What the U.S. needs to do to provide compassionate care in hard times to combat serious illness of COVID-19 epidemic: Expanded Mesenchymal Stem Cells may offer hope

COVID-19 has affected the United States leading it to a national emergency with health care and economic impact, propelling the country into a recession with disrupted lifestyles never seen before in recent history. COVID-19 is a serious illness leading to multiple deaths in the United States. The article in JAMA from Arentz et al published the picture of COVID-19 in the United States serious illness which is not pretty. The mortality looked similar to other countries with some additional issues. A small proportion of patients develop serious illness leading to septic shock and multiple organ dysfunction syndromes. The presently approved treatments are supportive, but not curative for the disease. Dr. Manchikanti one of the authors of the manuscript stated that, “The cure of COVID-19 is essentially dependent on the patient’s own immune system.” In coronavirus infection, the immune system is over activated as the body attempts to kill the virus, which in fact leads to the production of large number of inflammatory factors. This results in a severe cytokine storm like a tornado.” This induces organ damage, starting with changes in air exchange, leading to acute respiratory distress syndrome, followed by cardiac injury and eventually multi-system organ failure and death.

Dr. Manchikanti also stated that “countries are facing extraordinary circumstances.” The article by Atluri, Manchikanti, and Hirsch to be published in Evolutionary Therapeutic Strategy section of Pain Physician , deals exactly with this problem and shows a potential solution with infusion of expanded umbilical cord mesenchymal stem cells. Authors are requesting the President and Coronavirus Task Force to take a 3-pronged approach and provide on a specific and limited basis for permission to give patients expanded umbilical cord mesenchymal stem cells by minimizing regulatory burden and instituting appropriate safeguard to avoid negative consequences from unscrupulous actors. Dr. Manchikanti stated that, “even though there is very limited evidence, the evidence is emerging and what is shown in these Chinese reports is very encouraging.”

Be encouraged, stay positive, and do all you can to remain healthy!
The manuscript is in press in the Pain Physician.
CLICK FOR MORE | Abstract | Manuscript | Fact Sheet |
ASIPP ® Members and Friends:
We want to thank you for your patience following the announcement of the postponement of the 2020 Annual Meeting due to Covid-19. We are pleased to report that the Dallas Hyatt Regency has been very gracious and has worked quickly with ASIPP to secure the same meeting space and same room rate for the new meeting dates of September 4-6.
What you need to know:
  • New this week! Registration is reopened: If you have not yet registered for the meeting, you may register by clicking here.
  • If you have already registered for the meeting, there is nothing more you need to do; your registration will remain as is. If you cannot attend the rescheduled meeting, please send a written request for full refund by April 2, 2020 to or
  • After April 2, the refund and cancellation policy will remain the same except with different deadlines.
  • For information regarding rescheduling or cancelling your flight, click here.
  • If you have booked a room at the Hyatt, the hotel has cancelled all rooms in our April room block. We will alert you when the hotel is ready to accept reservations for our new dates.

Click for the updated brochure. Visit  for more details. We will update this site frequently with new information as it becomes available
Pain Management
Workgroup to Hold Evidence Review Advisory Meeting
Please find the letter  addressed to American Society of Interventional Pain Physicians, along with other pain organizations from the Pain Management Workgroup Evidence Review advisory meeting with important updates.
They are planning an evidence review advisory meeting for LCD policies on facet joint injections and medial nerve branch procedures. The meeting, which will be a combined meeting with all Medicare Administrative Contractors (MACs), is currently planned for May 28th in Nashville and as a teleconference. A link to the meeting and registration information will be posted to each MAC’s website and the CMS Landing Page within the next 2‐3 weeks.  ASIPP will be watching for this posting and will notify you so that you may register to attend.

Some of the ASIPP members are already serving on this committee; however, it is crucial that each state contact their own carriers and try to represent them. We need as many people as you can participate.
It is very crucial that you participate and understand. If you register you should be able to ask questions and give opinions, etc.
Please block your time for May 28 th from 1:00 to 3:00 pm CST.
We are pleased to offer this coronavirus webinar that is designed for
Interventional Pain Management and covers medical and business aspects.

Webinar Agenda

  • Medical Aspects of Coronavirus (Symptoms, Diagnosis, Treatments, Background, Timeline of Future Events, Projections, and Update on New York – Devi Nampiaparampil, MD (Dr. Devi)

  • National and California Coronavirus Response: Navigating Multiple Agencies for Patient and Physician Safety and the Survival of Business – Vanila Singh, MD

  • Statistics and Ohio as an Example of Early Intervention in Prevention of Spread and Lifting Regulations on Opioid Prescribing – Amol Soin, MD

  • Telemedicine options- Examples of use in Pain, how to Interface, Options for Billing and Coding – Ricardo Buenaventura, MD

  • Business and Economic Impacts and Tips for Survival  – Amol Soin, MD
Question and Answers
Register for this informative webinar early. There is limited space. During the webinar you will be able to text questions to speakers. If you prefer send your questions before the webinar to . The webinar will be recorded and made available to all registrants. Once you register webinar access info will be sent to you.
ABIPP Recognizes Your Knowledge and Expertise

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 or call 270-554-9412 x4217 or by email at .
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, Tennessee 38120
June 27 - June 28, 2020 | Hilton Memphis
Dr. Devi Pens Book
Hospitals and healthcare workers struggle to keep up with the demand as the new coronavirus (COVID-19) spreads across the U.S. and throughout the world. 

Hundreds of millions of people are social distancing, quarantining, and sheltering in place to slow down the spread of the virus. The stock market is plunging and the global economy is heading into a recession because of the virus and because of the measures we are enforcing to stop it. Schools are closed. Restaurants, bars, and gyms are closed in many areas of the country. Major sports events, concerts and shows have been cancelled. Perhaps our greatest asset in this fight against the new coronavirus-- healthcare workers-- are becoming infected on the front lines. In the midst of this crisis, Doctor Devi explains what you need to know in a concise and easy-to-understand Question and Answer format.

Dr. Devi Nampiaparampil, a Harvard-trained doctor and a professor at NYU School of Medicine, breaks down the issues in this clear and compassionate handbook. What makes this virus so dangerous? How can I protect myself and my family? How did this happen?

This book discussed the fundamentals behind the coronavirus epidemic.
For the latest guidelines, please always check:
Clinicians Struggle With
PPE Shortages
"We are told every day to defy ... scientifically proven best practices"

Clinicians on the front lines of the COVID-19 pandemic are scraping to find gowns, goggles, respirators, and other personal protective equipment (PPE) -- and coming up empty-handed.

Many are frustrated with their employers for tightening protocols and access to protective gear; others blame the government for not doing more to ramp up production of these goods.

"I just feel like apparently we're expendable," one California emergency room physician speaking on the condition of anonymity told MedPage Today.
Senate Approves Roughly $2 Trillion in Coronavirus Relief
Legislation to provide direct payments to many Americans, expand unemployment insurance, offer health-care providers additional resources

WASHINGTON—The Senate approved the largest  economic stimulus package  in recent memory, moving the estimated $2 trillion bill to the House as Congress seeks to give American families and businesses a financial shield against the ravages of the new  coronavirus pandemic .

Senators approved the legislation 96-0, with four senators absent, after round-the-clock negotiations between the Trump administration and leading senators. Following precipitous declines, investors in the past two days  have sent U.S. stocks soaring  in anticipation of the bill’s passage. President Trump has said he would sign it immediately.
Steny Hoyer (D., Md.), the House majority leader, said late Wednesday that the House would consider the stimulus bill on Friday.
Announcing A New ASIPP ® Partnership - Fedora Billing
And Revenue Cycle
Management Company 
After long discussions, in addition to our NorCal liability program for ASIPP ® members, now we are able to offer unique benefits for revenue cycle management with billing, etc.

Fedora ( ) is a company known to many of our board members and others. ASIPP ® has reached an agreement with Fedora to provide exclusive discounts on billing or revenue cycle management that will decrease practice costs and promote growth, or at least stop deterioration. It is not just a billing company; they streamline the billing and receivable process and constantly update payor regulations keeping your practice up to on date on a daily basis. 

You may view the ASIPP ® billing program website at the following link:  

Some of the ASIPP ® Billing Program highlights are below:
Up to 50% savings for ASIPP ® members for their billing or revenue cycle management for their offices and surgery centers:
  • Expertise in interventional pain management billing for all types of services
  • 99% Clearing House Rate
  • 95% First-Time Claim Passage
  • 23.4 Average Days in A/R
  • Eligibility and Benefits Verification 
  • Pre-Certification/Prior Authorization
  • Denials and A/R Management 
COVID-19: "Pandemic is accelerating", warns WHO

According to the European Centre for Disease Prevention and Control (ECDC), since 31 December 2019 and as of 24 March 2020, 378,041 cases of COVID-19 have been reported, including 16,365 deaths.

Join The Group Purchasing Organization Today
ASIPP ® has formed a partnership with Henry Schein and PedsPal , a national GPO that has a successful history of negotiating better prices on medical supplies and creating value added services for the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today. While the cost of contrast media has skyrocketed due to the single dose vial issue, because we have partnered with Henry Schein, this could enable you to purchase Omnipaque 240mg/50mL for slightly above $4.50.

It will be easy for  ASIPP ® members in good standing to enroll today and begin to realize the savings this partnership can bring. Members can join or see sample prices by going to l   

Click on “view our discounted supplier prices” (Username:ASIPPmember and Password: Save) or click on the words "join for free now" and begin saving today!
An urgent dispatch from the COVID-19 front lines
We are physicians. We are experts at triaging and prioritizing action. Our decisions mean the difference between life and death. We regularly balance competing interests in the setting of constrained resources. We fight hard for our patients. Our job has been likened to “walking through minefields in clown shoes.” It breeds humility. If we make a bad decision, the unthinkable happens. And we are frequently reminded of the fragility of life. We have glimpsed the future of COVID-19 and are horrified. At this point, New York alone is outpacing Lombardia, and  the U.S. is outpacing every Western country thus far . We aren’t waiting for the cavalry to ride in, because there isn’t one coming. It’s up to us.
Here’s what we should demand of our state and federal governments

Physicians, nurses, and hospitals have been working nonstop for weeks and know the tsunami is here. We should have acted long ago, but we cannot waste time arguing about what could’ve been done. We are in the now, and we are going to need your help. The prescription for ending this epidemic is: leadership, organization, creativity, hard work, and proven public health measures. We will need to draw on every resource to do this in the most efficient and effective manner so we can save lives, and everyone else can get back to their own.

It is critical to  flatten the curve . If our ventilators run out, like the toilet paper did, many will die unnecessarily because of shortages. Survival for those who become critically ill is poor, despite every desperate measure we take. Our horror as health care workers on the front line is that we have little to offer patients to change the course of their disease.

States can bend the curve and “buy time” with decisive leadership and action. Buying time means we can:

  • Create better, widely available tests to know who is infected
  • Acquire PPE to protect health care workers
  • Adjust our “business as usual” processes
  • Discover a new therapy that makes this disease an inconvenience and not a death sentence
  • Find a vaccine that is safe and effective
  • Reinstate our normal life-saving care for those who are not infected
FDA Approves Plasma
Treatment for Coronavirus
on Conditional Basis
Plasma would come from patients who have recovered from Covid-19

SILVER SPRING, Md.—The Food and Drug Administration has begun to allow doctors to treat some patients with the blood plasma of patients who have recovered from the coronavirus-caused Covid-19 disease.

The treatment must be approved on a case-by-case basis, and patients must meet certain conditions, the FDA said.

The treatment is considered investigational, and based on the possibility that the so-called convalescent plasma—a portion of whole blood from recovered victims—contains antibodies to the virus that may be effective against the infection.

The agency stressed that “convalescent plasma has not been shown to be effective in every disease studied.” So the plan is for clinical studies of the procedure to begin, probably in about two weeks, FDA officials said. The agency said such research is necessary before routinely using such an approach to treat patients with Covid-19.
Limited COVID-19 Testing Bad for Public Health on Many Levels
Can't reopen America without adequate testing to determine community spread

Targeted, community-based strategies -- as opposed to total shutdowns -- can still help stop the COVID-19 coronavirus epidemic, but only if accompanied by widespread, aggressive testing efforts.

At a Monday press briefing, President Trump bemoaned, "our country was not meant to be shut down," and announced plans "to allow local economies to cautiously resume activity" in a matter of weeks, not months.

This, combined with other statements from experts, seemed to signify the desire to shift back to the more localized strategy of contact tracing, isolation, and quarantine similar to CDC protocol in the earliest stages of the U.S. outbreak when cases came from returning travelers from China.
Fraudulent Coronavirus Tests, Vaccines and Treatments
ISSUE: Some people and companies are trying to profit from this pandemic by selling unproven and illegally marketed products that make false claims, such as being effective against the coronavirus.
These fraudulent products that claim to cure, treat, or prevent COVID-19 have not been evaluated by the FDA for safety and effectiveness and might be dangerous to you and your family. The FDA has also seen unauthorized fraudulent test kits for COVID-19 being sold online.
BACKGROUND: Because COVID-19 has never been seen in humans before, there are currently no vaccines to prevent or drugs to treat COVID-19 approved by the FDA. Currently, the only way to be tested for COVID-19 is to talk to your health care provider.
  • The FDA advises consumers and health professionals to be cautious of websites and stores selling products that claim to prevent, treat or cure COVID-19.
  • Do not take any form of chloroquine unless it has been prescribed for you by your health care provider and obtained from legitimate sources.
  • If you have symptoms of COVID-19, follow the Centers for Disease Control and Prevention’s guidelines and speak to your health care provider. Your health care provider will advise you about whether you should get tested and the process for being tested in your area.
Consumers and health care providers can help by reporting suspected fraud to the FDA’s Health Fraud Program or the Office of Criminal Investigations at
Essentials of Regenerative Medicine in Interventional
Pain Management
Essentials of Regenerative Medicine in Interventional Pain Management is a book to bring concise, collective, and comprehensive information to interventional pain physicians practicing regenerative medicine in managing chronic pain. Regenerative medicine is an integral part of interventional pain management within the definitions of interventional pain management and interventional techniques.

Each chapter contains an introduction of the subject, historical context,pathophysiology, applicability of regenerative medicine with its evidence base, indications, anatomy, technical aspects, complications, and precautions for each topic when available and applicable. This comprehensive book consists of 35 chapters, more than 350 figures, and 50 tables.
Essentials of Regenerative Medicine in Interventional Pain Management | ORDER |
Pain Physician March/April
2020 Articles Available Online Now
The March/April issue of Pain Physician  features
Evolutionary Therapeutic Strategies
Sairam Atluri, MD, Laxmaiah Manchikanti, MD, and Joshua A. Hirsch, MD

Position Statement
Laxmaiah Manchikanti, MD, Christopher J. Centeno, MD, Sairam Atluri, MD, Sheri L. Albers, DO, Shane Shapiro, MD, Gerard A. Malanga, MD, Alaa Abd-Elsayed, MD, MPH, Mairin Jerome, MD, Joshua A. Hirsch, MD, Alan D. Kaye, MD, PhD, Steve M. Aydin, DO, Douglas Beall, MD, Don Buford, MD, Joanne Borg-Stein, MD, Ricardo Buenaventura, MD, Joseph A. Cabaret, MD, Aaron K. Calodney, MD, Kenneth D. Candido, MD, Cameron Cartier, MD, Richard Latchaw, MD, Sudhir Diwan, MD, Ehren Dodson, PhD, Zachary Fausel, MD, Michael Fredericson, MD, Christopher G. Gharibo, MD, Myank Gupta, MD, Adam M. Kaye, PharmD, FASCP, FCPhA, Nebojsa Nick Knezevic, MD, PhD, Radomir Kosanovic, MD, Matthew Lucas, DO, Maanasa V. Manchikanti , R. Amadeus Mason, MD, Kenneth Mautner, MD, Samuel Murala, MD, Annu Navani, MD, Vidyasagar Pampati, MSc, Sarah Pastoriza, DO, Ramarao Pasupuleti, MD, Cyril Philip, MD, Mahendra Sanapati, MD, Theodore Sand, PhD, Rinoo Shah, MD, Amol Soin, MD, Ian Stemper, MS, Bradley W. Wargo, DO, and Philippe Hernigou, MD

Health Policy Review
Laxmaiah Manchikanti, MD, Mahendra R. Sanapati, MD, Amol Soin, MD, Maanasa V. Manchikanti, BS, Vidyasagar Pampati, MSc, Vanila Singh, MD, and Joshua A. Hirsch, MD

Laxmaiah Manchikanti, MD, Mahendra R. Sanapati, MD, Vidyasagar Pampati, MSc, Amol Soin, MD, Sairam Atluri, MD, Alan D. Kaye, MD, PhD, Joysree Subramanian, MD, and Joshua A. Hirsch, MD

Sanjeeva Gupta, MD, and Manohar Sharma, MD
Control Your Waiting Room TV

Customized waiting room TV exclusively for ASIPP ® members. Create your own ad-free television broadcasts using our videos, custom informational slides and your own YouTube videos. Even add local weather reports, news and live messages.
Send in your state society meeting news to Holly Long ,
ASIPP ® | Pain Physician Journal | Phone | Fax | Email