Anesthesia Industry and Market News: eAlerts
eAlerts are the latest industry information regarding regulatory changes, helpful compliance reminders, or any number of relevant topics in the fast-paced, ever-evolving speciality of anesthesia.
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January 23, 2012
The new calendar year is the last year in which “eligible professionals” (EPs) can begin to participate in the Medicare incentive program for electronic health records (EHRs) and receive the maximum available bonus payment, $44,000 over a five-year period. Although the final regulations on the EHR program appeared in mid-2010, there is still a fair amount of confusion over whether anesthesiologists can qualify for the bonus. In this Alert, we will review the cumulative requirements for participation in a program whose summary is deceptively simple:
January 17, 2012
Do you realize that we have just passed the 20th anniversary of the Medicare Fee Schedule? A product of 1989 legislation, the Physician Fee Schedule went into effect on January 1, 1992. (And William Hsiao, PhD, whose study of Resource-Based Relative Value Systems was the basis for the change from charge-based payment methodology, is still teaching at the Harvard School of Public Health today.)
Postoperative Pain Management Procedures Can Still Be Reported Separately from the Anesthesia Service
January 9, 2012
A change to some language in the Anesthesia Services chapter of the Medicare National Correct Coding Initiative (NCCI) manual recently created considerable confusion among participants in the on-line discussion maintained by the Medical Group Management Association (MGMA) for the Anesthesia Administration Assembly (AAA).
January 3, 2012
Medicare’s Value-Based Purchasing (VBP) program for hospitals, mandated by the Affordable Care Act, took off upon the release of final regulations on April 29, 2011. VBP marks the start of true pay-for-performance, as opposed to pay-for-reporting, at the hospital level.
December 27, 2011
On Friday, December 23, President Obama signed legislation extending 2011 Medicare Fee Schedule payment rates for two months.
December 19, 2011
Texas has revised its statute on medical informed consent, 25 Texas Administrative Code, Chapter 601, effective January 16, 2012. The new rules, adopted by the Texas Medical Disclosure Panel, require physicians to inform patients of the risks of anesthesia and/or perioperative pain management and to obtain their signed consent for these procedures.
December 12, 2011
ABC recently conducted a survey of clients and others to assess the anesthesiology community’s level of interest in a network of independent practices participating in joint quality improvement and cost-effectiveness initiatives.
December 5, 2011
The end of the year is a good time to review Medicare’s Physician Quality Reporting System (PQRS). Several clients have recently raised questions about the PQRS program and it is likely that a number of other readers could use a refresher course.
November 28, 2011
In just under five weeks, on January 1, 2012, physicians, hospitals, health plans and claims clearinghouses will be required to be in compliance with the ASC X12 Version 5010 HIPAA standard for the electronic transmission of healthcare claims and other administrative communications such as claims, remittance, eligibility, claims status requests and responses.
November 21, 2011
Several readers have asked how to plan for the next few years now that the United States Supreme Court has announced that it will review the constitutionality of the Affordable Care Act (the “ACA”) next year. The answer depends on whether the Supreme Court’s decision, which is expected by early summer, upholds the ACA, invalidates it in part, or decides that the entire statute must fail.
November 14, 2011
More than 750 companies offering some form of electronic health record solution have entered the market within the last few years, according to a report entitled "US Markets for Electronic Medical Records in 2012" by the Millennium Research Group.
November 7, 2011
Every November, the Centers for Medicare and Medicaid Services (CMS) issues a final version of the regulation updating the Physician Fee Schedule – and for the past eleven years, the update announced by CMS has been a decrease in payment rates, thanks to the Sustainable Growth Rate (SGR) formula. This year is no exception.
October 31, 2011
Two recent court decisions combine to offer anesthesiologists an important warning about expressing their opinions regarding colleagues.
October 24, 2011
The finalized regulations on Accountable Care Organizations (ACOs) are here. CMS will begin accepting applications from potential ACOs on January 1, 2012, for April 1 or July 1 start dates
October 17, 2011
For over a decade, anesthesia software vendors have worked to provide health information technologies for the perioperative process. To this day, hospital adoption of an anesthesia Electronic Medical Record (EMR) remains low for non-academic facilities. Many people and companies have expressed an opinion on the subject and the most common reason offered is the failure to make an anesthesia EMR a hospital purchasing priority.
October 10, 2011
Thriving or even surviving as an independent anesthesia group is more challenging all the time. Medicare payment rates are dropping, fee negotiations with private health plans are painful and hospitals are seeking ways to stop paying stipends to their anesthesiology groups. CMS and TJC regulations and standards are more complex and ever-changing — let alone increasingly difficult to implement.
October 3, 2011
Fielding a patient satisfaction survey is becoming de rigueur for medical practices, hospitals, ambulatory surgery centers (ASCs) and other providers. One of the early versions of an accountable care organization (ACO), California’s Integrated Healthcare Association, ten years ago launched a pay-for-performance program in which patient satisfaction accounted for thirty percent of the overall quality score. Patient-centricity and consumerism are as important to healthcare reform as quality and efficiency. .
September 26, 2011
The Medicare eRx Incentive Program is turning out to be the Full Employment for Healthcare Writers program.
E-Prescribing by Anesthesiologists and Pain Physicians: Web Portal to Request Exemption is up and Running
September 17, 2011
Just two weeks ago, we published an Alert headed “Anesthesiologists Will Soon Be Able to Request Their Exemptions.” “Soon” is now. CMS has just announced a new provider website, the Quality Reporting Communication Support Page, to enter requests for hardship exemptions from the electronic prescribing (eRx) requirement along with supporting rationales.
September 12, 2011
Medical practices and other entities covered under the Health Insurance Protection and Portability Act of 1996 (HIPAA) are required to provide notification following a breach of unsecured protected health information.
September 6, 2011
The Centers for Medicare and Medicaid Services (CMS) released the Final Rule on Changes to the Electronic Prescribing (eRx) Program on August 31, 2011. Physicians who did not submit the eRx code on ten claims for patient visits between January 1 and June 30, 2011 are subject to a 1-percent payment penalty beginning on January 1, 2012.