States withholding reimbursements to non-ACGME fellowship trained physicians

[nopain1234]

Ive heard rumblings of this, where is this happening and do you foresee this becoming more of a trend going forward?

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[gaseous_clay]

Ive heard rumblings of this, where is this happening and do you foresee this becoming more of a trend going forward?

When you mention states, are you referring to commercial insurers within a particular group of states or government payors like Medicaid?

 

[RoloTomassi]

Ive heard rumblings of this, where is this happening and do you foresee this becoming more of a trend going forward?

You mean no ACGME pain fellowship or primary residency?

 

[nopain1234]

You mean no ACGME pain fellowship or primary residency?

Yea non-accredited fellowship

I’m mainly referring to commercial insurances

 

[drusso]

Ive heard rumblings of this, where is this happening and do you foresee this becoming more of a trend going forward?

Societies are thinking about writing letters.

 

[RoloTomassi]

Yea non-accredited fellowship

I’m mainly referring to commercial insurances

Strange given the trend to give mid-levels more privileges.

Societies are thinking about writing letters.

In support of or against holding reimbursement? They have conflicting interests

 

[myrandom2003]

This won’t fly.
All you need is certification in your primary specialty.
In addition many states have rules about not requiring certification to get privileges and other rules that will violate state insurance rules and then complaints can be filed to the states insurance commissioner.

 

[nvrsumr]

Would be great. Way too many “providers” putting downward pressure on reimbursement.

Won’t ever happen. Talk about this happening on this board for 15+ years.

 

[nopain1234]

So to be clear, this hasn’t happened anywhere and isn’t going to anytime soon?

It impacts my decision to hire a future partner

 

[nopain1234]

Societies are thinking about writing letters.

Would this be enough to enforce such a large change? Seems awfully opportunistic IMO and there are too many other parallels in other specialties

So we will have the latitude to tell neurosurgeons they aren’t allowed to do ESIs? What about interventional radiologists? Heck what about general anesthesiologists who are fully capable of doing LESIs

 

[nopain1234]

I for one am much more worried about the ground swell of CRNAs who are actively trying to enter the pain space. I’ve had more than a dozen ask me to proctor them for their online “fellowships”. I believe they’re up to 4

 

[Darkside_]

I for one am much more worried about the ground swell of CRNAs who are actively trying to enter the pain space. I’ve had more than a dozen ask me to proctor them for their online “fellowships”. I believe they’re up to 4

How do you respond to this request diplomatically?

Do you guys also train them to perform peripheral nerve blocks for perioperative purposes?

 

[nopain1234]

How do you respond to this request diplomatically?

Do you guys also train them to perform peripheral nerve blocks for perioperative purposes?

Basically say no in a nice way. They’re obtaining regional experience from weekend courses.

 

[Pain Applicant1]

I was going to open up a second office early in my career in the Bronx in NYC. I wasn't yet board-certified in pain and some state or city (don't remember) bureaucrat wouldn't give me the necessary permission/permit/license/whatever to open up a pain clinic without board certification, despite being board eligible. I was going to fight it but ended up having kids instead so they put the kibosh on that. Thank god for that.