May 12, 2010

If you are on the ASA Grassroots Network email list, you have already received the urgent appeal below. This is about a brand-new possibility for bringing the Medicare anesthesia conversion factor into line with the rates received by other specialties and the only way it will work is if enough Members of Congress become interested. That depends on your calls to your own Member. This is so important that we want to make sure anesthesiologists see the ASA appeal even if they aren’t participating in the Grassroots Network (yet).

ASA Request

Call Today: Urge Your Lawmaker to Co-sign the Anesthesiology Medicare Payment Letter

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Four key members of the U.S. House of Representatives are seeking support from their colleagues for a letter to the Department of Health and Human Services requesting a review of the accuracy of Medicare's payments for anesthesia services.

Representatives Gene Green (TX), Sue Myrick (NC), Eddie Bernice Johnson (TX) and Leonard Lance (NJ) have authored a bipartisan letter asking Secretary Kathleen Sebelius of the U.S. Department of Health and Human Services to use the authority granted her under Section 3134 of the Patient Protection and Affordable Care Act (PPACA) - a provision known as "Misvalued Codes Under the Physician Fee Schedule" - to review Medicare payments for anesthesia services as possibly misvalued or undervalued. The authors are seeking cosignatories.

The text of the "Green, Myrick, Johnson, Lance letter" is at the end of this message.

Talking points and call instructions are available online. Please call your U.S. Representative today!

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Dear Secretary Sebelius:

As part of the authority granted to you under Section 3134, Misvalued Codes Under the Physician Fee Schedule, of the Patient Protection and Affordable Care Act (PPACA), we ask that you review Medicare payments for anesthesia services as possibly "misvalued" and potentially undervalued.

Anesthesiology suffers from a significant payment disparity under the Medicare system. While modest disparities between Medicare and commercial physician payment rates are longstanding and well-recognized, the disparity in payments for anesthesia services is unique. A July 2007 Government Accountability Office (GAO-07-463) report found that within a representative sample of anesthesia services performed in 41 Medicare payment localities, Medicare payments represented only 33% of commercial insurance payment rates for the same service. In contrast, the Medicare Payment Advisory Commission (MEDPAC) consistently reports Medicare's payments for other physician services represent approximately 80% of commercial rates when averaged across all physician services and geographic areas. Accordingly, we believe the unique level of the disparity known as the "33% problem" warrants consideration as "misvalued."

Although the anesthesia payment system is linked to the system for payments for other physician services - the Resource-based Relative Value Scale (RBRVS), the two differ methodologically. Accordingly, we would ask that you consider this issue with the involvement of individuals with recent clinical experience, generalized expertise in the valuation process used for Part B services, and specific expertise in unique payment methodologies specifically including that employed for anesthesia services. A thorough review by these experts of possible inaccurate links between the anesthesia payment system and RBRVS system may prove fruitful. Indeed, some payment observers have suggested that misvalued links between the two systems are contributing to the anesthesia payment disparity.

Thank you for your efforts to ensure accurate and appropriate payment levels under Medicare and for your consideration of this request.

/s/                                         /s/                                       /s/                                           /s/
Gene Green                      Sue Myrick                       Eddie Bernice Johnson     Leonard Lance
Member of Congress      Member of Congress     Member of Congress         Member of Congress

 

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If you are an ASA member and you have questions about this campaign, you should contact the ASA Office of Governmental and Legal Affairs, 1501 M Street, N.W. Suite 300 Washington, DC 20005, Telephone: (202) 289-2222, Fax: (202) 371-0384, Email: mail@asawash.org.

We hope that Congress will hear from so many of anesthesiologists and CRNAs that they will be sure to convey the urgency of the request to Secretary Sebelius.

With best wishes,

Sincerely,

Tony Mira
President and CEO