Reversal of 2014 ESI Cuts Coming in 2015?

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Sig123

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Anyone see this posted on the ASIPP website today? Seems like good news for once:

Epidural Cuts Reversed for 2015, Continued for 2014, Pay Your AMA and ASIPP Dues to
Keep a Voice for IPM

April 14, 2014

We are now entering Phase 3 of the epidural cuts. As promised, ASIPP has been working aggressively on this issue. We are making progress and have some major updates on the epidural cuts as some important reminders regarding your AMA Membership.
The Good News:
Following the process initiated by Representative Ed Whitfield, in a bicameral, bipartisan discussion with Arkansas delegation which included Senators Boozman and Pryor, and 4 house members, we heard the good news that epidural cuts will be fixed for 2015 in the proposed schedule which will be released in June 2014. According to Administrator Tavenner the problem is two-fold.
1. There was a process issue, her folks moved on the cuts before they had the AMA recommendations. She is working to change the process so that they don't act until they have information from AMA in the future.
2. She is addressing the payment issue in the next physician payment proposed rule, which is likely to come out in June 2014. Unfortunately it will NOT help the payments for 2014, but will put a fix in place for 2015. Ms. Tavenner has repeatedly stated that she has taken notice of all the folks talking to her about the issue, as they are not necessarily those she has been in contact with previously. She commented more than once that she is taking a personal role in addressing the issue.
How or what the fix will look like remains to be seen, but her staff will alert us when the proposed rule is ready to go. Most likely they will accept AMA RUC recommendation.
The Bad News and the Future Actions:
The bad news is we do not have a fix for this year. Consequently, we will still be attempting to get the reversal of the cuts through the house, for this year with payments from January 1, 2014. The Energy and Commerce Committee staff have held numerous meetings with them. Also, we now have House Majority Leader Eric Cantor involved in resovling this issue. Consequently, we believe that the house actions will get us the reversal of the cuts.
We would like to thank all the Members of Congress involved in this and many of our members, specifically, John Swicegood. Without John, the Arkansas delegation, who spoke directly to Ms. Tavenner on a phone conference, this would not have happened. Without John and Cindy Swicegood's involvement and Congressman Ed Whitfield's initiation of the discussion with the Administrator this could have never happened. We also recognize our membership for sending over 11,000 letters to CMS and over 65,000 letters to Members of Congress, and the 40 letters sent to CMS from Members of Congress.
Renew Your AMA Membership to Keep Our Voice on the AMA HOD, CPT and RUC
In order for ASIPP to maintain its seat on the American Medical Association (AMA) House of Delegates (HOD) submitted our member spreadsheet to the American Medical Association (AMA), we must submit our membership data to the AMA for a 5-year review to determine that we still meet the 35% membership AMA/ASIPP match requirement needed to maintain our HOD seat. We would urge you to check your membership status by April 11, 2014. If you are not current on your dues renew them this week. If you are not already a member, we urge you to join the AMA. You can check your membership status by clicking on the following link: https://commerce.ama-assn.org/membership/

Joining the AMA will further strengthen our specialty's representation at the national level through the AMA HOD, the AMA's policymaking body, and strengthen our ability to meet the challenges in interventional pain management today with thoughtful, well-organized responses, specifically in the areas of coding (CPT) and reimbursement (RUC).

As a member of the AMA, you will get access to a broad range of practice management resources and publications such as the Journal of the American Medical Association, AMNews, AMA Morning Rounds and the Archives journals. So this is a win-win request.

Please take this opportunity to support the critical activities of ASIPP by joining the AMA today. To join the AMA, visit https://commerce.ama-assn.org/membership/ or call (800) 262-3211.
Let us continue our fight by advocacy for 2014 reversal of the cuts through keeping our AMA memberships current (thus keeping our seats on the AMA HOPD, CPT, and RUC) and paying ASIPP dues as well. The expenses of fighting the epidermal cuts continue to mount so if you have not paid your assessment or regular dues, please pay these as soon as possible. (Dues and Assessment Form)
Thank you for doing your part to save IPM.
Thank you,
Lax and Ramsin

Members don't see this ad.
 
Nobody has anything to say about this? Call me optimistic -- but this seems like pretty darn good news.
 
Yeah. It is amazing news and many thanks to the leaders and supporters of ASIPP who made it happen. But, like anything with medicare, I'll believe it when I see my reimbursement change . . .

Also, I've been resistant to joining the AMA for a long time now as I never felt they represented specialists particularly well. But, I never recognized that being an AMA member helped ASIPP maintain a seat on the HOD. It looks like it's time to sign up.
 
Members don't see this ad :)
It's definitely a positive, but we can't stop pushing until it becomes a reality. Plus, it does nothing for 2014. Also, it wouldn't reverse any other procedure cuts (there were many, other than the ESIs) including the massive cuts in in-office stim. It is promising, though.
 
exactly. hopefully they will find a way to retroactively properly pay for services done in 2014. Otherwise, I can see them in the future rescinding the 2015, if they see what was 'saved'.

either way, asipp is important to support, that's why I went this year and every other year thus far to their meeting.
 
As of this point, it is just wishful thinking that there is a fix. Neither Congress nor CMS will guarantee to fix a problem in physician reimbursement, and it is a long way before 2015. We have stopped performing all interlaminar and caudal epidural steroid injections for Medicare and commercial insurance tied to Medicare rates and will not resume unless this "fix" restores previous values. Some patients are suffering significantly because they cannot be off anticoagulants at all, and we were able to provide caudal injections for them before the most recent series of Medicare fiascos.
 
As of this point, it is just wishful thinking that there is a fix. Neither Congress nor CMS will guarantee to fix a problem in physician reimbursement, and it is a long way before 2015. We have stopped performing all interlaminar and caudal epidural steroid injections for Medicare and commercial insurance tied to Medicare rates and will not resume unless this "fix" restores previous values. Some patients are suffering significantly because they cannot be off anticoagulants at all, and we were able to provide caudal injections for them before the most recent series of Medicare fiascos.
Do you tell your patients this? If not, just quietly doing it will have no effect, in fact, the decreased "utilization" may cause them to declare victory in cost savings. If you tell the patients (ie, "voters") there's a chance that voter backlash could cause action. All politicians care about is keeping their own jobs, and unless they fear voters could throw them out on the street, they're unscathed.
 
You're not doing interlaminar C ESIs?
 
As of this point, it is just wishful thinking that there is a fix. Neither Congress nor CMS will guarantee to fix a problem in physician reimbursement, and it is a long way before 2015. We have stopped performing all interlaminar and caudal epidural steroid injections for Medicare and commercial insurance tied to Medicare rates and will not resume unless this "fix" restores previous values. Some patients are suffering significantly because they cannot be off anticoagulants at all, and we were able to provide caudal injections for them before the most recent series of Medicare fiascos.
is this because you are doing the procedures in-office?

as my office has long been the recipient of a large proportion of medicaid, i have not yet seen an influx of medicare patients, but i expect they will come.
 
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