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Conference Pics


(Left) President Vinod Malik welcomes FMA President David Becker to the FAPM conference.


Presidents meet with conference sponsor.

(L-R) Michael Creamer, President of FSPM&R, Kevin Kline, Medtronic Regional Manager,and Vinod Malik, President of FAPM.

Conference Pics1

Check out more Conference photos on our Facebook page.

MACRA rule expands exemptions and provides more flexibility for physicians

The Florida Academy of Pain Medicine has researched recent actions of the Centers for Medicare and Medicaid Services including the MACRA rules and MIPS program. See here, and here and registration here "Medicare Speaks 2016" which offers sessions in Tallahassee on November 2-3, 2016. FAPM will continue to keep our members updated on important issues affecting the practice of pain medicine.  

OCTOBER, 2016 

The Florida Academy of Pain Medicine’s Annual Scientific Meeting this year provided attendees with excellent national and international speakers, three distinct pre-conference workshops, great social events, and a first class hotel venue. We thank all of those who attended this conference, and we hope you will plan to join us again next year. 

I want to remind any members who have not paid their 2016 dues that our fiscal year ends on December 31, 2016, so please send your check in or pay online with your credit card. Within the scope of the Florida Medical Association, the FAPM is one of the smaller specialty affiliates. Dues collection provides only 25% of our budget, yet we maintain an office and staff to serve our members. However, without our members financial support we could not meet our budget needs nor could we provide the services for our members or present our annual conference. I ask every pain medicine physician in Florida to become a member of the society that best represents your interests and that is the Florida Academy of Pain Medicine! 

Our Education Committee is already in the planning stages for our annual scientific meeting to be held on June 16-18, 2017, at the Hyatt Regency Grand Cypress Hotel where we can best meet the interests of our members, exhibitors and sponsors as we did for several previous years. Mark the dates on your calendar and plan to join your pain medicine colleagues at this beautiful hotel in the heart of Disney World. Bring your family members so they can enjoy all of the amenities of this hotel as well as the many attractions in the Orlando area. 

If we can be of any service to you as a member, please do not hesitate to call our office at 727-581-4319. 


Vinny Malik, MD, President 

A.M. Trescot (Ed.) Peripheral Nerve Entrapments Clinical Diagnosis and Management
▶ This book features over 50 videos of examination and injection techniques, at least 2 per nerve ▶ Contains "Pain Problems Index" to navigate by symptom  ▶ Includes anatomy, injection technique, and complications for each nerve
Featured as a single volume, this is a comprehensive guide to possible nerve entrapment syndromes and their management. Each chapter covers a single nerve, or group of closely related nerves, and goes over the clinical presentation, anatomy, physical exam, differential diagnosis, contributing factors, injection techniques, neurolytic/surgical techniques, treatments of perpetuating factors, and complications. 
(Read More)


Turn the Tide:
The Fight to End the Opioid Crisis


 Pre-Conference Workshops Provide Special Certification Recognition

Attendees registering for the Florida Academy of Pain Medicine pre-conference workshops will receive a certificate depicting their special training received in these programs. Specialist certificates will be presented for Musculoskeletal Ultrasound and International Pain Therapies, Interdisciplinary Approaches to Pain Medicine, and Physical Medicine and Rehabilitation Treatments and Therapies. (Complete Program)

The "Musculoskeletal Ultrasound and Interventional Pain Therapies" will include ultrasonography of the shoulder, knee and hips as a correlation of physical findings and clinical anatomy. The Interventional Spine Procedures will teach the use of innovative techniques such as facet joint injections, nerve blocks, neuroaugumentation, spinal fusion and implantable drug delivery systems.

The "Interdisciplinary Approach to Pain Medicine Workshop" features nationally known speakers on pain medicine issues on such topics as: pain, stress, mood, cognitive and memory holographic pain treatments, low level inflammation and fascia stimulation and sensitization, opioid crisis concerns, medical laser applications and much more.

The third workshop deals with PM&R treatments and therapies. Featured topics include updates on subacute rehabilitation, medical marijuana update, intrathecal therapies, treatment and management of spinal stenosis, and multimodal approaches to the treatment of low back pain.

Each workshop offers 8 CME hours.


FAPM Offers Three Great
Pre-Conference Workshops

The “Musculoskeletal Ultrasound and Interventional Pain Therapies” will include ultrasonography of the shoulder, knee and hips as a correlation of physical findings and clinical anatomy. The Interventional Spinal Procedures will teach the use of innovative techniques such as facet joint injections, nerve blocks, neuroaugmentation, spinal fusion and implantable drug delivery systems. 

The “Interdisciplinary Approach to Pain Medicine Workshop” features nationally known speakers on pain medicine issues on such topics as: pain, stress, mood, cognitive and memory holographic pain treatments, low level inflammation and fascia stimulation and sensitization, opioid crisis concerns, medical laser applications and much more. 

The third workshop deals with PM&R treatments and therapies. Featured topics include updates on subacute rehabilitation, medical marijuana update, intrathecal therapies, treatment and management of spinal stenosis, and multimodal approaches to the treatment of low back pain. 

The complete program for these workshops can be found on the FAPM website where you can also register online. Don’t miss out on the latest treatments in these special workshops.

President's Message
May 2016

AAPM MeetingAAPM's 33rd Annual Meeting
March 16-19, 2017 (Preconference Sessions: March 15-16, 2017)
Loews Sapphire Falls Resort
Orlando, Florida

FAPM Board Reviews
CDC Guidelines for
Prescribing Opioids for Chronic Pain 

The FAPM Executive Board met recently to discuss the CDC Guidelines for Prescribing Opioids for Chronic Pain. It was noted that the original draft by CDC was not altered, in spite of over 4,000 testimonies from societies, corporations and individuals.

However, the board recognizes the challenges involved with prescribing opioids for chronic pain, and the necessity for safety precautions and effectiveness when providing pain treatments.

Therefore, we support the efforts and concerns expressed by the American Academy of Pain Medicine in the following letter: (MORE)

Drug industry on edge for Obama action on prices
Peter Sullivan –The Hill
The pharmaceutical industry is anxiously awaiting a series of regulatory actions from the Obama administration aimed at combating high drug prices. 

Drug prices have been a major issue on the campaign trail, with Hillary ClintonBernie Sanders and Donald Trump pounding pharmaceutical companies.

Martin Shkreli, the ex-pharmaceutical company CEO who made headlines for hiking the price of a life-saving drug by 5,000 percent, also has put the issue of drug prices in the spotlight.

Spending on drugs in 2014 grew by a sharp 13 percent, the most in a decade. The spike was driven partly by new high-cost drugs for Hepatitis C, but it seemed to point to a larger issue.

A Kaiser Family Foundation poll in August found that 24 percent of the public had not filled a prescription in the past year because of cost. (More)

President’s Message:
February, 2016

VMalik,DO I am often asked the question, “What is the mission or purpose of the Florida Academy of Pain Medicine?” My answer is simple, We are a unique medical specialty society that represents physicians practicing in the field of pain medicine. As such, we are involved with education training, as provided at our annual conference, legislative issues affecting the practice of medicine in Florida, and research of medical issues confronting our members. (More)                         

FAPM  annual membership renewal notices have been mailed to our membership list. This year the renewal can be paid online. The renewal fiscal year is January 1-December 31, 2016.
Thanks to each of you for your continued support of the
Florida Academy of Pain Medicine.

    December 14, 2015 

Dear FAPM Members and Friends: 

Vinod Malik, DOAt this busy season of the year, I wanted to take a moment to wish everyone a Happy Holiday Season and a wonderful New Year. As we are all involved in the medical profession, may each of us enter the New Year with renewed confidence in our abilities to treat our patients with the best possible care. 

As we face the issues confronting our medical professions, be assured that your FAPM Board Members will continue to address your concerns and interests in dealing with legislative matters, practice management issues, and medical education programs. 

Our “Executive Committee” is planning an excellent program for the annual FAPM Scientific Meeting to be held on August 12-14, 2016, at the beautiful Waldorf Astoria Hotel in Orlando. I hope you all are planning to attend this event. 

Let us all be proud of the profession we serve and strive for excellence in all that we do for our profession, patients and community. 

Fraternally yours,

Vinod Malik, DO

FAPM President



THE CAPITAL: TALLAHASSEE, October 20, 2015 ...... The Legislature may have inadvertently made it harder for legitimate patients to get critical pain medications when it passed a 2011 law aimed at shutting down rogue clinics that branded the state as the “pill mill capital" of the country. But now, a powerful state senator said he intends to fix the problem. (Read More)


FL BdMedicineSealFL Bd Medicine

Pain Management Physicians If you are a physician practicing in a Pain Management Clinic and were registered based on the 6th qualification option in Rule 64B8-9.0131, F.A.C ., please keep in mind that as a part of your 40 hours of Continuing Medical Education (CME) required per biennium, you must complete 15 hours of live lecture format, Category I CME in pain management for every year you practice in pain management. These will need to be reported to CE Broker along with the rest of your CME credits in order for the Board to renew your license. Answers to many questions regarding license renewal can be found at the Board of Medicine's website at flboardofmedicine.gov 

CE Broker
Have you signed up for a CE Broker account?

License renewal is coming up for half of Florida's allopathic physicians in Jan, 2016 and for all of Florida's osteopathic physicians in March, 2016. This is the first year that the online renewal system will be linked to CE Broker, the Florida Department of Health 's online CME tracking system. If you haven't signed up for your CE Broker account and begun reporting, do so by visiting www.cebroker.com. There are three account options: free, professional and concierge. As an FMA member, you can get a discount on CE Broker's concierge service to take over the process of managing, tracking and reporting your CME. Simply send your certificates to CE Broker's trained staff members, and they will handle the rest.

Congratulations to
Dr. Felix Linetsky

Felix Linetsky, MDDr. Felix Linetsky, FAPM Board Member and nationally recognized medical education leader, has written a chapter in the Second Edition of Pain Medicine and Management – Just the Facts Textbook published by McGraw Hill. Chapter 71 – Regenerative Injection Therapy (aka – Prolotherapy was co-authored by Peter Peter Staats and Mark Wallace, MD. This book can be purchased from Amazon for the amount of $80.90.

FAPM Represented at Florida Board of Pharmacy's
Controlled Substances Meeting (see below) 

The Florida Board of Pharmacy’s Controlled Substances Standards Committee recently met at Delray Beach, Florida, to discuss issues regarding the availability of certain medications for patients. They have been receiving numerous complaints from patients and physicians across the state regarding this issue. 

Jeffrey Zipper, MD, the Immediate Past President of the Florida Academy of Pain Medicine, attended this meeting representing the Academy. He noted that those attendees at this meeting made several recommendations for the board to consider. The board will review these matters and report back to the committee at the next meeting. 

FAPM will continue to monitor the activities of the Florida Board of Pharmacy, and report any new developments to the members.

FAPM Welcomes New Board Member

At the FAPM Annual Scientific Meeting on Saturday, June 25, the attendees elected TSE CHUNG LEE, M.D. to the Board of Directors as a Member at Large. Dr. Lee is presently in practice at the PRC Pain Associates in Daytona Beach as an Interventional Physiatrist. He will be representing the FAPM at the FMA House of Delegates in Orlando.

Dr. Lee earned his medical degree at the Medical College of Ohio in Toledo, Ohio. He completed a residency in Physical Medicine and Rehabilitation at New York University, Rusk Institute in New York City. He then completed a Fellowship in EMG/Musculoskeletal/Spinal/Ultrasound in Napa, California under the direction of Marko Bodor, M.D.

He is further a member of the American Academy of Physical Medicine and Rehabilitation, the International Society of Interventional Spine and the American Institute of Ultrasound Medicine. He is a Diplomate of the American Board of Physical Medicine and Rehabilitation and of the American Board of Pain Medicine.

The Florida Academy of Pain Medicine is pleased to welcome Dr. Lee as the newest member of the Board of Directors.


2015-2017 Board of Directors
President - Vinod Malik, MD
President Elect - Stanley Dennison, MD
Vice President - Peter Taraschi, DO

Secretary - Felix Linetsky, MD

Treasurer - Kenneth Botwin, MD

Immediate Past President - Jeffrey Zipper, MD

Member-at-Large - Susanti Chowdhury, MD

Member-at-Large - Tse Lee, MD

Member-at-Large - Raul Monzon, MD

Member-at-Large - Albert Ray, MD

President's Message

As the newly elected President of the Florida Academy of Pain Medicine, I want to thank the Board and Members for the vote of confidence in my ability to lead this Academy.

At our recent FAPM Scientific Meeting in Orlando, we set records of the number of physician attendees and for the number of exhibitors. Our program offering 20 Category 1A CME credits was highly complimented by the attendees, and the exhibitors greatly appreciated the increased attendance and interest in their products and services.

I want to thank our Gold Sponsor, Medtronic and the other special event sponsors -St. Jude Medical and Quest Labs. On our website ­you can find a list of all of our exhibit sponsors and their services. I hope you will support them by using their services whenever possible.

Our membership will reach new heights this year, and I hope everyone reading this message will be sure to join FAPM. Our fiscal year ends on December 31st and you can pay dues on our website. In order for FAPM to remain a viable Academy, we need the support of every pain medicine physician in Florida.  

Speaking at our conference luncheon, FMA President Alan Pillersdorf, MD reminded everyone to support their medical associations so we can present a united front of strength as we face the challenges of our profession.

We are currently in the process of evaluating this year's conference, and planning for the 2016 program. Hopefully, each of you will want to attend that event in Orlando on August 12-14, 2016.

At this conference we will continue to offer a comprehensive program emphasizing pain medicine issues including interventional and integrated techniques. We plan to offer additional workshops and welcome any suggestions from our members on topics of interest to you. Just email your ideas to our executive office at websterk427@gmail.com .

Fraternally, Vinod Malik, MD
FAPM President

  • 2014ConfAwards

Political Pulse
Description: http://fapmmed.net/pulse.png

Description: Herald Tribune  Politcs

The battle for Florida
Herald-Tribune Politics provides a visual guide to the gubernatorial battle for Florida in geographic terms. Political Editor Jeremy Wallace examines a number of issues facing the campaigns as the race reaches its peak. For example, Duval County, “once a solid Republican stronghold,” is eroding for the GOP. However, Gov. Rick Scott is likely to once again dominate among rural voters as he did in 2010. On the upside for Charlie Crist, he has an opportunity to take a bite out of the margin that carried Gov. Scott in 2010 in Miami-Dade and Broward counties.

  Description: Herald Tribune

Physicians touchy about marijuana
Many physicians are speaking out against a proposed constitutional amendment to legalize medical marijuana in Florida, saying its passage could lead to abuse. The Herald-Tribune says the overarching concern is that “Yesteryear’s ‘pill mill’ doctor will become tomorrow’s ‘pot doc,’ someone who rubber-stamps prescriptions for medical marijuana regardless of concern.” The FMA has cited the issue of potential drug abuse as one of its reasons for opposing the amendment.


Overstep on painkillers
Prescription painkiller crackdown has gone 'way too far,' some doctors believe
Tampa Bay Times 9/2/2014

Tampa anesthesiologist Dr. Rafael Miguel helped lead the fight against a surging prescription drug abuse crisis in Florida.

As vice chair of the state's Board of Medicine, Miguel called for legislative change to stem the flow of drugs that led to thousands of overdose deaths each year.

Eventually, people listened.

Laws tightened. Police stepped up enforcement. And deaths declined by 23 percent from 2010 to 2012.

Miguel now is in a different drug battle — one for more access to narcotics, not less.

The obstacle, Miguel and other doctors report, are pharmacies that are increasingly second-guessing them, asking to see medical records or refusing service.

"They call us sometimes and ask if (a prescription) is medically necessary," said Miguel, 59, who has a Brandon clinic and teaches pain medicine at the University of South Florida. "Well, if I write a prescription and it's got my DEA number and my signature on it, what do you think, I'm joking around?"  (Read More)

Walgreens’ Good Faith Dispensing Protocol

From: Bob Twillman [mailto:btwillman@aapainmanage.org] 
Sent: Monday, October 07, 2013 1:10 PM
To: Jeffrey Zipper
Subject: Academy update: Walgreen information, request feedback 

Last June, your Academy's Policy and Advocacy Department sent all members a letter summarizing the situation with respect to Walgreens’ Good Faith Dispensing protocol. That information also provided members with an easy way to report problems encountered with patients filling prescriptions for opioid analgesics. After hearing more concerns expressed by many of you at the Annual Clinical Meeting held in Orlando, we have decided that we need to re-send this information.

Attached is the original memo, for your review. If you and your patients have been having problems getting prescriptions filled, please provide feedback using this form.  The form is also in the attached document with more information as to what we are seeking and how the information will be handled.

As always, thank you for your support of the Academy.

Bob Twillman, PhD, FAPM
Deputy Director
Director of Policy and Advocacy


Dear Colleagues, as you can see from the missive below it appears the FAPA’s #1 Legislative priority this year is to obtain controlled substance prescribing privileges (all hands on deck)!! Given the fiasco that Florida has recently experienced with the advent of “pill mills” this would be an unwise turn of events and must be opposed for the safety of our patients. THE PAIN MANAGEMENT COMMUNITY MUST FIGHT TO PREVENT THIS LEGISLATIVE INTIATIVE.
Dr. Zipper
,President FAPM 
Read More

Pill Mill Crackdown Pays Off

The Florida Academy of Pain Medicine is proud of the role our board and members have played in the development of effective policies that have contributed to the decline of "pill mills" in the state of Florida. Over the past four years our lobbyists, presidents, staff members and  our affiliate medical societies have worked tirelessly to see these policies implemented to the fullest extent of the law. 

Our congratulations to every physician and organization that stepped up to the task that made these changes happen.

[ EDITORIAL-2014 TheLedger.com -All rights reserved ]

Florida's Effective Policies: Pill Mill Crackdown Pays Off

Florida, once labeled "the pill mill capital of the country," has shown that it's ready to relinquish that title.

A report last week by the U.S. Centers for Disease Control and Prevention found that changes in Florida policies and law enforcement have led to what appears to be "the first documented substantial decline in drug overdose mortality in any state during the past 10 years."
(Read More)

  • Leaders & SpeakersFrom left, Rigoberto Guzman, MD, President FSPMR; Jeffrey Zipper, MD, President FAPM; Alan Harmon, MD, President FMA; Vinod Malik, MD, President-Elect, FAPM
  • Marla Golden, DO, receiving the Felix Linetsky Education Award
  • Jeffrey Zipper, MD, President, Florida Academy of Pain Medicine receiving the FAPM Distinguished Service Award
  • Alan Harmon, MD, President, Florida Medical Association
  • Albert Ray, MD, Past President FAPM
  • Kenneth Webster, Executive Director, FAPM
  • Ken Webster's Special Lady

FAPM Conference Is Big Success

With excellent pre-conference programs on basic pain issues, ultrasound treatments and physical medicine and rehabilitation, the conference provided special training in multiple modalities. The pre-conference workshops were followed by offering twelve CME credits in areas related to pain medicine issues.

Featured speakers included Alan Harmon, MD, President of the Florida Medical Association and Judy Foreman, author of the bestselling book, “A Nation in Pain". The panel discussions held on the second day featured specialists in various disciplines, a representative on E-FORCE and PDMP issues, and legal and legislative programs. Panel moderators were: Albert Ray, MD, FAPM Past-President, and Jeffrey Zipper, MD, current FAPM President.

Highlights of the annual membership luncheon included FAPM awards. Marla Golden, DO, received the Felix Linetsky, MD, Education Award for her leadership and participation in FAPM educational programs the past few years. The Distinguished Service Award was presented to Jeffrey Zipper, MD, for his leadership in legislative issues affecting the practice of medicine in Florida. Lynne Columbus, DO, from Clearwater, Florida was elected to the FAPM Board of Directors.


Insurance companies should not meddle
in patients’ treatment

By Albert Ray

You pay your insurance premiums on time, and you know exactly what kind of medical and prescription coverage to expect. But what happens when your insurance company decides it doesn’t want to provide the same coverage anymore?

That’s exactly what happened to “Mark,” one of my patients suffering from osteoarthritis and a serious lower-back injury. Without treatment for the severe, debilitating pain, Mark simply could not function. As a 60-year-old man living by himself, Mark has been completely self-reliant. He has no one in his household to help him deal with the pain, so pain management has been critical to his quality of life and ability to function.

For years, Mark underwent physical therapy and a full range of interdisciplinary treatment to restore his quality of life. Thankfully, his pain has been consistently managed with medications. I prescribed a specific dosage of painkillers that provided adequate pain relief without any sedation or adverse side effects. Although not perfect, Mark’s situation was manageable. And as important, he was paying his insurance premiums on time — to a major Florida insurance company — until suddenly, he received a notice that this unscrupulous company planned to arbitrarily limit the amount of pain medication he could receive in any given month.

As Mark’s doctor, I had to find a way to provide him with a new prescription that fell within the limits of this new, arbitrary insurance-coverage limit. Sadly, it also meant that I had to reduce his dosage from 90 milligrams per day to 80 milligrams, which meant that Mark would have less pain relief and an increase in the level of sedation because of the insurance company’s interference with my patient’s treatment.

Why would an insurance company interfere this way? Was it just plain greed, a simple case of trying to save a few bucks so it could pocket more profits?

Unfortunately, Mark’s case is not unique. In 2011, Florida lawmakers took steps to fight “pill mills” that were thriving in our state and allowing people to abuse prescription drugs. Unscrupulous people from around the country would drive here to buy pain medication and sell it on the black market.

Since passage of new laws aimed at fighting pill mills, doctors and pharmacists, working closely with law enforcement, were able to reduce the number of pill mills and prescription drug-abuse incidents. But the unfortunate side effect is that legitimate patients, in desperate need of pain-management treatment, are getting shafted by insurance companies who use the new law as an excuse to alter insurance coverage and boost their profits.

They are playing games with patients, forcing them to jump through hoops, fill out mountains of paperwork to justify even the slightest adjustment to a sleeping-pill prescription or an arthritis treatment. And when they get called on it, they point to the laws passed in 2011 that were designed to fight criminals and illegal drug abuse.

No insurance-company executive should have the right to tell a doctor what to prescribe for a patient, nor should they be able to impose arbitrary limits that could radically affect a patient’s well being. Most of all, insurance-company executives should never be allowed to interfere with treatments they previously agreed to pay for. Such meddling can only be ascribed to one motive: greed and profiteering on the backs of patients who have dutifully paid their premiums.

The Legislature was right to combat prescription-drug abuse in 2011. But now greedy insurance companies are abusing the law. Until state lawmakers do something, patients will continue to suffer.

Albert Ray, M.D., is the medical director at The LITE Center and clinical associate professor at the University of Miami Miller School of Medicine.

Read more here: http://www.miamiherald.com/2014/05/21/4129354_insurance-companies-should-not.html#storylink=cpy


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 


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! 

Jeffrey A. Zipper, M.D.

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. 

Jeffrey A. Zipper, M.D.
FAPM President


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.  


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. 
Jeffrey Zipper
President FAPM
Chief Executive Officer

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)


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

Pictures from Past Conferences

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.

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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.

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.

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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.