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                            Judy ForemanJudy Foreman to Speak at Conference

Judy Foreman, nationally syndicated health columnist and author of her recently published book, "A Nation in Pain - Healing Our Biggest Health Problem" will be a featured speaker at the Florida Academy of Pain Medicine Conference. Her presentation will be on Saturday, June 21, 2014 at 10:30 A.M.  (Read More)


Patient Op-Ed: Denying necessary prescriptions to needy patients 

The Florida Academy of Pain Medicine is working diligently to bring attention to our legislature, patients and citizens regarding the problems patients are having getting drug prescriptions filled. The following article was printed in the Tampa Bay Times in support of our concerns over this process of denying necessary prescriptions to needy patients. Please feel free to share this article with you patients, colleagues and staff. We will continue our efforts to help patients across the state to be able to have their physician prescribed drug requests filled. Should you have any similar cases to report of patients not getting their prescribed drugs in a timely manner, please let us know. Together we can help alieviate this problem. (Read OpEd)

Fraternally, Jeffrey Zipper, FAPM President 


ALERT ALERT

Dear Colleagues, 

            The FAPM has hired a public relations firm to help bring media attention to issues of importance and concern to us and our patients. We are presently working on a project to help our patients gain better access to their needed medications from Pharmacies. To that end, if you have any patients experiencing difficulty with getting their prescriptions filled for CS’s please contact Mr. Brian Burgess from Meteoric Media Strategies ASAP at 850-273-2270 or email to brianjburgess@gmail.com. Thank you! 

Regards,
Jeffrey A. Zipper, M.D.
President


Peripheral nerve blocks -- revision to the Part B LCD
LCD ID number: L29258 (Florida)
LCD ID number: L29466 (Puerto Rico/U.S. Virgin Islands)

The local coverage determination (LCD) for peripheral nerve blocks was most recently revised January 1, 2013. Since that time, major revisions were made throughout the entire LCD. The ‘Indications and Limitations of Coverage and/or Medical Necessity’ section of the LCD has been revised to clarify indications versus limitations of coverage. In addition, the ‘CPT®/HCPCS Codes’, ‘ICD-9 Codes that Support Medical Necessity’, ‘Documentation Requirements’, ‘Utilization Guidelines’ and ‘Sources of Information and Basis for Decision’ sections of the LCD were revised.
Effective date

This LCD revision is effective for services rendered on or after March 17, 2014. First Coast Services Options Inc. LCDs are available through the CMS Medicare coverage database at http://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx external link.

Coding guidelines for an LCD (when present) may be found by selecting “LCD Attachments” in the Jump to Section…” drop-down menu at the top of the LCD page.

Note: To review active, future, and retired LCD for jurisdiction 9, please click here


FAPM has a “Neutral” Position on Medical Marijuana Amendment:
Florida is facing a pain medicine crisis, and lawmakers must find a way to deliver pain medicine to legitimate patients while still blocking these controlled substances from those who abuse them. No matter how Floridians vote on medical marijuana amendment this November, the real burden must be on lawmakers to overhaul our pain medicine regulations so that patients with legitimate health issues can get the medications they need to have a high quality of life. They deserve to have this access legally and without undue excessive burden.

Congress Reaches Deal on SGR Repeal

Today, February 6, 2014, Congress reached a bipartisan, bicameral agreement on a bill that would repeal the Medicare Sustainable Growth Rate (SGR) and replace it with a pay-for-performance system that would evaluate and incentivize quality health care. All 3 congressional committees of jurisdiction—the Senate Finance Committee, the House Ways and Means Committee, and the House Energy and Commerce Committee—have agreed on 1 piece of legislation that will now move through the legislative process as a consensus bill.

Specifically, the legislation would:

  • Repeal the SGR immediately
  • Provide positive annual payment updates of 0.5% for 5 years
  • Install a Merit-Based Incentive Payment System (MIPS), which would include prospectively set performance thresholds and offer flexibility in the imposition of performance requirements that are inappropriate for some specialties
  • Delay the effective date of the MIPS program 1 year, from 2017 to 2018
  • Increase the MIPS funding pool and adjust the phase-in of penalty risks for those who fall in the lowest performance quartile to be capped at a maximum of 9% (as opposed to the previous 12%)
  • Sustain a 5% incentive payment for physicians participating in alternative payment models
  • Double original funding for technical assistance to small practices of 15 or fewer professionals
  • Recognize the development of functional status quality measures as a priority

Many of the provisions of the bill are improvements from previous proposals and current law. AAPM&R advocated strongly to incorporate items that would be beneficial in highlighting the care that physiatrists provide. However, because this legislation is not budget neutral, legislators will now spend several weeks considering budget-cutting options to offset the cost of the repeal. Some options have been leaked, including cuts to postacute care and changes to the in-office ancillary services exceptions to the physician self-referral law (Stark law). 

Your Academy is advocating tirelessly to ensure that the SGR repeal is not achieved on the backs of our physician members. Stay tuned for additional information in the coming weeks. 

 Regards,
Jeffrey A. Zipper, M.D.
FAPM President


House passes a budget that delays 24% reduction in Medicare Pay

Physicians have received another holiday season reprieve from financial disaster as the Senate today easily approved a bipartisan budget deal -already passed by the House -that delays an almost 24% reduction in Medicare pay from January 1 to April 1.

The Senate voted 64 to 36 in favor of the 2-year budget deal. The House of Representatives approved the measure 332 to 94 on December 12.

Now lawmakers will tum their attention to other bipartisan legislation that would repeal the Medicare compensation formula responsible for the scheduled cut, and others like it, scheduled over the course of the last 10 years. Congress has typically postponed the reductions in December weeks or days before the rate change, stoking uncertainty for physicians in the run-up.

The 3-month "doc fix" in the budget bill, which President Barack Obama has promised to sign, will give physicians a 0.5% raise for the first 3 months of 2014, much to the delight of organized medicine. However, medical societies did not get everything they wanted. The bill both preserves an annual 2% reduction to Medicare rates called for by the across-the-board budget cuts called sequestration and extends it 2 years beyond its original expiration date of 2021.

Aside from the temporary doc fix, the bill approved by the Senate today will replace $63 billion worth of sequester cuts over the course of 2 years in both defense and nondefense programs and reduces the budget deficit by a net $23 billion. It sets the stage for lawmakers to forge an even more comprehensive budget agreement early next year, which is needed to forestall another partial government shutdown, such as the one in October, and to avoid defaulting on federal debt.

10-Year Rate Freeze or a Modest, Temporary Raise? Now that the Senate has passed the budget bill, lawmakers have a little more than 3 months to consider 2 very similar bipartisan bills in the House and Senate that would repeal Medicare's sustainable growth rate (SGR) formula for physician pay. Both measures would shift compensation from fee-for-service to pay­for-performance and consolidate 3 Medicare incentive programs.


ALERT, ALERT, ALERT 

Medicare will deny claims for referring physicians who are not enrolled in PECOS as of January 6, 2014. Physicians must be enrolled to prescribe durable medical equipment. For more information, refer to their website at https:llcms.hhs.gov/. (at the time of this post, this website is down).

Some of our vendors are concerned that prescribing physicians who are not enrolled will not be able to prescribe the durable medical equipment that you have prescribed in the past.  


December 16, 2013

President’s Message 

Dear Colleagues, 

            I would like to take this opportunity to wish everyone a safe and Happy Holiday season. Once again the house of medicine is coming under reimbursement pressure from the annual mandated Congressional SGR formula cuts, budget sequester cuts, the President’s ACA and CMS spending reductions. Cuts to MC reimbursement for those of us practicing pain medicine are especially severe this year. The private practice of medicine appears to be dying a “death by a Thousand cuts” in the US! While this news is disheartening, it is incumbent upon medical leadership to make our voices heard to protect access to care for our patients and preserve our ability to make a living. 

            The recent passage of the bi-partisan Congressional budget deal has revoked 40 billion of the 63 billion automatic budget cuts due to sequestration. The brunt of the remaining 23 billion in budget cuts due to sequestration will largely be borne by physicians and hospitals. Both physicians and hospitals will continue to be subject to an automatic 2% across the board reduction in MC reimbursement for our services for the next two years. Congressional staffers believed that Medicare providers were the” least painful” target. 

            CMS recently released the FY-2014 MC Physician Fee schedule. The schedule takes into account an automatic 24% SGR reduction unless action is taken by Congress to avert this annual issue. Presently the House Ways and Means Committee have unanimously approved a bill to repeal and replace the MC SGR formula. Hopefully passage by the House and Senate will follow. If the SGR cuts are not repealed there will be devastating financial consequences for all healthcare providers! Even if the SGR formula is repealed this year physicians who provide IPM services for MC beneficiaries will experience severe reductions in reimbursement for those services. This is especially so for providers performing office based IPM procedures. Your Academy will keep you posted as to the outcome of these events.

            On another note FAPM is preparing for this year’s legislative session in Tallahassee. Dr. Stanley Dennison, Chairmen of FAPM’s legislative committee, will be leading our legislative initiative this year. We have two major legislative issues for 2014. 

1)      FAPM will once again seek to preempt to the State all regulation concerning the licensure, registration and governance of PMC’s in an effort to void all local municipalities and county ordinances in excess of what is required by State law.

2)      FAPM will seek legislation to prohibit commercial insurers from deeming IPM procedures as experimental or investigative when they are clearly covered services recognized as reimbursable by a federally funded government payor.     

To that end, we have hired Mr. Chip Case from Jefferson Monroe Consulting to help with our lobbying efforts and Mr. Brian Hughes from Meteoric Media to facilitate a PR campaign on our behalf. Dr. Dennison and I will be working closely with these gentlemen to help achieve our goals for this year’s legislative session. 

Lastly, many of our member’s patients are experiencing difficulty obtaining necessary opioid analgesic medications for treatment of their conditions. This is leading to significant frustration and stress for healthcare providers and our patients. FAPM will ask our PR agency for help in designing and implementing a campaign focused on addressing this situation in multiple media outlets. Hopefully, we can put some pressure on legislators to address this issue. 

I wish all a Merry Christmas and Happy New Year! I will keep you posted on developments as we move forward this year with our agenda. 

Sincerely 

Jeffrey A. Zipper, M.D.
President FAPM
 


ALERT ALERT

Dear Colleagues,           

            FSCO the Medicare administrate contractor for jurisdiction J 9 has retracted its previous article titled “Ultrasound Guidance for Needle Placement in the Office Setting”. This retraction was based upon input from your specialty society CAC representatives. Although this article has been retracted there are still some limitations on these services (please see attachment). Please also note, that in the 2014 proposed rule for Revisions to Payment Policies under the Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) proposes a reduction in the relative value units (RVUs) based on equipment inputs and procedure time assumptions for Current Procedural Terminology (CPT®) code 76942. 
Regards,
Jeffrey Zipper
President FAPM
Chief Executive Officer
 


ALERT ALERT
FY 2014 Medicare OBS Reimbursement Rates for SCS Trials


September President's Message

Dear Colleagues,
           
I hope everyone has enjoyed their summer and all are ready to get back into the swing of things. I would like to start off by thanking Dr Albert Ray our immediate past president for his leadership and tireless efforts in serving our organization over the past two years; as well as, Dr. Felix Linetsky, Dr Kenneth Webster and the entire FAPM board of directors for putting on an excellent educational program at this year’s annual scientific conference. If you were unable to attend this year’s conference you certainly missed out and I hope to see you at the conference next year. In fact, place it on your calendar today! (June 20-22, 2014). The Florida Academy of Pain Medicine largely exists to advocate for and to protect the rights of the chronic pain patients and the physician community that serves them within the State. Your membership in this organization is of paramount importance and without your support we would not have a voice in Tallahassee. I personally value your membership in the Academy and believe that together we are making a difference in your practice and patients’ lives. I hope each of you will see fit to renew your membership this year. If you know of a colleague that is not presently a member of FAPM, please encourage him or her to join today!  (READ MORE)


2014 Sponsor Exhibitor Prospectus


FMA’s Business of Medicine Survey Reveals Florida Physicians’ Top Concerns 


Florida Medical Association Installs
W. Alan Harmon, M.D.
as 137th FMA President

The Florida Medical Association installed Jacksonville physician W. Alan Harmon, M.D., FACP, as its 137th President this evening during the 2013 FMA Annual Meeting in Orlando. Dr. Harmon is known among his colleagues as a dedicated physician leader who has made many contributions to organized medicine.

“Dr. Harmon has served the medical profession at the county, state and national levels, and he is committed to making Florida a better place for physicians to practice medicine,” said FMA Executive Vice President Timothy J. Stapleton. “His knowledge of the many complex issues facing doctors today is a great asset to the FMA.”

Board certified in internal medicine and gastroenterology, Dr. Harmon practices with the Borland-Groover Clinic in Jacksonville. He graduated with honors from the University of Florida College of Medicine in 1976, and he completed his residency in internal medicine and a fellowship in gastroenterology at the University of Alabama in Birmingham.

Dr. Harmon has served on numerous FMA committees as well as the FMA Board of Governors and the FMA PAC Board of Governors. He has been a delegate from the FMA to the American Medical Association, and he also served as FMA Treasurer from 2007 to 2011. He is a Past President of the Duval County Medical Society, the Florida Society of Internal Medicine and the Florida Gastroenterological Society. Dr. Harmon is a Fellow of the American College of Physicians and was elected last year to the AMA Council on Medical Service.

Dr. Harmon succeeds Vincent DeGennaro, M.D., who served as FMA President from 2012-2013. Other FMA officers for 2013-2014 are: President-Elect Alan Pillersdorf, M.D.; Vice President Ralph J. Nobo Jr., M.D.; Secretary John Katopodis, M.D.; Treasurer Ronald Giffler, M.D.; Speaker David J. Becker, M.D.; and Vice Speaker Corey L. Howard, M.D.

Contact Information:
Erin VanSickle
evansickle@flmedical.org
(850) 339-3184
www.FLmedical.org


Annual Scientific Meeting
Draws Record Attendance

Conference Pictures

Conference Pictures

Conference Pictures


Conference a Great Success

2013 FAPM Awards Recipients
Special Award  Presented at Conference Luncheon
Left to Right: Rigoberto Puente-Guzman,MD, President of FSPR&R
Ralph Nobo, MD, Vice-President of FMA, Albert Ray, MD, President of FAPM, Kenneth Webster, Ed D. FAPM Executive Director receiving the Presidential Achivement  Award, and Jeffrey Zipper, FAPM  President-Elect




          Two Leadership Members of FAPM Author Major Works

Congratulations to Felix Linetsky, MD and Albert Ray, MD for recent publications in a major new textbook on Pain Medicine.

 Felix Linetsky, MD, FAPM Board member, chairman of the FAPM Education Committee responsible for  our excellent Annual Educational programs, and President of the American Academy of Regenerative Orthopedic Medicine,  has coauthored “Treatment of Chronic Painful Musculoskeletal Injuries and Diseases with Regenerative Injection Therapy (RIT): Regenerative Injection Therapy Principles and Practice,” along with Hakan Alfredson, MD, PhD,  David Crane, MD, and Christopher Centano, MD. This chapter was published in the Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches: the American Academy of Pain Medicine Textbook on Patient Management and released last month. This chapter offers a comprehensive review of regenerative injection therapies including treatments related to pathology of connective tissue, mechanism of action of chemical injectates and biological injectates;  provides a step by step approach to differential diagnosis and treatment; and offers future directions for regenerative injection therapies.

Dr. Linetsky and his co-authors are all internationally recognized experts in the field of regenerative injection therapies, and have combined their knowledge and skills in this excellent chapter.  Dr. Linetsky will be speaking and also teaching an Ultrasound Guided Treatment course at our upcoming annual meeting in June 28-30, 2013. The FAPM has named an award in Dr Linetsky’s honor: The Annual Felix Linetsky Award for Excellence in Education, to recognize his lifelong dedication to helping patients receive better care through education.  Dr. Linetsky will be available for private conversations for those interested.

Albert Ray, MD, current president of FAPM and president of the Foundation for Pain Medicine, has served as the section editor on Integrative Approaches for the  Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches: the American Academy of Pain Medicine Textbook on Patient Management.  He has served as the editor for 25 chapters including such topics as pain perception, neuroplasticity and sensitization, muscle pain treatment, addictive disorders, mental status exam of pain patients, psychological assessment s and treatments, hypnosis, acupuncture, manual therapies, regenerative therapies, interdisciplinary functional restoration programs, spirituality, disparate populations, sleep and pain, empowerment for pain sufferers and their caregivers, geriatric issues in pain, primary care issues, patient advocacy, neonatal pain, disability assessment, the Double Effect, and failure to treat issues. Within this book, Dr. Ray has authored a chapter entitled “Neuroplasticity, Sensitization, and Pain,” and coauthored “Pain as a Perceptual Experience” with Ms. Rhonwyn Ullmann, MS, and Michael Francis, MD; as well as “Manual Therapies,” with Mr. John Barnes, PT,LMT, NCTMP and Ms. Rhonwyn Ullmann, MS.

Dr. Ray, has dedicated his medical career to the understanding, treatment, and teaching of pain in the whole person, and has also served as the president of the American Academy of Pain Medicine, the Southern Pain Society, and the National Pain Foundation. He has been a Director at Large for the American Board of Pain Medicine and still sits on their Exam Council.  Dr. Ray has also been a pioneer working for the establishment of Pain Medicine as a primary specialty. Dr. Ray will be leading a course in Basic Pain Medicine at our Annual Educational Meeting next month.

The FAPM will have this brand new textbook available at the exhibit hall at Booth 306 for anyone interested. Come join this exciting meeting and meet our authors in person.


FL Doc Arrested for Running Pill Mill, 3rd Offense
A St. Petersburg doctor who was accused in 2011 of helping operate an illegal pain clinic in Pasco County was arrested again Thursday on charges that he was doing the same thing in Citrus County. (Read More)


From the President:

Dear FAPM Members:
The Florida Academy of Pain Medicine strives to represent our members on important issues that affect your ability to practice medicine in the state of Florida. While we have expanded our member services the past two years, including Executive Offices and services, we have not increased your annual dues.

However, it is important for the success of our programs to maintain a strong member base. As we enter the fourth quarter of our fiscal year we need every member to be sure their dues are current. We have a current list of dues paying members for this year posted in our membership section on this website. Please check to see if your name appears. If your name is listed, thank you for your support of FAPM programs. If your name is not listed, please take a moment to pay them “on line”. Your support is needed now so that FAPM can continue to represent you on issues that affect your medical practice.

Take time to check our website often to stay informed of important medical matters. We strive to maintain up-to-date communication so that our members are properly informed.

Fraternally,
Albert Ray, MD, President

                                                 Membership Benefits
Active website with regular updates, special alerts and blast emails.
Educational programs designed to keep you up-to-date on the latest developments in pain medicine. Discounted fees for members.
Information resources to provide practical insight into dealing with third party payers and regulatory agencies.
Annual scientific conference with nationally known speakers and relevant topics.
PAC FUND to support legislative issues pertaining to pain medicine.
Opportunities for the exchange of information and experiences with colleagues who have encountered problems similar to those with which you are dealing.
PainInfo, the Academy’s periodical newsletter, which keeps you informed as to upcoming meetings, Academy activities, and economic, legislative and regulatory information (both state and national) which affects your practice.
Representation within Florida’s recognized organized medicine body, the Florida Medical Association, both via a seat in the FMA House of Delegates and a seat on the FMA Specialty Council.



 




New FDA guidance urges patient outreach regarding important drug recall related to Aspergillus Meningitis FLORIDA DEPARTMENT OF HEALTH COLLABORATES WITH HEALTH CARE PROFESSIONALS IN ONGOING FUNGAL MENINGITIS OUTBREAK INVESTIGATION ~New FDA guidance urges patient outreach~
(Read More)





NY Times- FDA Won't Require Special Training



 

Join the Court Fight to Protect Physician Medicare Data



Attorney General Bondi's Weekly Briefing: Prescription Drug Diversion: Combating the Scourge
Congress Approves 10-Month SGR Patch



Note!The Electronic - Florida Online Reporting of Controlled Substances Evaluation program (E-FORCSE) is Florida's Prescription Drug Monitoring Program (PDMP). The PDMP was created by the 2009 legislature in an initiative to encourage safer prescribing of controlled substances and to reduce drug abuse and diversion within the state of Florida.   Remember:  Section 893.055, Florida Statutes, requires health care practitioners to report to the PDMP each time a controlled substance is dispensed to an individual. This information is to be reported through the electronic system as soon as possible but not more than 7 days after dispensing. This reporting timeframe ensures that health care practitioners have the most up-to-date information available.



MAJOR ALERT!! House GOP agrees to doc pay-rate extension

ALERT! CVS tells some Florida doctors it won't fill their prescriptions for narcotics

ALERT! Lyons: Doctors on CVS blacklist feeling branded



Pain Management Regulations Affect
More Than Pain Management Specialists

Linda A. Keen
of counsel to The Florida Healthcare Law Firm



2011 Conference Presentation

MSK Medicine Council Outstanding Service Award

The AAPM&R Outstanding Council Service Award was established this year to recognize service/volunteerism of Council members who contribute to the success of the Academy in fulfilling its mission and serving its membership in ways not limited to research, education, and product development.
Congratulations to Andrew Sherman, MD, MS—the first MSK Medicine Council recipient of the AAPM&R Outstanding Council Service Award! Outstanding Council Service Award recipients will be recognized at the Annual Assembly at our Council business meeting on Friday, November 5, at 5:45 pm, and will be announced during the Forty-Second Walter J. Zeiter Lecture and Awards Ceremony on Saturday, November 6, at 11 am.