October 16, 2019
Pain Physician
September/October 2019 Issue Features
The September/October issue of Pain Physician features a cost utility analysis of cervical interlaminar epidural injections as well as several systematic reviews, randomized trials and original research.
Cost Utility Analysis
Laxmaiah Manchikanti, MD, Vidyasagar Pampati, MSc, Allan Parr, III, MS, Maanasa V. Manchikanti, ., Mahendra R. Sanapati, MD, Alan D. Kaye, MD, PhD, and Joshua A. Hirsch, MD.

Narrative Review
Inna Blyakhman, MSc, and Krishnan Chakravarthy, MD, PhD.

Comprehensive Review
Ajay B. Antony, MD, Anthony J. Mazzola, MD, Gurpreet S. Dhaliwal, MD, and Corey W. Hunter, MD.

Narrative Review
Gabriel Fregoso, MD, Annie Wang, MD, Kelly Tseng, MD, and Jingping Wang, MD, PhD.

Retrospective Review
Leonardo Kapural, MD, PhD, Nicholas Lee, ., Kevin Neal, MD, and Michael Burchell, MD.

June 27 - June 28, 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 27
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 27-28
ABIPP Competency Exam
Regenerative Medicine Competency Exam
Endoscopic Lumbar Decompression Competency Exam

939 Ridge Lake Blvd. | Memphis, TN 38120  
Dead or Married: At Population Level, the Choice Grows Starker
New mortality data show gap between the married and the unmarried keeps growing

A friend once taught her dog to lie down and play dead in response to "Would you rather be dead or married?" When it comes to humans, though, the choice seems to be real, at least at the population level -- and a new CDC analysis found that the mortality gap between married persons and everyone else continues to widen.

In 2017, the age-adjusted death rate for married people age 25 and older was 780 per 100,000, versus 1,369 to 1,657 per 100,000 for the never-married, divorced, and widowed, according to a "Health E-Stats" release Thursday from the CDC's National Center for Health Statistics .

Moreover, the rate for married people edged downward from the 2016 level, whereas it ticked upward for each of the other unmarried groups.
The report's authors -- Sally C. Curtin, MA, and Betzaida Tejada

HHS releases regulations to overhaul the Stark Law to entice value-based payment arrangements

The Trump administration has proposed new exemptions and safe harbors to the Stark Law and anti-kickback statute to spur more physicians and healthcare facilities into value-based care arrangements.
The reforms, a proposed rule from the Centers for Medicare & Medicaid Services and another proposal from Health and Human Services' Office of Inspector General, aim to update the 1989 Stark Law that bans physicians from referring patients to facilities they have a financial stake in. The proposed regulations would create a permanent exception to the law to shield legitimate value-based deals from penalties.

“Unfortunately the looming threat of liability under the Stark Law has discouraged many providers from entering into value-based arrangements in the first place,” Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said in a call with reporters Tuesday.

Objective Marker of Chronic Pain on the Horizon
— Cerebral blood flow shows promise in early study

Brain scans focusing on spatial variations in cerebral blood flow correlated with the presence -- though not severity -- of chronic knee pain, researchers said.
The findings could eventually lead to a "brain signature of chronic pain," according to Dorothee Auer, MD, of Queen's Medical College in Nottingham, England, and colleagues.
With sufficient data collected from 44 patients and 29 healthy controls in an ongoing study of knee osteoarthritis, variance in cerebral blood flow (as measured with MRI arterial spin labelling) distinguished patients with chronic pain from controls with encouraging accuracy (area under the receiver-operating characteristic curve of 0.83), Auer and coauthors wrote in a manuscript posted to the medRxiv preprint server .

CMS Unveils New Rules: Too Little Too Late?
Physicians have too much paperwork but Kevin Campbell, MD, says this one change is not enough

This past week, CMS announced a new "rule" known as the Omnibus Burden Disruption. This apparently has been issued to address the rising rate of burnout among U.S. physicians due to ridiculous and oppressive paperwork requirements instituted by the government. While the devil is likely in the details, the rule is supposed to "remove Medicare regulations identified as unnecessary, obsolete, or excessively burdensome on hospitals and other healthcare providers to reduce inefficiencies and move the nation closer to a healthcare system that delivers value, high quality care, and better outcomes for patients at the lowest possible cost."
My goodness -- this sounds like Shangri-La, right? Why now, all of a sudden, are the regulations that were considered absolutely necessary by the Obama administration, now considered burdensome and obsolete? Apparently this new "rule" will "increase flexibility for providers and reduce burdensome regulations." In fact the CMS press release goes on to say that the new rules will allow providers to focus on their patients: wow -- what a novel thought! I am so glad that our government thought of that one!

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

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

HHS: Don't Withdraw Opioids Suddenly
Department issues guideline on tapering and discontinuation
Clinicians seeking to wean patients off opioid painkillers should do so slowly and only with shared decision-making involving the patient, according to a new guideline released Thursday by the Department of Health and Human Services (HHS).

The lone exception is when patients face a life-threatening crisis if opioids are continued, the document stated.

Clinicians seeking to wean patients off opioid painkillers should do so slowly and only with shared decision-making involving the patient, according to a new guideline released Thursday by the Department of Health and Human Services (HHS).

The lone exception is when patients face a life-threatening crisis if opioids are continued, the document stated.

FDA issues warnings to companies selling illegal, unapproved kratom drug products marketed for opioid cessation, pain treatment and other medical uses
The U.S. Food and Drug Administration issued warning letters to two marketers and distributors of kratom products – Cali Botanicals of Folsom, California, and Kratom NC of Wilmington, North Carolina – for illegally selling unapproved, misbranded kratom-containing drug products with unproven claims about their ability to treat or cure opioid addiction and withdrawal symptoms. The companies also make claims about treating pain, as well as other medical conditions like depression, anxiety and cancer.

“We have issued numerous warnings about the serious risks associated with the use of kratom, including warnings about the contamination of kratom products with high rates of salmonella that put people using kratom products at risk, and resulted in numerous illnesses and recalls. As part of our efforts to assess kratom for contamination in the products tested, we also found high levels of heavy metals in kratom products. Despite our warnings, companies continue to sell this dangerous product and make deceptive medical claims that are not backed by science or any reliable scientific evidence,” said Acting FDA Commissioner Ned Sharpless, M.D. “As we work to combat the opioid crisis, we cannot allow unscrupulous vendors to take advantage of consumers by selling products with unsubstantiated claims that they can treat opioid addiction or alleviate other medical conditions.”


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