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Conflicts and Kickbacks: Risks for Hospital-Based Physician Groups

Frank Carsonie, JD Chair, Health Care & Life Sciences Practice Group Benesch, Friedlander, Coplan & Aronoff LLP, Columbus, OH Nathan Sargent, JD Associate, Health Care & Life Sciences Practice Group Benesch, Friedlander, Coplan & Aronoff LLP, Cleveland, OH Hospitals and hospital-based physician groups enter various types of service ...
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Documenting Medical Necessity in Anesthesia: Think Comorbidities

Summary In ABC's experience, issues around proper documentation of medical necessity represent the leading cause of anesthesia claims denials. While medical necessity may be thoroughly shown in the anesthesia record, we encourage anesthesia practitioners to ensure that they share this information with their billing and coding partner. ABC clie...
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What Is the Value of Data and What Data Has Value? Today’s Anesthesia Management Challenge

Jody Locke, MA Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MI What is it that makes today's anesthesia providers so good at managing patients safely through the trauma and discomfort of surgery? While many will cite the value of experience, the most critical factor is the availab...
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Building High-Performing Teams in Anesthesia

Summary Effective teams, including high-performing teams spanning departments, disciplines and services, are central to the development of a "culture of safety." Hallmarks of high-performing teams include an aligned vision, complementary skills, achievable goals and metrics, participative leadership, a culture of trust and a preoccupation with...
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Staying Focused in Ambiguous Times

For Carmel Schacar and I. Glenn Cohen of Harvard Law School, writing in Health Affairs, "uncertainty" was 2017's word of the year for health law and bioethics.1 In many ways, that capsule summary suits a description of healthcare in general and anesthesia in particular during the past 12 months as the frenetic pace of change continued unabated and ...
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It’s Time to Measure Patient Satisfaction with Anesthesia Care: PRACTICE MANAGEMENT™ 2018

Summary The benefits of surveying patient satisfaction with anesthesia care are becoming increasingly evident in a competitive environment of quality reporting in which anesthesia groups can use reports of outstanding service and communication to help demonstrate value to institutions and payers. We offer highlights of a presentation on measur...
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Disrupting the Disruptive Physician

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNOne would think (or hope) that by the time anesthesiologists complete their training and begin practicing, they have mastered not only their clinical field, but also the ability to work well with others and behave appropriately. If you've spent any time as a member of an anes...
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Anesthesia Drug Shortages Persist: What Groups Can Do

Summary Drug shortages remain a serious problem, and anesthesia providers are particularly vulnerable, with anesthesia drugs often among those in short supply. We offer a glimpse of current trends, advocacy initiatives by the American Society of Anesthesiologists and others, research on causes and potential solutions, and programs at individual ins...
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How (Others’) Stupid Compliance Mistakes Can Save Your Life

Mark F. Weiss, JD The Mark F. Weiss Law Firm, Dallas, TX, Los Angeles and Santa Barbara, CASome inner desire stronger than my willpower beckoned me to stare at them through the glass. I was nine years old. It was both titillating and embarrassing.There were 10 photographs in gritty black and white, arrayed in order behind glass on the post office w...
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Why Report? The 2018 Anesthesia Quality Measures: Key Considerations for Groups

Summary Though the low-volume threshold for the 2018 Quality Payment Program has been raised, loosening the requirement for participation by anesthesiologists and nurse anesthetists, anesthesia groups that continue to report quality data through a Qualified Clinical Data Registry can reap some important benefits. We present the anesthesia qual...
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HIPAA Business Associate Agreements: Why These Contracts Matter

Kathryn Hickner, Esq. Ulmer & Berne LLP, Cleveland, OH No one loves drafting, reading or negotiating HIPAA Business Associate Agreements (BAAs). Yet many of us need to do so, and some of us do so daily.They are often boring, dense and technical, but BAAs are important from both a legal and a business perspective, and they deserve our attention....
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Anesthesia Groups: Target Over-Utilized OR Time to Improve Efficiency

Summary To improve efficiency in the OR, reduce your hours of over-utilized OR time, increase first-case on-time starts, use an OR manager with a solid grounding in the scientific principles of OR efficiency to drive improvement with electronic notifications, and search the scientific literature to find examples of what works. We summarize these an...
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Anesthesiologists in the ICU: Economics and Other Considerations

Very few private anesthesia practices provide services in their hospitals' intensive care units (ICUs). The lack of enthusiasm for staffing the ICU relates directly to a perception that ICU coverage is not as profitable as operating room (OR) coverage. The entire Anesthesia Business Consultants client database only yields a few examples of private ...
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Informed Consent for Anesthesia: ‘It’s a Process, Not a Form.’

Summary A direct dialogue between the anesthesiologist and patient is best in obtaining informed consent for anesthesia, according to attorney Judith Jurin Semo, JD, who spoke at ANESTHESIOLOGY® 2017. We present a summary of selected takeaways from Ms. Semo's presentation. Faced with tight time constraints and pressure to maximize operating room ef...
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The Smart Anesthesia Group’s Guide to Defending a Payer Audit

Vicki Myckowiak, Esq. Principal, Myckowiak Associates, PC, Detroit, MIAnesthesia groups currently find themselves in the uncomfortable position of being a target of the Office of Inspector General (OIG) of the Department of Health and Human Services, the largest inspector general's office in the federal government, with approximately 1,600 people d...
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Anesthesia and Pain Group Compliance in 2018: A Year for Heightened Diligence?

Summary With civil monetary penalties, assessments and exclusions based on prohibited conduct and violations of healthcare laws on the rise, anesthesia and pain groups might consider enhancing efforts to improve practice compliance and documentation in 2018. We provide several examples of settlement agreements reported by the Health and Human Servi...
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2017: A Year of Uncertainty for Healthcare and Anesthesia

We close the year with a glance back at some of the most significant healthcare- and anesthesia-related developments of 2017. The word of the year in health law and bioethics was "uncertainty," Carmel Schacar and I. Glenn Cohen of Harvard Law School proclaimed on Health Affairs' blog. The same might well be said of the healthcare sector as a whole ...
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2018 CPT Coding and Key Reimbursement Changes Pain Management and Anesthesia

• The 2018 CPT edition includes 170 new CPT codes, 60 revised codes and 82 deleted codes along with two new modifiers. It is important to understand the changes and what should be documented to support the utilization of these codes.• The majority of the changes for 2018 were new CPT codes added to the Surgery section, Pathology/Laboratory section ...
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Is it Time to Add TAP Blocks to Your Anesthesia Practice?

First described in 2001, the transverse abdominis plane (TAP) block is a peripheral nerve block designed to anesthetize the nerves supplying the anterior abdominal wall (T6 to L1). In a 2011 meta-analysis, the TAP block was shown to reduce the need for postoperative opioid use, increase the time to first request for further analgesia and provide mo...
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2018: Anesthesiologists to See Cuts to Some Ancillary Procedure Payments

The 2018 Physician Fee Schedule (PFS) (published in the Federal Register on November 15, 2017) contains significant reductions in the work values for several flat-fee ancillary services. Flat-fee services are those for which payment is determined under the Resource Based Relative Value Scale (RBRVS) and for which time is not a factor in determining...
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