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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July 29, 2013
The first Alert this month looked at preventable hospital readmissions and ways to attempt to reduce the rate, which was 12.3 percent for Medicare patients in 2011. There is much more to say on the topic, including an interesting study published in the June 2013 issue of Health Affairs, Limits of Readmission Rates in Measuring Hospital Quality Suggest the Need for Added Metrics by Matthew J. Press and colleagues.
July 22, 2013
In a little more than two months, individuals and small businesses will be able to enroll in health plans offered by the Health Insurance Exchanges (HIEs) created under the Affordable Care Act. By the deadline of January 1, 2014, all states must have an operational individual and small-business exchange. The Congressional Budget Office estimates that nine million people will obtain coverage through HIEs in 2014, a number predicted to rise to 22 million people by 2022.
New PQRS Reporting Requirements in the Proposed 2014 Medicare Fee Schedule Rule—Limited Impact on Anesthesia
July 15, 2013
Just as happens every summer, CMS has released its proposed rule with updates and changes to the Medicare Physician Fee Schedule that will take effect on January 1, 2014. Not unexpectedly, the Agency is projecting that the sustainable growth rate (SGR) impact would be a 24.4 percent cut in 2014. Do not bank on this number though. It is going to change before the end of the year.
July 8, 2013
Bundled payments are coming. Are there any readers who have not heard? But do we know what “bundled payments” might mean for anesthesiologists and pain physicians?
July 1, 2013
In 2011, 12.3 percent of Medicare hospital admissions were followed by a potentially preventable readmission, according to the Medicare Payment Advisory Commission (MedPAC), which has just released its latest Report to Congress on Medicare and the Health Care Delivery System.
June 24, 2013
Some payers are sowing confusion regarding whether nerve blocks placed for the management of postoperative pain are separately payable.
Anesthesia Business Consultants, Tulane University and Medical Business Solutions Announce Partnership to Present the First Annual “Advanced Institute for Anesthesia Practice Management”
June 18, 2013
Anesthesia Business Consultants (ABC) announces today that it has partnered with Medical Business Solutions and Tulane University School of Medicine, Department of Anesthesiology to present the first annual Advanced Institute for Anesthesia Practice Management (AIAPM). This event will be held at the Cosmopolitan Hotel in Las Vegas, Nevada on April 11-13, 2014. The main goal of this new partnership is to offer our attendees the finest and highest level practice management and billing meeting experience available in the anesthesia marketplace at this time.
June 17, 2013
A "bundled" payment covers a defined package of services delivered by two or more providers during a single episode of care or over a specific period of time. Nine out of nineteen provider-payer pairs studied by Bailit Health Purchasing, LLC have fully operationalized at least one bundled payment. Two more pairs are conducting observational pilots and three others have embarked on developing a bundled payment program.
June 10, 2013
The attorney-client privilege seems like a simple enough concept, but it is full of complexities. Anesthesiologists and administrators who handle communications with their groups’ lawyers need to know how to protect the privilege. Ongoing whistleblower litigation, U.S. ex rel. Baklid-Kunz v. Halifax Hospital Medical Center, Case No: 6:09-cv-1002, 2012 U.S. Dist. LEXIS 158944 (M.D. Fla. Nov. 6, 2012), offers valuable guidance.
June 6, 2013
The New York Times has continued its assault on colonoscopies in its June 1st article entitled “The $2.7 Trillion Medical Bill: Colonoscopies Explain Why U.S. Leads the World in Health Expenditures.”
June 3, 2013
The Sustainable Growth Rate (SGR) formula that constrains the annual update to the Medicare payment rate is projected to reduce physician payments by 24.4% in 2014, unless Congress intervenes.
May 28, 2013
In order to be their hospitals’ valued partners, anesthesiologists should understand the needs and forces driving the institutions’ leadership. Some of the strongest of those forces today are creating a wave of merger and acquisition (M&A) activity. In 2012 there were more than 100 deals in the U.S., twice as many as three years earlier. If the relationship dynamics do not encourage partnership between the group and the C-suite, it is nevertheless important to be able to gauge whether one’s hospital is going in the right direction (or staying in the right place).
CMS Instructions for Healthcare Providers and Facilities in the Event of a Disaster or an Emergency Situation
May 23, 2013
Natural disasters in America are always difficult. Our first concern is about the safety and welfare of the people involved. The buildings, the cars that are tossed around like toys and the personal belongings, while precious to their owners, quickly become meaningless when life and limbs are at risk. Anesthesia Business Consultants' (ABC) prayers are with the victims of the Moore, Oklahoma tornado this past Monday. Catastrophic events like the recent tornado, Hurricane Sandy, and flooding throughout the plains a few months ago, make us all appreciate what is most important to us.
May 20, 2013
With remarkable timing, news of a lawsuit brought by the parents of a teenager left in a permanent vegetative state after a routine endoscopy coincides with the announcement that the Food and Drug Administration (FDA) has granted Premarket Approval for the SEDASYS® system, a computer-assisted personalized sedation system.
Anesthesia Practices Can File Claims for Repayment under MasterCard and Visa Class Action Settlement
May 15, 2013
Anesthesia practices that accept Visa and MasterCard payments are among the “merchants” that may be able to collect a portion of the fees paid to the card issuers under the proposed settlement in the Payment Card Interchange Fee and Merchant Discount Antitrust Litigation pending in federal District Court in New York.
May 13, 2013
Astonishingly, after decades of discussion, there is still a lot of uncertainty as to what the anesthesia medical direction rules mean by the requirement that the medically-directing anesthesiologist be “immediately available.”
April 29, 2013
The American Hospital Association (AHA) has just released a report that describes the strategies that will help its nearly 5,000 member hospitals succeed in the value-based healthcare environment. This report, Metrics for the Second Curve of Health Care, will be of interest to all anesthesiologists who want to understand and meet their hospitals’ needs—and that should include all anesthesiologists who work in a hospital. Whether you have held the anesthesia franchise at your institution for decades with no competition, or whether you are seeking ways to improve or even launch a relationship with a hospital, you will benefit from knowing administration’s goals.
April 22, 2013
Physicians who refer or order services for Medicare patients must be enrolled in PECOS, the Medicare Provider Enrollment, Chain, and Ownership System database, and physicians who bill Medicare are required to list the name and National Provider Identifier (NPI) of the ordering/referring physician on their claims in order to be paid. The source of these requirements is Section 6405 of the Affordable Care Act.
Hospitals May Pay for Anesthesia and Pain Medicine EHRs without Violating the Self-Referral or Anti-Kickback Laws
April 15, 2013
The Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services Office of the Inspector General (OIG) last week published parallel proposed rules that would remove certain obstacles to hospitals’ paying for the electronic health record (EHR) technologies used by anesthesiologists, pain specialists and other physicians.
April 8, 2013
One of the Medicare Administrative Contractors (MACs), Noridian Administrative Services LLC, has published a proposed policy that would bar payment for peripheral nerve blocks placed pre-operatively for the management of post-operative pain. According to the draft policy, entitled Nerve Blockade: Somatic, Selective Nerve Root, and Epidural..