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2018 Physician Fee Schedule Includes Modest Anesthesia Increase

The 2018 Physician Fee Schedule (PFS) published by the Centers for Medicare and Medicaid Services (CMS) in the Federal Register on November 15, 2017 has set a national conversion factor (CF) of $35.9996 for non-anesthesia services. This includes all evaluation and management codes as well as all surgical procedures. This represents a 0.5 percent po...
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Expanding Into Non-Hospital Venues: The True Measures of Success

The typical anesthesia practice now includes a combination of traditional hospital facilities and ambulatory surgery centers (ASCs), endoscopy centers and other outpatient venues such as doctors' offices. With the continued migration of surgical cases from inpatient to outpatient place of service, a variety of service locations is considered essent...
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2018 Physician Fee Schedule Slashes Reimbursements for Some GI Anesthesia Services

SummaryThe 2018 Medicare Physician Fee Schedule reduces the base unit value for screening colonoscopy from 5 to 3—a 40 percent reduction that translates into an estimated 28 percent reduction in reimbursement, based on an average of 7.2 units billed. CPT codes 00740 (anesthesia for upper GI procedures) and 00810 (anesthesia for lower GI procedures)...
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Leading Leaders: Building Influence in a High-Talent Group

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNIn despair at the way its programs were organized, the business school at one university recruited as the director of programs a successful businessman, who had made a modest fortune in his own business and wanted to move on to a new career. "I will soon put some order in thi...
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Opioids a National Public Health Emergency: What Does it Mean for Anesthesia Practitioners and Pain Specialists?

Following on the heels of President Trump's declaration of the opioid epidemic as a national public health emergency, the president's commission on the opioid crisis last week issued its final report containing more than 50 recommendations for addressing what has been called the most serious drug problem in U.S. history. The report, the heightened ...
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The Smart Anesthesia Group’s Guide to Defending a Payer Audit

Anesthesia 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 dedicated to combating fraud, waste and abuse in government programs, i...
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Three Steps to a High Reliability Anesthesia Drug Delivery System and Medication Safety Improvement: ANESTHESIOLOGY® 2017

SUMMARY Anesthesiologists and nurse anesthetists should apply the principles and practices of high reliability industries, including aviation and nuclear power, in reducing medication errors in their institutions' anesthesia drug delivery systems, according to an anesthesiology and critical care medicine chair who spoke at ANESTHESIOLOGY® 2017. In ...
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Preparing for the Financial After-Life

Depending on how much fun you're having in the OR each day, at some point, you may decide to "discontinue full time professional engagement." Please note that I did not use the "R" word or the "W" word. With so many negative connotations, including declining physical and mental abilities and boredom, retirement, in the traditional sense of the word...
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A Refresher for Anesthesia Practices on Business Associate Agreements: Are Your Contracts in Order?

SUMMARY Covered entities, including anesthesia practices, are required under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to execute a contract with business associates to safeguard the privacy and security of protected health information (PHI). As the holder of the PHI, anesthesia groups should make sure they understand ...
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ASA, Anesthesia QCDRs Join Forces on MIPS Quality Measures

SUMMARY The American Society of Anesthesiologists and the anesthesia Qualified Clinical Data Registries, including ABC's QCDR, have formed a QCDR Roundtable to discuss and work on common interests related to measure development and implementation for the Merit-Based Incentive Payment System (MIPS). ABC encourages anesthesia groups participating in ...
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The National Practitioner Data Bank: What You Need to Know...

Neda M. Ryan, Esq. Corporate Compliance Attorney, ABCThe National Practitioner Data Bank (NPDB) was established under Title IV of the Health Care Quality Improvement Act of 1986 and has been operational since September of 1990. The NPDB impacts both anesthesiologists and certified registered nurse anesthetists (CRNAs) as certain entities are requir...
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What Anesthesia Providers Should Know About Emergency Preparedness, Mass Casualty and Trauma

SUMMARY The mass shooting in Las Vegas reminds us of the vital role of anesthesiologists and nurse anesthetists in large-scale emergency preparedness and disaster response. We present a selection of items on this topic, including an OR Mass Casualty Checklist developed by the American Society of Anesthesiologists, a comprehensive must-read cha...
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Phoenix Project: Reconstructing a Local Group from the Ashes of Its Predecessor

Dateline PhoenixPhoenix. No, not the city in Arizona, but the mythical bird. The one that springs to life from the ashes of its predecessor.Anesthesia groups, like birds, have a life cycle. Birth to death. Formation to failure.The group's founders hatch the concept and bring it into existence. The group obtains business traction in its infancy and ...
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Anesthesia Practitioners: Expand Your Safety Role to Reduce OR Greenhouse Gas Emissions

SUMMARY The public health impact of the environmental pollution created by the healthcare sector is commensurate with the scale of hospital deaths due to preventable medical errors, recent research shows. The operating room is an environmental hot spot and major generator of waste, and the greenhouse warming potential of inhaled anesthetics is...
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Building Professional Resilience: Strategies For Anesthesia Practitioners

Brianna Barker Caza, PhD Associate Professor, Asper School of Business, University of Manitoba, Winnipeg, Manitoba, Canada M. Teresa Cardador, PhD, MPH Assistant Professor, School of Labor and Employment Relations, University of Illinois at Urbana-Champaign, Champaign, IL It is becoming all too common for physicians to report feeling overwhelmed by...
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News for Anesthesia Groups: ACA Repeal, ADRs, Opioid Prescribing and Medicare ID Cards

SUMMARY This eAlert offers news briefs of interest to anesthesia practices on: the Republicans' latest attempt to repeal and replace the Affordable Care Act; the new Medicare ID number initiative and what practices should be doing now to prepare; a primer on additional documentation requests (ADRs) and why a timely response is essential; and c...
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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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CMS Emergency Waivers Help Hospitals and Anesthesia Providers Care for Hurricane-Affected Patients

SUMMARY The Centers for Medicare and Medicaid Services (CMS) has issued several waivers and modifications of certain federal healthcare program requirements to enable beneficiaries impacted by Hurricanes Irma and Harvey to receive emergency and other care and to allow providers to be reimbursed for their services. It behooves all anesthesia ca...
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Why Your Compliance Efforts May Be Worthless

Mark F. Weiss, JD The Mark F. Weiss Law Firm, Dallas, TX, Los Angeles and Santa Barbara, CAIt's a riddle almost as inscrutable as that of the Sphinx: How can a physician or pharmacist or facility owner be convicted of a federal crime for violating a state law? The answer is, unfortunately, quite simple, quite questionable and quite dangerous. It tu...
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A Compliance Reminder for Anesthesia Groups: Check Monthly OIG Work Plan Updates

​SUMMARY The Office of Inspector General has begun issuing monthly rather than yearly or biannual updates on its Work Plan. Anesthesia and pain groups should become familiar with the new format on OIG's website and subscribe to the agency's Work Plan updates to stay informed. The 2017 Work Plan includes two anesthesia-related items: non-covere...
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