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Submitted By Robert J. Barth, Ph.D. (AADEP Program Chair)

Dramatic Changes Ahead for Medical Claims Evaluation

Contributed by AADEP Faculty David J. Depaolo JD and Robert J. Barth Ph.D.

AADEP is pleased to announce that WorkCompCentral CEO David Depaolo has agreed to speak at the Annual Scientific Session. Mr. Depaolo will address the radical changes that lie ahead for the evaluation of medical claims, due to federal health care reform.

Fed by the hysteria of the general media and partisan politics, the focus of the health-care debate has been on the more recent passage of Health Care and Education Reconciliation Act of 2010, but health-care reform (and what really concerns the medical claims evaluator), began the moment President Obama took the oath of the Office of the President followed by the first law passed under his presidency, HR1.

HR1 was reported in the media as a monumental government financial stimulus package promising millions of dollars in various public works projects, but fully one-third of the bill was dedicated to the most important piece of the health care reform puzzle - the part that doesn't deal with insurance or Medicare: electronic health records and outcomes-based objective health care standards.

For the first time in this nation's history the health records of every person living in America will become "public knowledge" to every health-care provider who has authorization; and for the first time in this nation's history there will be a mandate of treatment protocols that will drive standards based medicine. The dramatic implications of these developments for medical claims evaluations will be the focus of Mr. Depaolo’s presentation.

These mostly uncontested provisions of the law are having a profound effect on the health-care industry, and will significantly impact the way that the medical claim evaluator conducts his or her practice, and interacts with the applicable medical claims system - be it workers' compensation, personal injury courts, Social Security, private disability insurance, or any other system.

Mr. DePaolo, president of WorkCompCentral, a workers' compensation news and education service, will be presenting "What Healthcare Reform, and the Future in General, Means to the Medical Claims Evaluator." Having studied HR1 from the outset, Mr. DePaolo will provide insight into the provisions of HR1 that will impact your practice, and will provide his forecast into the future of medical claims evaluation based on the realities of the provisions of HR1 and subsequent health-care reform law.

Click HERE to register online.

Click HERE to view the Annual Meeting brochure.

IN MEMORIAM

ELIZABETH GENOVESE, MD, MBA, FAADEP

1957-2010

SHE WAS A FRIEND

SHE WAS A LEADER

SHE IS A HEROINE

ELIZABETH LIVED HER LIFE TO ITS FULLEST

OUR HEARTFELT SYMPATHY, THOUGHTS AND PRAYERS ARE WITH HER FAMILY, CO-WORKERS AND THE MULTITUDE OF PROFESSIONALS WHOSE LIVES SHE TOUCHED

Doctor Genovese earned AADEP Fellowship in 1999, served on the AADEP Board of Directors for two full terms from 2001-2007, edited the AADEP Disability Newsletter, and provided education and motivation as a member of the AADEP core faculty for more than a decade. Doctor Genovese received the prestigious AADEP President’s Award in June 2009. We were all privileged to share her knowledge as a faculty member in January 2009 at the AADEP 22nd Annual Scientific Session and Advanced Clinical Skills.

The family asks that in lieu of flowers donations should be made to:
Gastrointestinal Oncology Research Fund
Kimmel Cancer Center at Jefferson
Thomas Jefferson University
Blumle Building
233 South 10th Street
Philladelphia, PA 19107

Please leave memories and comments in the comment section of this blog.

Doctors:

Now what evaluating physician has not been the recipient of less than complete or honest information? And what would you be willing to give to be able to see through the vail of dishonesty???

Even our representatives still blush about "what the definition of 'is' is".....

Doctors:

Happy Holidays to all.....If you remember, I recently sent to you a message on "Unlocking the Truth"...After talking to FBI agent Lee Howell (retired) - who has replaced Raymond Lauer for the Advanced Skills Session - SDPM Module 2: When and Why Is It Fraud/Abuse?  I really believe this will be a highly enlightening program for all, especially those who work with corporations and businesses, as these issues arise so frequently....but don't take my word for it....come and listen to the first 5 minutes, have some coffee...I think you will find this most enlightening and will help you in your practice....not that anybody would ever lie to us....

Click HERE to see Lee Howell's Agenda

Dave Randolph
AADEP 23rd Annual Meeting Program Chair

Doctors:

As the use of real science to deny ineffective, expensive, invasive morbidity enhancing procedures to the workers compensation population increases, I am seeing a greater number of certain marginal providers...."Pain Specialists", proceduralists, and "Semioticians" (those who specialize in treating symptoms) migrating to private insurers for their respective activities....They continue to practice their interesting and often refuted practices getting reimbursed through sources which are not as dedicated to science.

Think "Climategate"......now termed "Scientific Fascism"....no matter what your politics might be, we are all interested in learning the truth, however unpleasant it might be.

Doctors:

Click HERE to read a very short editorial from "The Back Letter" November, 2009.......now, where can you come to hear the truth about these remarkably costly and ineffective interventions?.....Start with Orlando in January......come and hear the real truth, not just what they want you to hear. Our preconference programs are loaded with highly qualified medical scientists (like Suzanne Novak, Bill Nemeth, Jim Talmage, Russell Travis, Trang Nguyen, Gary Freeman, Bob Barth, Mark Finneran to name a few). The nationally recognized Rick Deyo and Eugene Caragee will be providing you a new concept called "Truth"...you may have heard of it.....this stuff you can use every day to help stop adverse events. Come listen and add your voice.

Dave Randolph
AADEP 23rd Annual Meeting Program Chair

Doctors:

I hope all of you are enjoying the holiday season, even with the growing economic concerns...
As I mentioned in my last message, these changes may open new doors and pathways for us all. We can easily see that a number of interventions provided by some of our painful colleagues are not only less than helpful, they are very expensive, often performed  without scientific scrutiny, and serve to increase morbidity and mortality. They hurt people, and make us ALL look bad.

Do you know why? Are you aware of the science which allows me to make these bold assertions? Could you defend such statements at a deposition or in open court? Could your reports be enhanced by knowing and understanding these issues?

Does it make you angry to learn of Pain specialists billing $1,000,000 a month?????

Perhaps you should consider joining us or inviting a colleague for a few days in January in Orlando. Our voices can be heard by spreading the "Science of Pain Management" and dispelling the voodoo.....this must be stopped.

I would welcome your input...

Dave Randolph
AADEP 23rd Annual Meeting Program Chair

Doctors:

Only the cave dwellers among us believe health care will survive unchanged after the past few months. It would seem, however, that a more promising future exists for those who are able to provide scientifically sound critiques of medical care.

There is no doubt that the need for such talent and skill will increase over the next few years, as both medical and administrative needs for such evaluation increase. The ability to address and assess effective interventions can best be accomplished by experienced medically trained physicians, skilled in science and knowledgeable in the published literature.

Armed with such knowledge and experience, such a physician should be able to confront numerous future opportunities....

Perhaps you might know someone who would like to join us in this quest.

Dave Randolph
AADEP 23rd Annual Meeting Program Chair

Click HERE to view the Annual Meeting brochure.

Click HERE to register online.

I am writing to you to let you know about our upcoming AADEP Annual meeting being held in Orlando, January 7-9, 2010. Our focus this year will be on "Science and Pain Management". I believe you will find this program helpful and informative, especially when you are asked to address the evidence to support some of these practices.

On Thursday, January 7th, we will have a number of preconference seminars to help you thaw out. I would ask you to look at Russel Travis's program on "Controversial Diagnoses Including MRIs and the Evidence to Resolve" Russell and his team (Jim Talmage and Trang Nguyen) will provide you with a large selection of about 100 recently published abstracts taken from reputable journals, dealing with various aspects of spine problems. This interactive program will acquaint you not only with the recent  literature, but also on how to take these articles apart and learn the most from them. This will be a rare opportunity for you to sharpen your scientific skills and improve the quality of your reviews, by learning how the pro's do it.

Suzanne Novak and Bill Nemeth will once again provide a half day program dealing with opiates and the increasing problems we see with its' use.

The Annual program is designed to provide you with numerous pearls on the use of new (and old) science to refine your  knowledge and use of the literature. Drs Gene Carragee and Rick Deyo will again join us to report on more recent advances in the Spine, both their own studies and those published by other authors. Jeff Buchalter, an anesthesiologist from the University of Florida, will talk to you about "real" pain management...(as opposed to what some of us have been seeing).

This is only skimming a few of the points about the program. You should soon be getting a brochure about this course in the mail, you may also click HERE to view the brochure, I would encourage you to look at the program and consider coming to Orlando (next to SeaWorld) and thawing out for a few days, while you learn a bit about more recent advances. We have tried hard to provide you with a different type of program this year. I hope you will like what you see and consider joining us for a few days.

Please click HERE to register online.

Dave Randolph
AADEP 23rd Annual Meeting Program Chair