Another dragon is slinking away, although it isn’t yet slain. On February 15, 2012, Health and Human Services Secretary Kathleen G. Sebelius announced that “HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).” In other words, medical practices no longer need to ensure that they will be ready for ICD-10 by October 2013.
The press release noted that the final regulation adopting ICD-10 as a standard was published in January 2009, and that it set a compliance date of October 1, 2013 (itself a delay of two years from the compliance date initially specified in the 2008 proposed rule). HHS has not given any hint regarding a new compliance deadline.
ICD-10 is a set of codes used to identify and describe diagnoses (ICD-10-CM) and procedures (ICD-10-PCS), replacing ICD-9. It will...
Please take a moment to participate in the second annual ASA nationwide survey on anesthesia drug shortages. This brief survey will help ASA continue to work with legislative and regulatory policymakers to develop policies that help to avert drug shortages, provide advanced notification and mitigate the effects of drug shortages. Data from last year's survey was instrumental to ASA in demonstrating the urgency of addressing drug shortages.
For this survey to be successful, ASA will again need a high participation rate of members. Please complete this survey and encourage other ASA members to do so as well. http://www.surveymonkey.com/s/asadrugshortagesurvey
I. Revised Anesthesia Conversion Factors
CMS has just updated the Medicare conversion factors (CFs) for anesthesia services. The new national, unadjusted CF is $21.52, up from $21.41 for the first two months of 2012. Download the list of locality-adjusted CFs here.
As noted on the CMS website, “Medicare payment rates under...
Last week saw the launch of the latest version of the iPad – and the beginning of the end, perhaps, of the IPAB.The Independent Payment Advisory Board (IPAB) was created by the Patient Protection and Affordable Care Act (ACA) in 2010. IPAB is responsible for recommending specific proposals to contain the growth rate of Medicare spending if spending per capita is projected to exceed targets also established by the ACA. From 2015 through 2019, that target is based on measures of inflation. Starting in 2020, the target is based on the growth of the gross domestic product plus one percentage point.Binding Recommendations and Other ReportsAt the start of every year, IPAB must submit recommendations to Congress to reduce spending if the targets are going to be exceeded. If IPAB fails to meet this deadline, the Secretary of Health and Human Services (HHS) must develop a proposal. Congress must consider the IPAB...
When physicians, hospitals, home health agencies and other providers decide to create an Accountable Care Organization or other integrated delivery system, one major issue that will soon command attention is the distribution of patient care revenues. How will the various providers share the pie?One model comes from the PROMETHEUS® Payment allocation system.i PROMETHEUS, a methodology developed beginning in 2004 by a team led by Alice G. Gosfield, Esq. and François de Brantes, M.S., M.B.A. pays providers a single, risk-adjusted payment across inpatient and outpatient settings to care for a patient diagnosed with a specific condition. The payment is based on “evidence-informed case rates” (ECRs) and is theoretically equal to the resources required to provide care as recommended in well-accepted clinical guidelines. Thus the total payment for a typical episode of care, or the ECR, is equal to:Types of services typically involved in treating the condition* Frequency * Price per serviceA portion of... 
For the last several months the literature on Accountable Care Organizations (ACOs) has flourished. So has the volume of workshops, seminars and webinars, all with the intent of educating providers on what the future will look like, and many addressing how physicians might participate. Independent anesthesia groups are trying to not only understand the ACO rules but are also working hard to determine how they will function in any of the possible structures that emerge in their communities.There are various traditional obstacles to the formation of multispecialty groups, such as those posed by the antitrust and antikickback laws. The Patient Protection and Affordable Health Care Act calls upon the Secretary of Health and Human Services (HHS) to adopt regulations that will foster the development of ACOs, and that includes resolving potential conflicts between the antitrust, antikickback and Stark laws and the efficiencies expected to result from the formation of ACOs.Given that...