All of you are familiar with some of the regulatory requirements that affect your practice, as identified by their acronyms and initials: HIPAA, CMS, CoPs,PQRS, SCIP, ACO, HCAHPS. For hospital-based practices, there are now two additional “ingredients” in our regulatory alphabet soup that will require your attention: OPPE and FPPE. Historically, hospital medical staff appointments and reappointments have been primarily a subjective process, where the clinical chief signed off on credential/privilege requests, perceived competencies and specific skills. The Joint Commission and other accrediting bodies and payers have established more stringent guidelines for the ongoing evaluation of medical staff members. The Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) are now becoming part of every hospitalbased anesthesia practice’s routine. These evaluations are expected to occur on a regular basis and serve as the key component to the hospital reappointment process. Key Components   In adopting the Accreditation Council for...

Participating in Medicare’s Physician Quality Reporting System (PQRS) has taken on a new flavor this year.  While until now participating has meant a potential annual bonus of several thousand dollars, not reporting in 2013 will entail a penalty in 2015.  Losing out on a bonus is less galling than forfeiting a percentage of each remittance.  No anesthesiologist, CRNA or pain physician is doomed to lose money for failing to report the applicable PQRS measure(s).  This Alert will provide a reminder of the steps you need to take to earn the bonus and to avoid future penalties. It is a testament to the undue complexity of the program that we are now in its seventh year, and yet uncertainty lingers.  As a reminder, the incentive payments and “payment adjustments” for each year are as follows: YearPayment/AdjustmentMadeReporting YearPayment or (Adjustment) 200820071.5%2009 20081.5% 201020092.0% 201120102.0% 201220111.0% 201320120.5% 201420130.5% 201520140.5% 20152013(1.5%) 2016 onward2014 onward(2.0%)  ...