Anesthesia Industry eAlerts
Sent to subscribers every Monday morning, our eAlerts deliver timely updates on regulatory, legislative and practice management developments of interest to anesthesia professionals.
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September 19, 2016
The clinician community—anesthesiologists and nurse anesthetists included—breathed at least a partial sigh of relief last week. The Centers for Medicare and Medicaid Services (CMS) announced that clinicians would not suffer financial penalties in 2019 based on their performance in 2017 under the new Quality Payment Program (QPP) that implements the Medicare Access and CHIP Reauthorization Act (MACRA).
September 12, 2016
This week’s eAlert offers a compendium of news items and practical advice for anesthesia providers and practice managers, gleaned from a variety of sources. We hope you find these items interesting and useful in your anesthesia practices.
September 6, 2016
The premise is elegant in its simplicity: The more information you have about a surgical patient’s biology, the greater your ability to tailor anesthesia medication appropriately for that patient and lower their risk of an adverse drug reaction (ADR), longer hospital stay or hospital readmission, and the better and more cost-effective the overall quality and safety of your anesthesia care.
August 29, 2016
The developers of the Maslach Burnout Inventory define physician burnout as “an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.” Some suggest its relative absence should be considered a measure of quality. No matter how one defines it, it is not a good thing—for physicians, care teams, practice management professionals, patients or healthcare organizations. As the data show, anesthesiologists unquestionably suffer from it right alongside their peers in other specialties.
August 22, 2016
An anesthesiologist recently received a several-year prison sentence for prescribing controlled substances without a legitimate medical reason. One of this physician’s patients died from taking hydrocodone, which the physician had prescribed for no legitimate medical purpose.
August 15, 2016
We would like to say it isn’t so, but ransomware attacks haven’t tapered off; they’ve soared. So far in 2016, ransomware attacks have risen 300 percent since 2015 (from 1,000 to 4,000 attacks daily), according to a government report.1 The healthcare sector—anesthesia providers included—is especially vulnerable.
August 11, 2016
Anesthesia Business Consultants (ABC), a leading provider in billing and practice management for the anesthesia and pain management specialty, is pleased to announce that the Summer 2016 issue of its quarterly newsletter, The Communiqué, is now available.
August 9, 2016
The Anesthesia Business Consultants (ABC) affiliate company and trusted Anesthesia Information Management Systems (AIMS) partner, Plexus Technology Group, LLC (Plexus TG), is pleased to announce Anesthesia Touch™ is now a fully-rated AIMS solution as scored by providers and recorded by KLAS research with a score of 891.1
August 8, 2016
An anesthesiology group decides not to provide labor epidural anesthesia to women with limited English proficiency (LEP).1
August 1, 2016
The death in April of the musician Prince from an accidental overdose of fentanyl is only one of the more highly publicized instances of a public health problem in the United States that has reached epidemic scale. According to the Department of Health and Human Services (HHS), 44 people die every day in the U.S. from an overdose of prescription painkillers.
July 25, 2016
Few are unfamiliar with the general state of veterans and healthcare in our country. According to statistics recently released by the VA, an average of 20 veterans died from suicide in 2014.1 Further, there is a backlog of nearly 500,000 veterans waiting 30 days or longer to receive care at VA facilities across the U.S. This is higher than the numbers from one year ago when reports were released that showed veterans dying while waiting for care as a result of the backlog.2 In an effort to combat these problems—seen, in part, as a result of a shortage of physicians—the VA issued a Proposed Rule, Advanced Practice Registered Nurses (APRN), aimed at allowing APRNs to practice within their full authority (Proposed Rule).
July 18, 2016
To hospitals, the Centers for Medicaid & Medicare Services (CMS) is acting like the terrible Wicked Witch of the West from the movie the Wizard of Oz because of their proposed plans for site-neutral rate reductions. The proposed modifications in reimbursement are included in the 2017 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System (CMS-1656-P) proposal submitted on July 6, 2016. The law provides for payment system policy changes, quality reporting provisions, and reduced pay rates that many hospitals would prefer to douse with water and have them disappear like the Wicked Witch rather than have payments reduced at their off-campus facilities.
July 11, 2016
Prior to addressing the main topic of today’s alert, we felt it necessary to inform our readership of the recent proposed changes made by the Centers for Medicare and Medicaid Services (CMS) in its CY 2017 Proposed Physician Fee Schedule (PPFS). In the CY 2016 PPFS, CMS proposed reexamining the anesthesia codes reported in conjunction with colonoscopy procedures (i.e., 00740 and 00810) as potentially misvalued. In the CY 2017 PPFS, CMS continues to maintain that 00740 and 00810 are misvalued and it “look[s] forward to receiving input from interested parties and specialty societies for consideration during future notice and comment rulemaking.” Moreover, CMS notes that although sedation services are included in certain endoscopic procedures, that anesthesia is being separately reported. As such, “[i]n the CY 2017 PFS proposed rule, CMS is proposing values for the new CPT moderate sedation codes and proposing a uniform methodology for valuation of the procedural codes that currently include moderate sedation as an inherent part of the procedure. CMS is also proposing to augment the new moderate sedation CPT codes with an endoscopy-specific moderate sedation code, and proposing valuations reflecting the differences in physician survey data between gastroenterology and other specialties.”1 As always, we encourage our readers submit comments to CMS or to reach to their professional associations and encourage them to submit comments. CMS will accept comments until September 6, 2016.
July 5, 2016
The transition to the International Classification of Diseases and Related Health Problems 10th revision (ICD-10) appears to have gone well so far, despite widespread anxiety that it would wreak havoc across healthcare as providers struggled to comply with the new coding structure, heightened specificity and documentation requirements. The Centers for Medicare and Medicaid Services (CMS) reports that total claims denials and other claims metrics remained essentially unchanged from the historical baseline to the fourth quarter of calendar year 2015.
June 27, 2016
All physicians, group practices and other providers who participate in Medicare are required to resubmit and recertify the accuracy of their enrollment information every five years through a revalidation process.
June 20, 2016
The ASA adopted its Statement on Principles for Alarm Management for Anesthesia Professionals at its annual meeting in October 2013. The introduction to the Statement provides as follows:
June 13, 2016
Have you ever found that you could not make heads or tails of a Medicare regulation? Have you wondered whether even CMS could decipher and coherently apply its own rules? The sheer volume of regulations makes it difficult to be certain of one’s interpretation:
June 6, 2016
Most anesthesiologists know in general fashion that there are "compliance" issues with professional courtesy, co-payment waivers and discounts for cash payments. Yet confusion persists about exactly how to handle these situations.
May 31, 2016
For patients who undergo a surgical procedure, the anesthesiologist’s bill sometimes comes as a surprise. If the hospital and the surgeon are participating in the patient’s health plan but the anesthesiologist is not in the network and bills the difference between his or her full charge and what the health plan paid, the amount that the patient owes can be a nasty shock. Large balance bills are often stressful for patients and are a major source of medical debt.
May 23, 2016
“Transparency” is a word that you will encounter more and more frequently in health policy articles, including ABC’s publications. Information transparency is a key for enabling healthcare purchasers to make value-based decisions concerning the quality and price of services. Those data are slowly becoming more available, but they remain largely inaccessible to most potential users.
May 16, 2016
“Patient Safety Issues Spur NIH Shake-Up” was an above-the-fold headline in the Washington Post on May 11, 2016. NIH Director Francis Collins, MD is replacing top leadership at the 200-bed Clinical Center with a new management team with experience in oversight, compliance and patient safety in the wake of an independent review that found that safety had become “subservient to research demands.”