Column from our keynote speaker Robert Laszewski on replacement of Obamacare with Republicans and Democrats working together..  

It is not a question of whether or not Republicans and Democrats will come to a compromise over replacing Obamacare. Since it will take 60 Senate votes, and the Republicans only have 52 seats, there is no way we can get to a solution to the Obamacare conundrum without a bipartisan compromise.

So, what might that look like?  

CNBC

Physicians generally billed uninsured or out-of-network patients several times what Medicare would have deemed appropriate, researchers found, with anesthesiologists topping the list of specialists racking up the most in excess charges.

In their study of Centers for Medicare & Medicaid Services records from the 2014 calendar year, Ge Bai, PhD, CPA, and Gerard F. Anderson, PhD, both of Johns Hopkins University in Baltimore, found that physicians typically charged a median of 2.5 times the Medicare allowable amount. They reported their findings from 429,273 physicians across 54 medical specialties in the January 17, 2017 issue of the Journal of the American Medical Association.

MedPage Today

Nearly 100 Conclusions on the Health Effects of Marijuana and Cannabis-Derived Products Presented in New Report; One of the Most Comprehensive Studies of Recent Research on Health Effects of Recreational and Therapeutic Use of Cannabis and Cannabis-Derived Products  

WASHINGTON – A new report from the National Academies of Sciences, Engineering, and Medicine offers a rigorous review of scientific research published since 1999 about what is known about the health impacts of cannabis and cannabis-derived products – such as marijuana and active chemical compounds known as cannabinoids – ranging from their therapeutic effects to their risks for causing certain cancers, diseases, mental health disorders, and injuries.  The committee that carried out the study and wrote the report considered more than 10,000 scientific abstracts to reach its nearly 100 conclusions.  The committee also proposed ways to expand and improve the quality of cannabis research efforts, enhance data collection efforts to support the advancement of research, and address the current barriers to cannabis research. 

National Academies of Sciences, Engineering and Medicine

Many of you probably have not seen the cuts implemented at ambulatory surgery centers effective January 1st for epidurals (16.3%), facet joint injections (25%), adhesiolysis (25%), and sacroiliac joint injections (16%). 

We need to act on this issue to not only reverse the cuts for this year, but also proactively approach the problem for next year.  And with a new Administration now in office, we have a chance to reverse these cuts retroactively and reinstate or improve the previous reimbursement for 2018.  

ASIPP will be assisting in this endeavor; however, the main impetus will be from the Society of Interventional Pain Management Surgery Centers (SIPMS). If you are a surgery center owner, or have significant interest in one, please complete the MEMBERSHIP FORM. 

You can also contribute through the ASIPP-PAC FORM.   

And if you know of anyone else with ownership in a surgery center, please send their information to Savannah Gold at sgold@asipp.org. Be sure to include the name of the contact person, name of the surgery center, and any other contact information

The order, issued late Friday, encouraged officials to use “all authority and discretion available to them” to waive or delay ACA provisions they deem onerous on individuals, states or insurers. It isn’t yet clear how many provisions officials may choose to apply that to or when, leaving the political and health care worlds in a state of some confusion.

At a minimum, the move signals Mr. Trump’s willingness to take aggressive public aim at the law often dubbed Obamacare, as Republicans in Congress wrestle with their own efforts to dismantle the law and come up with a new health-insurance system in its place.    

Wall Street Journal

The newly elected board effective April 20, 2017 is as follows:

President-Elect:  Hans Hansen, MD  

First Executive Vice-President of Regional Affairs [Emissary to the State Societies] (new):  Sudhir Diwan, MD  

First Executive Vice-President:  Frank Falco, MD  

Second Executive Vice-President:  Harold Cordner, MD  

Secretary:  Bradley Wargo, DO  

Treasurer:  Standiford Helm, MD  

Vice-President of Strategic Planning: Sanjay Bakshi, MD  

Vice-President of Strategic Alliances (new):  Sukdeb Datta, MD  

Directors Emeritus:  Ramsin Benyamin, MD, Peter Staats, MD  

Academic Directors:  Salahadin Abdi, MD, Christopher Gharibo, MD, Jay Grider, MD, Joshua Hirsch, MD  

Young Physician Directors:  Steve Aydin, DO,  Kaylea Boutwell, MD, George Chang Chien, DO, Devi Nampiaparimpil, MD, Amol Soin, MD  

Directors at Large:  Sheri Albers, DO, Scott Glaser, MD,  Dharam Mann, MD, Annu Navani, MD, Sanford Silverman, MD, Deborah Tracy, MD  

Resident / Fellow: Michael Lubrano, MD

Nonparticulate corticosteroids are safer and as efficacious as particulate corticosteroids in relieving radicular pain, according to a systematic review published in Physical Medicine and Rehabilitation.1 Based on their findings, the investigators suggest that nonparticulate corticosteroids should be the preferred treatment in patients receiving these agents via cervical and lumbosacral epidural steroid injections (ESIs) using a transforaminal approach. There was insufficient evidence for the researchers to make a recommendation on preferred steroid preparation when using a lumbar intralaminar approach.

“Given the lack of strong data favoring the efficacy of one [preparation] over the other, and the potential risk of catastrophic complications, all of which have been with particulate steroids, nonparticulate steroid preparations should be considered as first-line agents when performing ESIs,” the investigators wrote.  

  Clinical Pain Advisor