We knew it would be coming soon... but looks like it's here now!
Email from ASIPP:
After a nice Thanksgiving message, I would like to bring all of you back into reality. Things are rapidly deteriorating. Just as we thought, we were close to resolving the single-dose vial issue which is still not resolved. We have also been dealt a huge blow with the CRNA issue.
Above all, we have a major issue worse than fiscal cliff -ours is a real cliff. We can call it an IPM cliff. Essentially we have been thrown off the cliff with CMS delivering a major blow with the publication of the potential National Coverage Decision (NCD) topics.
It is now left up to us to fight among ourselves or to work together and form a united front. It is finally time to put arrogance, ignorance, and greed aside and preserve interventional pain management.
This is how it happened - CMS invited the public's input concerning any items and services that may be inappropriately used (i.e., underused, overused, or misused) or provide minimal benefit in hospitals, clinics, emergency departments, doctor's offices, or in other health care settings. CMS asked the public to be specific about items and services including surgical procedures, diagnostic tests or procedures, imaging or radiology services, lab tests, or durable medical equipment; treatment for diseases such as cancer, heart disease, kidney disease, or gastrointestinal disease; or procedures such as orthopedic or eye procedures. Based on the request from America's health insurance plans and multiple other insurers, CMS, among various other topics, has included facet joint blocks, epidural injections, and neurostimulators.
CMS obviously states that they reviewed and evaluated all of the submissions and believe that many of the suggested topics may be suitable candidates for further review. CMS also admits that there are LCDs for these subjects in almost every state. Here is the link for the list of NCD topics: http://www.cms.gov/medicare-coverag...icare-coverage-document-details.aspx?MCDId=19
If the NCD arrives with a negative or non-coverage decision, it will be devastating to our specialty. Believe me when I say that this is exactly what insurers want to happen. Remember the fate of IDET. The day after the decision, the entire interventional pain management will be shut down. This will not only affect Medicare/Medicaid, but all insurers. I always thought this would come from PCORI. Consequently, we were working on PCORI, to prevent this from happening. Now it turns out they are doing this administratively rather than through PCORI. There is a very slim chance of getting a positive decision, and also a slim chance of getting a neutral decision, but there is a significant probability that the decision could be negative. A negative decision is what we have to worry about.
Our defense of interventional pain management have surpassed getting paid for each nerve, fluoroscopy for each nerve or each joint, payment differentials in one setting than other setting, working on 50% relief or 80% relief or no diagnostic blocks; payment for multiple transforaminal with interlaminar, MAC anesthesia, now we are be fighting for our specialty. It can be eliminated in its entirety.
We beg you not to react hastily. We have a plan. We are working with the administration and Congress to resolve this issue. However, there is a good probability that we may not be able to resolve it until it goes to a hearing. Even then we need a well-orchestrated approach to succeed.
At this time we are requesting everyone who can afford to contribute as much as possible to ASIPP for the survival of interventional pain management and subsequently ASIPP. We are committed to doing whatever is necessary financially and otherwise.Vijay has contributed over $10,000. We also have received commitments from Ramsin and his partner, each $5,000; John Swicegood, $5,000; Jim Wilson, $5,000; David Bryce, $3,000; Sairam Atluri, $2,000; Kendall Hansen, $5,000; Aaron Calodney, $2,500; and Xiulu Ruan has contributed $3,000.
We are requesting a year-end tax deductible contribution of at least $1,000 from each member. We are providing a link to a form which will allow you to not only make this contribution but also to pay your 2013 dues in advance if you have not already done so. (Contribution and Dues Form) We believe many of the board members and membership can actually contribute at a much higher rate. As you all know, both of us have contributed substantially, especially Lax.
Let us work together to preserve the interventional pain management. I've always used this statement in reference to our future, but now the meaning has changed. We now have to preserve it for the present in order to have a future. As JFK once said, "Success has many fathers, but failure is an orphan."
Thank you,
Lax and Frank
Laxmaiah Manchikanti, MD
Chairman of the Board and Chief Executive Officer, ASIPP and SIPMS
Medical Director, Pain Management Center of Paducah
2831 Lone Oak Road
Paducah, KY 42003
Clinical Professor
Anesthesiology and Perioperative Medicine
University of Louisville, Kentucky
Phone: (270) 554-9412
Fax: (270) 554-5394
E-mail: [email protected]
Frank J.E. Falco, MD
President, ASIPP
Medical Director, Midatlantic Spine
139 East Chestnut Hill Road
Newark, DE 19713
Clinical Assistant Professor
Temple University Medical School
Philadelphia, PA
Phone: (302) 369-1700
Fax: (302) 369-1717
[email protected]
Email from ASIPP:
After a nice Thanksgiving message, I would like to bring all of you back into reality. Things are rapidly deteriorating. Just as we thought, we were close to resolving the single-dose vial issue which is still not resolved. We have also been dealt a huge blow with the CRNA issue.
Above all, we have a major issue worse than fiscal cliff -ours is a real cliff. We can call it an IPM cliff. Essentially we have been thrown off the cliff with CMS delivering a major blow with the publication of the potential National Coverage Decision (NCD) topics.
It is now left up to us to fight among ourselves or to work together and form a united front. It is finally time to put arrogance, ignorance, and greed aside and preserve interventional pain management.
This is how it happened - CMS invited the public's input concerning any items and services that may be inappropriately used (i.e., underused, overused, or misused) or provide minimal benefit in hospitals, clinics, emergency departments, doctor's offices, or in other health care settings. CMS asked the public to be specific about items and services including surgical procedures, diagnostic tests or procedures, imaging or radiology services, lab tests, or durable medical equipment; treatment for diseases such as cancer, heart disease, kidney disease, or gastrointestinal disease; or procedures such as orthopedic or eye procedures. Based on the request from America's health insurance plans and multiple other insurers, CMS, among various other topics, has included facet joint blocks, epidural injections, and neurostimulators.
CMS obviously states that they reviewed and evaluated all of the submissions and believe that many of the suggested topics may be suitable candidates for further review. CMS also admits that there are LCDs for these subjects in almost every state. Here is the link for the list of NCD topics: http://www.cms.gov/medicare-coverag...icare-coverage-document-details.aspx?MCDId=19
If the NCD arrives with a negative or non-coverage decision, it will be devastating to our specialty. Believe me when I say that this is exactly what insurers want to happen. Remember the fate of IDET. The day after the decision, the entire interventional pain management will be shut down. This will not only affect Medicare/Medicaid, but all insurers. I always thought this would come from PCORI. Consequently, we were working on PCORI, to prevent this from happening. Now it turns out they are doing this administratively rather than through PCORI. There is a very slim chance of getting a positive decision, and also a slim chance of getting a neutral decision, but there is a significant probability that the decision could be negative. A negative decision is what we have to worry about.
Our defense of interventional pain management have surpassed getting paid for each nerve, fluoroscopy for each nerve or each joint, payment differentials in one setting than other setting, working on 50% relief or 80% relief or no diagnostic blocks; payment for multiple transforaminal with interlaminar, MAC anesthesia, now we are be fighting for our specialty. It can be eliminated in its entirety.
We beg you not to react hastily. We have a plan. We are working with the administration and Congress to resolve this issue. However, there is a good probability that we may not be able to resolve it until it goes to a hearing. Even then we need a well-orchestrated approach to succeed.
At this time we are requesting everyone who can afford to contribute as much as possible to ASIPP for the survival of interventional pain management and subsequently ASIPP. We are committed to doing whatever is necessary financially and otherwise.Vijay has contributed over $10,000. We also have received commitments from Ramsin and his partner, each $5,000; John Swicegood, $5,000; Jim Wilson, $5,000; David Bryce, $3,000; Sairam Atluri, $2,000; Kendall Hansen, $5,000; Aaron Calodney, $2,500; and Xiulu Ruan has contributed $3,000.
We are requesting a year-end tax deductible contribution of at least $1,000 from each member. We are providing a link to a form which will allow you to not only make this contribution but also to pay your 2013 dues in advance if you have not already done so. (Contribution and Dues Form) We believe many of the board members and membership can actually contribute at a much higher rate. As you all know, both of us have contributed substantially, especially Lax.
Let us work together to preserve the interventional pain management. I've always used this statement in reference to our future, but now the meaning has changed. We now have to preserve it for the present in order to have a future. As JFK once said, "Success has many fathers, but failure is an orphan."
Thank you,
Lax and Frank
Laxmaiah Manchikanti, MD
Chairman of the Board and Chief Executive Officer, ASIPP and SIPMS
Medical Director, Pain Management Center of Paducah
2831 Lone Oak Road
Paducah, KY 42003
Clinical Professor
Anesthesiology and Perioperative Medicine
University of Louisville, Kentucky
Phone: (270) 554-9412
Fax: (270) 554-5394
E-mail: [email protected]
Frank J.E. Falco, MD
President, ASIPP
Medical Director, Midatlantic Spine
139 East Chestnut Hill Road
Newark, DE 19713
Clinical Assistant Professor
Temple University Medical School
Philadelphia, PA
Phone: (302) 369-1700
Fax: (302) 369-1717
[email protected]
