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.

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.

August 29, 2011

The Centers for Medicare and Medicaid Services (CMS) has just announced the Bundled Payments for Care Improvement Initiative. On August 23, 2011, CMS invited providers to apply to help test and develop four different models of bundling payments. Letters of intent and completed applications are due on September 22nd, October 21st or November 4th, depending on the payment model. Full information is available at http://innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html.

August 22, 2011

Anesthesiologists, nurse anesthetists and anesthesiologist assistants who last validated their enrollment in Medicare prior to March 25, 2011 are going to have to revalidate again by March 23, 2013. 

The revalidation is required under Section 6028 of the Affordable Care Act.  According to this statutory provision, all providers and suppliers who were initially enrolled before March 25, 2011 and have not revalidated since then must revalidate their enrollment information within 60 days of receiving notice from their carriers, but no later than March 23, 2013.

August 15, 2011
Attestation to earn a bonus under the Medicare Electronic Health Record (EHR) Incentive program began on April 18, 2011.  As of July a total of 566 Eligible Professionals (EPs) had received a total of $18,432,000 in incentive payments,

Most anesthesiologists and pain physicians – but not all – will be unable to participate successfully in the electronic health record (EHR) incentive program, at least for now.  Neither specialty appears on CMS’ most recent report of eligible physicians by specialty.  You have until October 2012 to begin and still receive the full bonus, however.

August 8, 2011
You already know that last week’s debt ceiling legislation, “The Budget Control Act of 2011” (S. 365), authorized $2.4 trillion in additional government borrowing, did not raise any new revenues and provided for $2.5 trillion in spending cuts over the next ten years.

August 1, 2011
A quick search of social networking sites Facebook, Linked In, Twitter and YouTube shows many busy anesthesia communities, and quite a few underutilized placeholders. In case the term “social media” or the names of the major media noted above are unfamiliar to any readers, we will borrow ASA’s useful definition:

"Social networking and media" is the term commonly given to various online and interactive technology tools that enable people to communicate easily via the internet to share information and resources, including social and professional networking sites, blogs, wikis, forums, virtual worlds, trade sites and Listserv® lists. Social media can include the exchange of text, audio, video, images, podcasts and other multimedia communications that are user driven. As the name implies, social media involves the building of communities or networks, encouraging participation and engaging participants of all ages.

July 25, 2011
Every anesthesiology department and practice should have a copy of ASA’s Manual for Departmental Organization and Management (the “MADOM”), the “essential reference” for any department. This publication has long been one of ASA’s most underappreciated resources – but it certainly should not be. The fact that it is free to members of the association is a benefit of membership, not a comment on its value. Others may purchase a CD or download the MADOM for $100 from the ASA website.

July 18, 2011
If you received any practice management or health policy newsletters at all, you almost certainly saw or heard the acronym “IPAB” last week. Two committees in the House of Representatives held widely publicized hearings on legislation to repeal the Independent Payment Advisory Commission or “IPAB,” a radical cornerstone of the Affordable Care Act (ACA).

July 11, 2011
Here we go again. The fearsome Sustainable Growth Rate (SGR) formula has forced the Centers for Medicare and Medicaid Services (CMS) to project a 29.5 percent decrease in payments to physicians in 2012, or an overall conversion factor (CF) of $23.9635, in the proposed Physician Fee Schedule (PFS) rule

July 5, 2011
Beginning on November 1, 2011, all physicians must use a new and minimally revised a Advance Beneficiary Notice of Noncoverage (ABN form. This revision is part of a regular three-year cycle and it contains minor changes only.

June 27, 2011
Some things should not be this complicated. Physicians' and other providers' signatures have come under renewed scrutiny, however, because the national Medicare Fee for Services (FSS) Error Rate for the most recent reporting rate was 7.8 percent. That translates to more than $24 billion paid in error.

June 20, 2011
Making it more expensive for beneficiaries to choose teaching and other higher-cost hospitals is one way that health insurers are protecting their margins. Raising deductibles and copayments in order to keep premiums deceptively level is another. The well-respected Drew Altman, Ph.D., President and CEO of the Kaiser Family Foundation, recently made three predictions...

June 13, 2011
American Society of Anesthesiologics members have acess to an up-to-date set of policy templates and implementationforms that will help their hopsitals satisfy The Join Commission's requirements for anesthesia services.