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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eAlerts
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Will the Medicare Physician Value-Based Payment Modifier Affect Your Anesthesia Group?
September 16, 2013
If you are an anesthesiologist practicing in a group of 100 or more eligible professionals (EPs) and submitting claims to Medicare under a single taxpayer number, you may be subject to the Value Based Payment Modifier (VBPM) in 2015. By 2017, all physicians participating in Fee-for-Service Medicare will be affected by the VBPM. This Alert is intended to help anesthesiologists familiarize themselves with the VBPM.
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Before the Shoe Drops: Anesthesiologists Can Help Hospitals Prevent Certain Hospital-Acquired Infections
September 9, 2013
Anesthesiologists increasingly point to their role in driving down the rate of surgical site and other hospital-acquired infections (HAIs). Not only does anesthesiologists’ and nurse anesthetists’ compliance with the relevant quality measures help the hospitals’ quality scores and satisfy PQRS requirements, preventing HAIs is good for patients and saves on health care system costs.
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Anesthesia Providers: Make Sure You Continue to Revalidate Your Medicare Enrollment When Medicare Asks
September 4, 2013
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, 2015. This is an update to the previously communicated timeframe of March 23, 2013.
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What Anesthesiologists Should Know About Third Party Payer Performance
September 3, 2013
The AMA and MGMA offer research-based tools on payer performance that may be helpful to practices negotiating participation contracts.
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CERT Errors of Interest to Anesthesiologists and Pain Medicine Providers: Will the New A/B Contractor CERT Task Force Make a Difference?
August 26, 2013
The Centers for Medicare & Medicaid Services (CMS) implemented the Comprehensive Error Rate Testing (CERT) program to measure improper payments in the Medicare Fee-for-Service (FFS) program. CERT is designed to comply with the Improper Payments Information Act (IPIA) of 2002, as amended by the Improper Payments Elimination and Recovery Improvement Act (IPERIA) of 2012. IPIA and IPERIA require the heads of Federal agencies, including the Department of Health and Human Services (HHS), to annually review programs it administers to improve agency efforts to reduce and recover improper payments
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Will Medicare Publish Information on Payments to Anesthesiologists and Other Physicians?
August 19, 2013
In May of this year, CMS released information on the average charges for the one hundred most common inpatient services at more than 3,000 hospitals nationwide. The following month, the Agency published average charges for 30 outpatient procedures. Are average charges—or payments—for physicians’ professional services next?
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Legislative Replacement for SGR is on the Horizon for Anesthesiologists and other Physicians
August 12, 2013
Legislation to repeal the Sustainable Growth Rate (SGR) formula is emerging in the House of Representatives. On July 31st, the Energy and Commerce Committee voted unanimously to pass H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013. This is the culmination of more than two years of work involving members of both the Energy and Commerce Committee and the House Ways and Means Committee, with feedback from healthcare providers. The bill now advances to the full Ways and Means Committee; the Senate Finance Committee is expected to produce its version in the fall.
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Drug Manufacturers' Payments to Anesthesiologists are Now Reportable Under the Sunshine Act
August 5, 2013
As of August 1st, certain manufacturers of drugs, medical devices and biologicals are tracking their payments to physicians, as required by the Physician Payments Sunshine Act (Sunshine Act), which is part of the Affordable Care Act. They will report payments and other items of value worth more than $10, as well as certain ownership interests held by physicians and immediate family members, to CMS annually. Reporting may begin immediately, on a voluntary basis, and must begin by next January. CMS will post the information, by physician, on a public, searchable website.
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Revisiting Readmissions as a Quality Metric for Hospitals and Anesthesiologists
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.
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Will the Health Insurance Exchanges Mean More Patients for Anesthesiologists?
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.
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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.
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Looking at Bundled Payments from an Anesthesiology Perspective
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?
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Preventable Hospital Readmissions—Opportunities for Anesthesiologists
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.
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Do the Payers Understand Nerve Blocks for Post-Anesthesia Pain?
June 24, 2013
Some payers are sowing confusion regarding whether nerve blocks placed for the management of postoperative pain are separately payable.
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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.
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Lessons from Bundled Payment Initiatives for Anesthesiologists
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.
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Anesthesia Group Communications and the Attorney-Client Privilege
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.
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Colonoscopies—Reducing the Cancer Toll, With or Without Anesthesia
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.”
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Update on the SGR for Anesthesiologists and Pain Physicians
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.
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Your Hospital is Ripe for a Merger or Acquisition: What Anesthesiologists Need to Know Now
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).
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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.
