It’s come to the point that a good part of my work with anesthesia groups involves surgery: removing an earworm—a catchy tune that continually runs through the group’s mind.
In fact, it’s always the same tune, part of The Clash’s Should I Stay or Should I Go Now:
Should I stay or should I go now? Should I stay or should I go now? If I go, there will be trouble, and if I stay it will be double. So come on and let me know. This indecision’s bugging me.
Stay, as in should our group remain independent?
Go, as in should we sell out to someone, maybe anyone, who’ll buy us?
But as is generally the case in life, the decision is not purely either/or, black or white, yes or no. There are many alternatives. And that’s what we “operate on” as part of what I call the Future FinderTM...
Most of the hospitals located in any of 75 Metropolitan Statistical Areas (MSAs) would be required to participate in a new program that bundles the payment for joint replacement surgeries under a proposal issued by CMS on July 9, 2015. As necessary members of the team that performs joint replacement surgeries, anesthesiologists in those MSAs should consider approaching their hospitals early in order to be sure of a seat at the table. And they should be prepared to share both the opportunity and the risks.The proposed rule for the Comprehensive Care for Joint Replacement (CCJR) is a significant departure from the voluntary Bundled Payment for Care Improvement (BPCI) program in that it requires virtually all affected hospitals to be financially responsible for all of the care of these patients for 90 days after discharge. (Hospitals already participating in the BPCI program will be excluded.)Physicians are not subject to the mandate but...
By:
Serene K. Zeni, Esq. Clark Hill, PLC, Birmingham, MI
Greg Moore, Esq. Clark Hill, PLC, Birmingham, MI
Alexandra A. Hall, Esq. Clark Hill, PLC, Birmingham, MI
It is not by chance that the discussions leading to the SGR “fix,” the Medicare Access and CHIP Reauthorization Act of 2015 (H.R.2), signed into law on April 16, 2015, began with an anesthesiologist, Republican Congressman Andy Harris, MD. The manner in which the Sustainable Growth Rate (SGR) would be fixed was particularly relevant to anesthesiologists who get roughly 31 percent of commercial payment when they bill Medicare, according to Jane Fitch, MD, chair of anesthesiology at the University of Oklahoma Health Sciences Center in Oklahoma City, in an interview with Anesthesiology News. Understanding H.R.2, therefore, is necessary to understand how anesthesia practices will be reimbursed in the future.
To understand the rationale underlying H.R.2, it is necessary to start with the basic assumption...
One of the largest anesthesia groups in the Midwest has won an important victory in US ex rel Donegan v. Anesthesia Associates of Kansas City, 2015 WL 3616640 (W.D. Mo., June 9, 2015), a False Claims Act (FCA) lawsuit initiated by a whistleblower several years ago. On June 9, 2015, a federal district court in Missouri granted the defendant’s motion for summary judgment, effectively ending the case unless the plaintiff or “relator” files and wins an appeal.Donegan should be helpful to anyone defending against allegations that they billed the federal government improperly for medical services, in violation of the FCA, based on someone else’s interpretation of an ambiguous rule. In the court’s own words, “A relator ‘must show that there is no reasonable interpretation of the law that would make the allegedly false statement true.’”This the relator, John Donegan, a CRNA formerly employed by the defendant, Anesthesia Associates of Kansas City...
Anesthesia Business Consultants (ABC), a leading provider in billing and practice management for the anesthesia and pain management specialty, is pleased to announce its latest partnership with Stat-App. Developed and piloted by Anaesthesia Associates of Massachusetts, the largest private anesthesia practice in New England, Stat-App focuses on improving the efficiencies of anesthesia practices to better serve the facilities they work in.The Stat-App infrastructure is designed to allow clinical providers to securely communicate with their colleagues, and to better understand who is available presently within their own facility utilizing GPS technologies. Leveraging devices that are already utilized today, the Stat-App brings a new capability to an anesthesia practice to better manage schedules, utilization and costs."The profitability, and even survival, of an independent multi-facility practice group depends upon correctly aligning valuable clinicians with an appropriate workload. Stat-App exists to optimize multi-facility practices, open lines of communication and to equalize provider workload," said Christopher...