Most of the final rates remained close to the proposed rates. The physician payment rate changed from a 4.4% cut to 4.5% cut. Consequently, we have identified additional reductions. Here are the sample pages for fee schedules:
|
|
Submit your abstracts by December 31, 2022
Questions should be directed to Savannah Gold at
|
|
Great news! Representatives Larry Bucshon (R-Ind.) and Ami Bera (D-Calif.), are introducing a bill that would prevent a 4.4 percent Medicare physician fee payment cut from taking effect on January 1, 2023, through the introduction of the Medicare Access and CHIP Reauthorization Act of 2015 and associated payment mechanism.
This is the bill we have been requesting from members of the Congress to introduce for some time for the last few months. ASIPP has supported this and ASIPP members have sent over 5,000 letters to Members of the Congress to date.
Representatives Bucshon and Bera are supported in this endeavor by six additional representatives, Kim Schrier M.D. (WA-08), Michael Burgess, M.D. (TX-26), Earl Blumenauer (OR-03), Brad Wenstrup, D.P.M. (OH-02), Bradley Schneider (IL-10), and Mariannette Miller-Meeks, M.D. (IA-02). Together they sent a Request for Information: Medicare Payment System Reform letter to members of Congress. Click here to view the RFI Letter.
|
|
Cuts could be devastating to patient care if Congress doesn't take action
Americans expect the best care from their doctors. Decades of experience, thoughtful interdisciplinary planning, and evidence-based research mean providers are treating them based on widely accepted standards of care.
For example, someone who has experienced a heart attack would never be discharged from a hospital without being prescribed medications to mitigate future cardiac events. A patient with acute pulmonary issues would receive medications and resources for oxygen therapy, if appropriate. Stroke patients receive the acute hospital-based care they need to save their lives, as well as a constellation of other types of care and services to decrease complications and enhance recovery -- pharmacological, dietary, and rehabilitative.
Physical therapy and occupational therapy are among the critical standards of care that would be included for all of these patients. These services help form the bedrock of ensuring good outcomes, decreasing secondary injury and complications, and reducing rehospitalizations.
|
|
FASIPP nomination applications are due no later than January 15, 2023. |
|
Resident/Fellow News and Updates |
|
A new California law ensures that doctors found to have engaged in sexual misconduct with patients will never again practice medicine in the state.
It's the latest example of states taking doctor sexual misconduct more seriously after long-standing criticism that medical boards have been too lenient.
The law, which takes effect next month, requires the state's medical board to permanently revoke these doctors' licenses instead of allowing them to petition the board for reinstatement after 3 years.
|
|
Beneficiaries may not be aware of the plans' limited networks or prior authorization rules
Many doctors tell variations of this same frustrating story after every new year. A long-time patient shows up for a routine scheduled appointment with "great news."
"Doc, I heard this terrific TV ad -- even had Star Trek's Captain Kirk -- about a better Medicare plan for me. So I called the number on the screen and an agent signed me up. He said I would save tons of money! So I dropped my drug and supplemental plans, and now my prescriptions, eyeglasses, and hearing aids will all be covered!"
The doctor groans to himself. This patient doesn't realize it, but he is no longer in Medicare. He has been enrolled in a commercial Medicare Advantage (MA) plan run by a private company with a provider network to which his long-time doctor does not belong. Or the doctor is contracted with the plan and in-network, but his practice is at capacity so he's not accepting new enrollees. Or the waiting list is long.
|
|
"Food as medicine" programs can lower blood sugar, reduce hospitalizations, experts note
The U.S. needs a "whole-of-government" approach to addressing diet-related diseases, Sen. Cory Booker (D-N.J.) said Wednesday at a Senate hearing on food as medicine.
"Currently in the United States, half our population is pre-diabetic [or] has type 2 diabetes," said Booker, who is chairman of the Senate Agriculture, Nutrition, and Forestry Subcommittee on Food and Nutrition, Specialty Crops, Organics, and Research. "That is something that isn't exclusively affecting older people ... one-quarter of our teenagers today are pre-diabetic or have type 2 diabetes. Much of that can be attributed to the alarming fact that ultra-processed foods now compose two-thirds of the calories in the diets of our children and teens."
A System Based on Wellness
Booker, a vegan who stopped eating added sugar for 2 months last summer, noted that in September, "the White House released a bold blueprint to end hunger, improve nutrition, and reduce the epidemic of diet-related diseases. A key component of the national strategy is a call to continue researching and scaling up 'food as medicine' programs, such as funding pilot programs to integrate medically tailored meals and nutrition counseling into our Medicare and Medicaid programs."
|
|
Bookmark the ASIPP Annual Meeting Website to stay informed on all announcements and resources related to the meeting.
|
|
Many cases are in children whose parents have chosen not to vaccinate
Measles cases continue to rise in central Ohio, with total cases hitting 74 this week, up from about 50 reported last week, according to Columbus Public Health.
Of the 74 reported cases, all have occurred in children and adolescents, with 69 cases among those younger than 5 years (18 cases in those ages 3-5 years, 33 cases in those ages 1-2 years, and 18 cases in those ages 12 months and younger), and five cases among those ages 5 to 17. Cases are evenly split between boys and girls.
Of note, 26 people have been hospitalized, and none have died.
No cases have been reported in fully vaccinated children, while 69 have occurred in those unvaccinated for measles, and four cases have occurred among children who received one dose of vaccine. One case has "unknown vaccination status."
|
|
- ASIPP Members Only Site Information - |
|
-
To log in for the first time you will need to click “forgot password” at the bottom of the login window.
- Check your email and then log in as directed.
-
If you have problems logging into your account, click here.
|
|
New more aggressive targets for blood pressure and lipids are among the changes to the annual American Diabetes Association (ADA) Standards of Care in Diabetes — 2023.
The document, long considered the gold standard for care of the more than 100 million Americans living with diabetes and prediabetes, was published December 12 as a supplement in Diabetes Care. The guidelines are also accessible to doctors via an app; last year's standards were accessed more than 4 million times.
The standards now advise a blood pressure target for people with diabetes of less than 130/80 mmHg, and low-density lipoprotein (LDL) cholesterol targets of below 70 mg/dL or no greater than 55 mg/dL, depending on the individual's cardiovascular risk.
|
|
Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
|
|
New Edition Now Available! |
|
| CASE REPORT |
Harman Chopra, MD, Alexander Shustorovich, DO, Seth Katzen, DO, and Joel Castellanos, MD
Abstract
BACKGROUND: Pain control remains a challenge for patients suffering from acute malignancy-induced pain. Dorsal root ganglion (DRG) stimulation, normally indicated for chronic pain syndromes, may be an effective tool against neuropathic pain in the setting of tumor invasion.
CASE REPORT: A 63-year-old woman with a past medical history significant for stage 1A endometrial adenocarcinoma status post robotic total hysterectomy and a recently diagnosed presacral mass (high-grade undifferentiated squamous carcinoma) presented for neurosurgical evaluation due to subacute onset of urinary retention, constipation, weight loss, and left lower-extremity pain associated with dysesthesia and impaired gait. Magnetic resonance imaging demonstrated direct invasion of the inferior sacrum and moderate spinal canal stenosis. After a multimodal regimen failed, the inpatient pain service was consulted for consideration of advanced modalities. Since the patient experienced relief from an epidural steroid injection (ESI), the team placed DRG trial leads proximal to the sacral mass at the left L5 and S1 DRGs. The patient had an immediate postoperative pain reduction of 75% to 90%. The primary team and family elected for a prolonged trial (> 7 days) as the patient’s neuropathic pain was significantly improved until the patient expired 22 days post placement.
CONCLUSION: To the best of our knowledge, this is the first DRG trial used to treat refractory, acute cancer-related pain.
KEY WORDS: Acute pain, cancer, case report, dorsal root ganglion stimulator, DRG trial, lumbosacral plexus, malignancy pain, neuromodulation, neuropathy, pain
|
|
| RANDOMIZED CONTROLLED TRIAL |
Mi Geum Lee, MD, PhD, Seung Hyun Chung, MD, PhD, Wol Seon Jung, MD, PhD, Dong Chul Lee, MD, PhD, Kyung Seob Yoon, MD, Jae Chul Koh, MD, PhD, and Hyeon Ju Shin, MD, PhD
Abstract
BACKGROUND: In a costoclavicular (CC) approach of an ultrasound (US)-guided infraclavicular brachial plexus block (BPB), a septum between the lateral and the medial/posterior cords can result in an incomplete block. We hypothesized that double injections in each compartment between the septum would result in a higher success rate of BPB than a single injection in the center of the CC space.
OBJECTIVES: This study was conducted to confirm the superiority of block quality achieved by septum-based double injections (experimental group; group E) over single injection in the center of the CC space (control group; group C).
STUDY DESIGN: A randomized, controlled trial
SETTING: Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Anam Hospital.
METHODS: Sixty-eight patients who underwent upper extremity surgery randomly received a single (SI group, n = 34) or a septum-based double injection (DI group, n = 34) using the CC approach. Ten milliliters of 2% lidocaine, 10 mL of 0.75% ropivacaine, and 5 mL of normal saline were used for BPB in each group (total 25 mL). Sensory-motor blockade of the ipsilateral median, radial, ulnar, and musculocutaneous nerves was assessed by a blinded observer at 5-minute intervals for 30 minutes immediately after local anesthesia administration. The assessed variables were the success rate, the rate of all 4 nerves blockade, and onset time.
RESULTS: Thirty minutes after the block, the success rate was significantly higher in the DI group than in the SI group (64.7% in the SI group vs 91.2% in the DI group, P = 0.009), and the rate of all 4 nerves blockade also significantly increased in the DI group compared to the SI group (44.1% in the SI group vs 91.2% in the DI group, P = 0). The onset time was significantly shortened in the DI group compared with the SI group (26.3 ± 5.6 min in the SI group vs 21.3 ± 6.2 min in the DI group, P = 0.010).
LIMITATIONS: We considered that the location of the septum was always between the lateral cord superficially and the medial/posterior cords below it. In some patients in whom the septum was not visible, a superficial lateral cord was injected first, and then deep medial and posterior cords were injected, assuming that the 2 compartments were divided by the septum.
CONCLUSIONS: Compared with the SI, the septum-based DI of CC approach increased the success rate and the rate of all 4 nerves blockade and shortened the onset time.
KEY WORDS: Brachial plexus block, costoclavicular approach, infraclavicular block, double injection, ultrasound
|
|
| RANDOMIZED CLINICAL TRIAL |
Zhiheng Chen, MD, Xin Wang, MD, Xiaoyan Cui, RN, BN, Guowang Zhang, MD, Jianguang Xu, MD, and Xiaofeng Lian, MD
Abstract
BACKGROUND: Local anesthesia is feasible for both transforaminal and interlaminar approaches in percutaneous endoscopic lumbar discectomy (PELD). However, the optimal approach for PELD has not yet been established at the L5/S1 segment under local anesthesia with 1% lidocaine.
OBJECTIVES: In this study, we compared the transforaminal approach with the interlaminar approach of PELD under local anesthesia for L5/S1 disc herniation (DH).
STUDY DESIGN: This was a prospective randomized clinical trial.
METHODS: From January 2019 to March 2020, 91 consecutive patients with L5/S1 DH who planned to undergo PELD in our unit were randomized to the transforaminal endoscopic lumbar discectomy (TELD, n = 46) or interlaminar endoscopic lumbar discectomy (IELD, n = 45). Both procedures were performed under local anesthesia with 1% lidocaine. The clinical outcomes were assessed as the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) score, and modified MacNab criteria. Patient satisfaction surveys and surgical complications were also recorded and analyzed.
RESULTS: Compared to the IELD group, the TELD group had a shorter operative time and postoperative bed rest time (P < 0.001) but a longer radiation time (P < 0.001) and lower VAS scores for intraoperative back pain (P < 0.001) and leg pain (P < 0.001). At the postoperative follow-up, there were no significant differences between the 2 groups in the VAS scores, ODI scores, or modified MacNab criteria. The surveys showed a significantly higher satisfaction rate in the TELD group than in the IELD group (P = 0.014). Six patients in the IELD group (13.3%) needed extra intravenous injections of sufentanil because of intense pain during the procedure. In the IELD group, there were 2 cases of neuropathic pain after surgery.
LIMITATIONS: Due to the study was included in a single spine center with a relatively small population and its relatively short-term follow-up, the study is not generalizable.
CONCLUSIONS: Both TELD and IELD can provide good clinical outcomes for L5/S1 DH under local anesthesia with 1% lidocaine. TELD was superior to IELD in terms of surgical-related experience and complications.
KEY WORDS: Lumbar disc herniation, L5/S1, transforaminal endoscopic lumbar discectomy, interlaminar endoscopic lumbar discectomy, local anesthesia, 1% lidocaine, low concentration, endoscopic spinal surgery, percutaneous endoscopic lumbar discectomy, intraoperative pain
|
|
ASIPP is now in collaboration with Curi Medical Liability Program
Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Curi is a full-service advisory firm that serves physicians and their practices. Their valued advice is grounded in your priorities and elevated in your outcomes. They are driven by a deep understanding of your specific circumstances in medicine, business, and life. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary risk management CME activities, visit our website.
|
|
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 independent physicians. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
|
|
ASIPP® is now offering our members the benefit of a unique revenue cycle management/ billing service.
We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
|
|
|
up-to-date news related to you, your practice, and your patients!
|
|
|
|
|
|
|
