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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November 13, 2017
The Centers for Medicare and Medicaid Services (CMS) will publish the final rule for the 2018 Medicare Physician Fee Schedule (PFS) in the Federal Register on November 15, 2017. The final rule includes several changes of significance to anesthesia providers and pain specialists. This eAlert focuses on changes in the PFS regarding anesthesia services for upper and lower endoscopy procedures and screening colonoscopies. We will explore changes in the conversion factor as well as the broader implications of other anesthesia-related changes in the 2018 PFS in next week’s eAlert.
November 6, 2017
Following on the heels of President Trump’s declaration of the opioid epidemic as a national public health emergency, the president’s commission on the opioid crisis last week issued its final report containing more than 50 recommendations for addressing what has been called the most serious drug problem in U.S. history. The report, the heightened focus on opioid addiction and overdose deaths spurred by the president’s directive, and actions by the Centers for Medicare and Medicaid Services (CMS) and other agencies are likely to impact pain specialists and anesthesia providers in several spheres, including prescribing, treatment, prevention, documentation and compliance, diversion prevention, fraud and abuse detection, and reimbursement.
October 30, 2017
Anesthesiology has a long history of improvements in patient safety, but anesthesia care providers know they can always do better. As healthcare’s transition to value-based care continues and clinicians are held to increasingly high standards for quality and safety through MACRA’s Merit-Based Incentive Payment System (MIPS) and other programs, anesthesia practices might consider incorporating the innovative safety improvement methodologies of high reliability industries into their practices.
October 23, 2017
Under the HIPAA Omnibus Rule, failure to have written business associate agreements in place can lead to sizable fines and penalties for covered entities, including anesthesia practices. In 2015, for example, Raleigh Orthopaedic Clinic, PA, of North Carolina paid $750,000 to settle charges that it potentially violated the HIPAA Privacy Rule by sharing patient protected health information (PHI) with a potential business partner without executing a business associate agreement. The vendor had agreed to transfer x-ray images to electronic media in exchange for harvesting the silver from the films.
October 16, 2017
When it comes to measuring the quality of anesthesia care—or the quality of care in any medical specialty, for that matter—why not compare apples to apples so that measures are reliable, straightforward, accurate and consistent?
October 9, 2017
The recent mass shooting in Las Vegas that killed 59 people and injured more than 500 others—the largest in United States history—painfully reminds us, again, that large-scale emergencies can happen virtually anywhere, at any time. Of course, this means anesthesiologists and nurse anesthetists in any hospital and geographic location could be required, on extremely short notice, to deliver emergency anesthesia care for many people with life-threatening and other traumatic injuries. That did happen to anesthesiologist Dean R. Polce, DO, of Sunrise Hospital and Medical Center in Las Vegas, who reported in an article in the Washington Post that he provided anesthesia for 27 surgeries in the wake of the shooting. Dr. Polce and anesthesia providers in area hospitals undoubtedly endured one of the harshest tests they’ll ever face of their clinical and crisis management skills.
October 2, 2017
Hospitals exist to protect health and treat illness, but healthcare has developed a culture of wasteful, environmentally unsound practices that actually causes harm, according to clinicians and scientists who have pioneered the emerging field of ecological sustainability in healthcare. “The fundamental tenet of healthcare practice is ‘Do no harm,’ but ironically, the practice of healthcare itself causes significant pollution, and, consequently, indirect adverse effects on public health,” one of these pioneers, Yale University anesthesiologist Jodi Sherman, MD, said.
September 25, 2017
The current Republican proposal to repeal the Affordable Care Act (ACA), known as Graham-Cassidy for its lead sponsors (Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana), could come up for a Senate vote this week. Essentially, the bill would change or eliminate such major provisions of the ACA as subsidized insurance coverage and Medicaid expansion, and give federal block grants to states to use in large part as they choose.
September 18, 2017
Anesthesia care providers, if you serve Medicare, Medicaid and Children’s Health Insurance Program (CHIP) patients in the counties and geographical areas impacted by Hurricane Irma and Hurricane Harvey, or have patients coming into your facilities who have been displaced from their homes and are in need of care, you need to know how government payers are responding to the crises and the compliance implications of these actions for your facilities and groups.
September 11, 2017
Anesthesia practices should be aware that the Health and Human Services Office of Inspector General (OIG) has converted to a "dynamic, web-based” format for its annual Work Plan that now publishes updates monthly rather than once or twice yearly. The change reflects the agency’s effort to “enhance transparency around OIG's continuous work planning efforts” and more effectively “respond to emerging issues.”
September 5, 2017
Given the intricacy of the interrelationships among payers, hospitals and clinicians (including anesthesia care providers), the evolving healthcare marketplace and the growing level of outrage among patients and consumer groups, balance (surprise) billing is certain to remain rooted in the spotlight for years.
August 28, 2017
In March 2010, Congress passed and President Obama signed the Patient Protection and Affordable Care Act (ACA). It would take a number of years for the various provisions of what we now refer to as Obamacare to be implemented. By 2014, these would include significant protections for patients trying to obtain and maintain health insurance, such as the elimination of pre-existing medical condition limitations, guarantees of key insurance provisions, such as obstetric care, and new ways to obtain health insurance.
August 21, 2017
It’s every anesthesia practice’s nightmare, but it happened last year to a large anesthesiology and pain management group in Arizona. A health data breach from unauthorized access by a third party affected nearly 883,000 patients. The information included patient names, providers’ names, dates of service, places of treatment, names of health insurers, insurance identification numbers, diagnosis and treatment codes, and, in some cases, Social Security numbers, bank account information, tax information, and more.
August 14, 2017
The use of physician extenders has become commonplace in medicine and anesthesia is no exception. More than 75 percent of all anesthetics are administered by CRNAs. Do AAs offer a viable alternative? Our perception is that most anesthesiologists still know relatively little about this profession, which is understandable given the current state of AA involvement across the country. Only anesthesiologists in Ohio and Georgia have much experience working with AAs.
August 7, 2017
The use of ultrasonic guidance (USG) in the placement of nerve blocks and catheters for postoperative pain management has become a standard of care for most anesthesia practices. It is also widely used for confirmation of vascular access, especially for the placement of central venous pressure lines (CVPs).
July 31, 2017
Peruse the most recent graph showing electronic health record (EHR) adoption rates among hospitals, and you’ll see a curve sloping steadily and optimistically upward. In 2015, nearly all reported hospitals (96 percent) possessed certified EHR technology, and 84 percent had adopted EHRs with advanced functionality. In addition, more than 80 percent of non-federal acute care hospitals had adopted all of the functionalities of a basic EHR—a nine-fold increase since 2008, before passage of the HITECH act of 2009, according to the Office of the National Coordinator for Health Information Technology.
July 24, 2017
Opioid prescribing in the United States quadrupled between 1999 and 2015, the Centers for Disease Control and Prevention (CDC) reports. In that time, more than 183,000 people died from overdoses related to prescription opioids. These numbers alone point to the need for pain specialists, anesthesiologists and nurse anesthetists to stay abreast of news and research about opioids that can be used to inform and improve their practices. The eclectic array of items presented here provides a minute sampling of the current information. Hopefully, it will be useful and spark further thinking and discussion.
July 17, 2017
The Centers for Medicare and Medicaid Services (CMS) has published a proposed rule for the second year of the Quality Payment Program (QPP), performance year 2018 (payment year 2020). The agency says it is “continuing to go slow and use stakeholder feedback to find ways to streamline and reduce clinician burden, and make it easier for clinicians to participate and put their patients first.” Comments on the proposed rule are invited by August 21, 2017.
July 10, 2017
They might seem innocuous and inconsequential in your anesthesia practice’s vast sea of paperwork and electronic data, but comparative billing reports (CBRs), administered by the Centers for Medicare and Medicaid Services (CMS) and prepared by a data mining company called eGlobalTech (eGT), are not something to ignore. Anesthesia groups need to know what CBRs are and educate billing and other office staff about the importance of referring these reports to group leadership and the appropriate clinicians in a timely fashion.
July 3, 2017
A recent survey by the Commonwealth Fund debunks the commonly-held belief that Medicaid offers an inferior level of care. According to the survey, Medicaid enrollees report better care experiences than the uninsured and similar experiences as the privately insured; receive preventive services at higher rates than the uninsured; and have fewer problems paying medical bills and fewer cost-related access problems than the privately insured and uninsured. Contrary to widespread perception, “Medicaid is giving people what they want and need—affordable health insurance and access to care,” said Sarah Collins, the Commonwealth Fund’s vice president for healthcare coverage.
June 26, 2017
In late 2017, the Centers for Medicare and Medicaid Services (CMS) will implement a new benchmark and five-star quality rating system for clinicians and group practices on Physician Compare, the website mandated by the Affordable Care Act (ACA) to help patients, families and caregivers make more informed choices regarding healthcare services. The changes will ramp up the level of information readily available to patients and others about clinician and group practice performance on clinical quality measures, and push healthcare providers, including anesthesia providers and pain specialists, into a new phase of accelerated transparency. Healthcare consumer sites such as Healthgrades and Vitals are likely to incorporate the information into their own portals.