Many “Covered Entities” within the meaning of the privacy and security provisions of the Health Insurance and Portability Act of 1996 (HIPAA) are managing more and more of their patient information electronically.  Indeed, not moving to electronic health records (EHRs) may cost physicians a percentage of their Medicare remittances—or at least the loss of a potential bonus of up to $44,000—under the EHR Incentive Program, as discussed in our last several Alerts.Collecting, analyzing, reporting and storing electronic patient information present perhaps even greater HIPAA challenges than does the use of paper records, however.  Data entered on a computer can be copied more easily, more cheaply, more prolifically and even passively.  Once unsecured data are moved from the computer on which they are created to other media, manually or wirelessly, controlling the information becomes nearly impossible.  The key word in the preceding sentence is “unsecured.”  The recently finalized HIPAA regulations on Breach Notification impose...

Last week, we announced the availability of a new web-based electronic health record (EHR) that will permit anesthesiologists to satisfy the Meaningful Use requirements for the Medicare EHR Incentive Program.  Although this technology, F1RSTUse, is relatively simple, requires little additional data entry and is an option for ABC clients and non-clients alike, it will not be the best solution for every reader.  Those of you who are not in a position to implement F1RSTUse or any EHR will be interested in a new hardship exception created by CMS when it released the final regulation on the Stage 2 Meaningful Use requirements on August 23, 2012.Anesthesiologists not participating in the EHR Incentive Program are the targets of the new exception based on “scope of practice,” along with radiologists and pathologists.  In the final rule, CMS added a new section, §495.102(d)(4)(iv), to the regulations which provides that “eligible professionals” (EPs) who designate their...

On Thursday, August 23, 2012 the Centers for Medicare and Medicaid Services (CMS) released the final rule on Stage 2 of the federal electronic health record (EHR) system incentive program.ABC is very pleased to announce F1RSTUse, the first complete EHR platform built exclusively for anesthesiologists and pain management specialists to satisfy easily Stage 1 of Meaningful Use as required to earn the Medicare EHR incentive payment.  Stage 1 requirements remain in effect for the next several years; one of the major changes of the August 23rd final rule was to extend the deadline to meet Stage 2 criteria until 2014.  Other changes contained in the 672-page rule (PDF) will be reviewed in future Alerts.The industry has been discussing the impracticality of attesting to Meaningful Use with current technologies and relationships that are in place for anesthesia.  We at ABC also noted the lack of ease implementing this requirement for the specialty.  Attestation was...

Preparing for negotiations requires an appreciation of the other side’s needs, wants, values and constraints.  Anesthesiologists who have contracts with their hospitals or surgery centers are in a continuous cycle of negotiations—as soon as one contract is signed, it is time to start working toward the next agreement.  One good place to start in understanding the facility’s position is to look at the advice hospitals are receiving from their consultants.  Below is an article recently written for that audience by ABC Vice President for Regulatory Affairs & Research Joette Derricks, CPC, CHC, CMPE, CSSGB.  This article addresses hospital employment of physicians who bill using RBRVS Relative Value Units, and of course anesthesiologists use the Relative Value Guide’s Base and Time Unit methodology and typically have group exclusive contracts to provide services to the hospital’s patients, but the discussion below can be read with the differences in mind. It is important to...

Anesthesiologists and pain physicians who have been receiving bonuses for participating in Medicare’s Physician Quality Reporting System (PQRS) should continue to do what they have been doing.  The proposed Fee Schedule rule (NPRM) for 2013 does not contain any new requirements affecting those who are already successfully participating, as we noted summarily in last week’s Alert.For physicians who have yet to earn a PQRS incentive payment, the NPRM would make reporting easier in future years.  This is important, because failure to report PQRS measures will result in financial penalties beginning in 2015—based on reporting in 2013.  The amount of the payment adjustment, positive or negative, will be as follows: 2013+0.5% 2014+0.5% 2015-1.5% 2016 on-2.0% CMS has stated that one of its major goals in developing its proposed changes was to increase participation to 50% of eligible providers in 2015.  In 2010, the overall level of participation was only 24 percent.  (“2010 Reporting Experience, Including Trends (2007-2011): Physician...