-care providers said the bill would have left far fewer people with coverage.

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CVS Health Fighting National Opioid Abuse Epidemic With Enterprise Initiatives

CVS Health (NYSE: CVS) announced today that, as part of the company’s broad commitment to fighting the national opioid abuse epidemic, it is enhancing its enterprise-wide initiatives supporting safe drug disposal, utilization management of pain medications and funding for treatment and recovery programs.
“As America’s front door to health care with a presence in nearly 10,000 communities across the country, we see firsthand the impact of the alarming and rapidly growing epidemic of opioid addiction and misuse,” said Larry J. Merlo, President and CEO, CVS Health. “Today we are announcing an expansion of our enterprise initiatives to fight the opioid abuse epidemic that leverages CVS Pharmacy’s national presence with the capabilities of CVS Caremark, which manages medications for nearly 90 million plan members.”
To support this goal, CVS Caremark will roll out an enhanced opioid utilization management approach for all commercial, health plan, employer and Medicaid clients as of February 1, 2018 unless the client chooses to opt out. This program will include limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to therapy; limiting the daily dosage of opioids dispensed based on the strength of the opioid; and requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

U. S. Attorney General Jeff Sessions announced the formation of the Opioid Fraud and Abuse Detection Unit, a new Department of Justice pilot program to utilize data to help combat the devastating opioid crisis that is ravaging families and communities across America. The new Opioid Fraud and Abuse Detection Unit will focus specifically on opioid-related health care fraud using data to identify and prosecute individuals that are contributing to this prescription opioid epidemic. Additionally, as part of the program, the Department will fund twelve (12) experienced Assistant United States Attorneys for a three (3) year term to focus solely on investigating and prosecuting health care fraud related to prescription opioids, including pill mill schemes and pharmacies that unlawfully divert or dispense prescription opioids for illegitimate purposes.

Steroid, Benzodiazepine Bridge Therapy Effective for Medication Overuse Headaches
In patients with medication overuse headaches, bridge therapy with intravenous (IV) methylprednisone and diazepam was shown to reduce headache pain and painkiller intake up to 3 months after withdrawal, according to research published in  Neurological Sciences . 1
Researchers retrospectively evaluated 94 patients with chronic migraine and  medication overuse  headache. A total of 46 patients underwent detoxification with a 5-day IV infusion of methylprednisone and diazepam in a day-hospital setting. The remaining patients refused detoxification therapy (n=48), primarily due to difficulties with receiving the therapy over the 5 days.
Harnessing the Power of Technology in Your Medical Practice
Ubiquitous connectivity is a personal and professional requirement in this digital age, but assessing the myriad mobile technologies available can be daunting. Steven Chan, MD, Clinical Informatics Fellow at the University of California, San Francisco, attempted to shed some light on telehealth in his presentation at the 2017 Psych Congress this week and provided instructions for how clinicians can connect with their psychiatric patients. 1
Recognizing the types of digital consumer is necessary for ensuring optimal use of digital tools. Digital immigrants are those individuals who are slow to adapt technology. They tend to use the Internet as a secondary information source and prefer hard copy information to virtual files. These individuals tend to learn slowly and methodically. Conversely, digital natives are efficient at multitasking and are often fast to accommodate new and different processes and products. They often prefer graphics to text, and the text they consume should be in small packages. Digital natives often learn quickly, and can master information presented to them in a random fashion.
Are Abuse-Deterrent Opioids the Answer to the Opioid Crisis?
Abuse-deterrent opioid formulations may not be the most effective solution to the opioid crisis, according to an editorial published in the  New England Journal of Medicine . 1
There is a trend toward higher drug-overdose deaths in middle-aged adults in the United States, attributed largely to the misuse and abuse of opioid medications. Despite the rise of opioid abuse across the nation, pharmaceutical companies are continuing to work toward influencing both state and federal opioid policies.
Department of Justice News

District Court Enters Permanent Injunction Against Two New Jersey Companies and Two Individuals to Stop Distribution of Unapproved and Misbranded Drugs
Two companies in New Jersey and two individuals have been enjoined from distributing their unapproved injectable skin whitening drugs and other drugs in violation of federal law, the Department of Justice announced today.
The U.S. District Court for the District of New Jersey entered a consent decree of permanent injunction against Flawless Beauty LLC of Ocean Township and Asbury Park, New Jersey; RDG Imports LLC of Asbury Park, New Jersey; and Jack H. Gindi and Susana B. Boleche. The injunction permanently enjoins the defendants from distributing unapproved and misbranded drugs in violation of the federal Food, Drug, and Cosmetic Act (FDCA). In addition, the injunction requires the defendants to recall and destroy all of their unapproved injectable skin whitening drugs.

Pharmacy Manager Pleads Guilty to Illegal Prescription Drug Diversion and Money Laundering
A pharmacy manager from Burnsville, North Carolina, pleaded guilty for her role in the fraudulent diversion of prescription drugs and money laundering, the Department of Justice announced today.
Karen Ann Turner, 37, pleaded guilty in the Western District of North Carolina to one count of conspiracy to commit wire fraud and one count of money laundering. Turner was charged in connection with a fraudulent scheme that operated out of pharmacies in Burnsville, North Carolina, and Travelers Rest, South Carolina. As a part of that scheme, Turner bought prescription drugs at lower prices by falsely stating that the drugs would be used to fill patient prescriptions through the pharmacies that she operated. Instead of using the drugs for patient prescriptions, Turner sold them at higher prices to unauthorized drug wholesalers. Some of the prescription drugs that Turner bought and sold were in short supply. Turner laundered the profits of her fraud scheme by transferring them through bank accounts that she controlled. Sentencing will be scheduled at a later date. 

State Society News 

October 7, 2017: New York
The 2017 The Art and Science of Pain Management: A Clinical and Research Update will be Oct. 7, 2017 at The Gideon Putnam, 24 Gideon Putnam Road, Saratoga Springs, NY 12866
The meeting is sponsored by Albany Medical College’s Department of Neuroscience and Experimental Therapeutics and the Office of Continuing Medical Education and the Albany Medical Center Provider Unit for Continuing Nursing Education. Registration Deadline is October 2, 2017.
For information regarding the conference, contact the Office of Continuing Medical Education by phone at (518) 262-5828, fax at (518) 262-5679 or e-mail at

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ASIPP | Pain Physician Journal | Phone | Fax | Email