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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What Anesthesiologists Should Know About Health Insurance Exchanges
December 31, 2012
A year from now, under the Affordable Care Act (ACA), a health insurance exchange should be up and running in every state.
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A HOLIDAY GREETING
December 24, 2012
We would like to thank all of our clients and other subscribers to the Alert for your support over the past year. Each Monday, copies now go out to more than 10,000 persons. Your feedback has been most helpful in letting us know what is important to you and where we might provide further information or clarification. Please continue to email us when you have comments or questions.
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Rental Networks, Claims Repricers and Anesthesia Practices
December 17, 2012
Everyone involved in the healthcare industry will inevitably learn about the confusing aspects of medical health insurance. Just when you thought you had a grasp on the insurance marketplace another complexity presents itself. Sometimes what you might have thought of as an insurance plan turns out not to be insurance at all.
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Attention Anesthesiologists: CMS Guidelines on Signatures and Check Boxes
December 10, 2012
It is a question asked quite often: Is marking a check box on the anesthesia record sufficient documentation? For medical review and for billing purposes?
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Anesthesia Managed Care Contract Rates
December 3, 2012
Across the United States and the District of Columbia, the average anesthesia managed care contract rate during the first several months of 2012 was $67.94.
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Giving Thanks for Anesthesiologists
November 26, 2012
Memorial Hospital—a hypothetical “Memorial Hospital”—considers itself extremely fortunate to have renewed its contract with Associated Anesthesiologists—a hypothetical “Associated Anesthesiologists”—for another three years. Although one newly-formed anesthesia management company (AMC) and one freshly-capitalized market leader among AMCs have approached Memorial, the hospital let the anesthesia group know that it would not be entertaining any proposal. If Memorial were to enumerate the attributes of Associated Anesthesiologists for which it is so grateful, the list would be as follows:
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The Fiscal Cliff and What it Means to Anesthesiologists
November 19, 2012
Now that the elections are over, nationwide attention has turned to the so-called “fiscal cliff.” The fiscal cliff refers to the effective date of automatic cuts in spending combined with increases in taxes mandated by law. It has been called a year-end “perfect storm” and “taxmageddon.” One commentator at CNN referred to the fiscal cliff as “the legislative equivalent of a slow-motion train wreck.”
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Final Fee Schedule Rule for 2013 Cuts Conversion Factors, Allows Payment to Nurse Anesthetists for Chronic Pain Services
November 12, 2012
As you expected, if you have been reading our Alerts, the final version of the Medicare Physician Fee Schedule Rule for 2013 contains a massive payment reduction.
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Anesthesiologists and Payment for Acute Pain Services
November 5, 2012
There continues to be considerable confusion as to which post operative pain management services are reimbursable and the criteria for ensuring that payment for them can be consistently obtained. Part of the issue has to do with the different modes of acute pain management currently being used across the country, but another point of confusion pertains to the provider categories for each type of service. While individual payor policies may vary, the essential parameters are quite consistent across all jurisdictions. Irrespective of what a particular group’s billing practices have been historically, it is a good time to reexamine previous assumptions and review current guidelines. The fact that a given payor has not questioned charges for a particular service historically is no guarantee that payments were received legitimately or that a subsequent audit might not uncover a significant overpayment. It should be noted that contract terms can be misleading; and all terms must be evaluated by a qualified expert to determine what services are payable and under what conditions. Many payor contracts, for example, describe what services are payable in one section and who may provide them in another. Under no circumstances, however, would it be appropriate for anesthesiologists or CRNAs to bill for post-operative pain management services provided by non-qualified providers or RNs employed by the facility.
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Wisconsin Providers: Anesthesiologist Assistants Licensure Effective Now!
November 2, 2012
Wisconsin Act 160 (Act 160) establishes a licensure requirement for anesthesiologist assistants (AAs). Prior to Act 160, AAs practiced under delegated authority. Act 160 also established the requirements for obtaining AA licensure, AA’s scope of practice, anesthesiologist supervision requirements as well as a Council on Anesthesiologist Assistants. This announcement summarizes some of the key aspects of the new law that Wisconsin anesthesiology providers need to know.
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Sedation by Non-Anesthesia Providers
October 29, 2012
Anesthesia services have spread far beyond the operating room over the past several decades. The demand for sedation and analgesia has gone up dramatically, reflecting not just population growth but also an increasing variety of nonsurgical procedures requiring that patients be protected against pain or prevented from moving.
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The SGR and Anesthesiology—It’s That Time of Year Again
October 22, 2012
With a new calendar year just over two months away, the medical and healthcare communities have begun the annual flurry of end-game activity seeking to influence payment rates. Anesthesiologists need little reminder of the Sustainable Growth Rate (SGR) threat and the 27 percent cut in Medicare payment that will take effect on January 1, 2013, unless Congress intervenes.
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Anesthesia Business Consultants to Aid Anesthesiologists in Securing the Benefits of Meaningful Use through Complete EHR with F1RSTUse
October 18, 2012
F1RSTUseTM is the first—and only—full-service EHR management platform built exclusively for anesthesiologists and pain management specialists to satisfy with ease Stage 1 of Meaningful Use as required to earn the Medicare EHR incentive payment. It is the only product that provides the full service measures to ensure success: tracking the necessary data points, providing reports of successful measures and ensuring that you are meeting all of the CMS requirements.
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Compensating Anesthesiologists for Attending Group Meetings
October 15, 2012
We are in the middle of the ASA Annual Meeting, which draws thousands of anesthesiologists from across the country to spend several days at meetings and lectures, all without compensation. We know the incentive for the rank-and-file: the opportunity to attend an incomparable array of refresher courses, panel discussions and other continuing education offerings. Hundreds of anesthesiologists come to educate others and participate in committee and board activities as specialty leaders.
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The OIG Targets “Personally Performed” Anesthesiologist Services
October 8, 2012
The Office of the Inspector General (OIG) within the Department of Health and Human Services has published its Work Plan for 2013. On the list of Medicare issues on which the OIG will focus next year is the following:
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A Warning for Anesthesiologists and Pain Physicians about Increased Billings through Better Technology
October 1, 2012
The percentage of patients requiring the highest level of service in the emergency department at Faxton St. Luke’s Healthcare in Utica, NY rose 43 percent in 2009, as reported in the New York Times on September 21, 2012. Level 5 ED visit services (CPT® code 99285) at Baptist Hospital in Nashville, TN increased by 82 percent in 2010, and by a comparable amount at Methodist Medical Center of Illinois in Peoria. More than 80 percent of Methodist Memorial’s Medicare ED evaluation and management (E/M) claims were for Level 5 services in 2010, as they were at Yuma Regional Medical Center in Yuma, AZ in 2007. At Baylor Medical Center in Irving, TX, 64 percent of all ED visits for Medicare patients were Level 5 services, and another 16 percent were Level 4.
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Value-Based Purchasing for Hospitals Starts Now–and for Anesthesiologists, in 2015
September 24, 2012
October 1, 2012, as we noted in last week’s Alert, is the deadline for ambulatory surgical centers to begin reporting quality measures to CMS or face payment penalties. October 1st is also a momentous date for hospitals, with the start of the Medicare Hospital Inpatient Value-Based Purchasing (VBP) Program.
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Anesthesiologists’ Role in Helping Surgery Centers Meet Their Quality Reporting Requirements
September 17, 2012
We are in the fifth year of Medicare’s Physician Quality Reporting System (PQRS) and most anesthesiologists and nurse anesthetists are at least aware of the program, even if they are not participating. Now it is the turn of the ambulatory surgery centers (ASCs) to start reporting quality measures to CMS or face payment penalties.
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Protect the Privacy and Security of Your Anesthesia Patients’ Electronic HIPAA Information
September 10, 2012
Many “Covered Entities” within the meaning of the privacy and security provisions of the Health Insurance and Portability Act of 1996 (HIPAA) are managing more and more of their patient information electronically. Indeed, not moving to electronic health records (EHRs) may cost physicians a percentage of their Medicare remittances—or at least the loss of a potential bonus of up to $44,000—under the EHR Incentive Program, as discussed in our last several Alerts.
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New Hardship Exception for Anesthesiologists to Avoid the EHR Penalty
September 4, 2012
Last week, we announced the availability of a new web-based electronic health record (EHR) that will permit anesthesiologists to satisfy the Meaningful Use requirements for the Medicare EHR Incentive Program. Although this technology, F1RSTUse, is relatively simple, requires little additional data entry and is an option for ABC clients and non-clients alike, it will not be the best solution for every reader. Those of you who are not in a position to implement F1RSTUse or any EHR will be interested in a new hardship exception created by CMS when it released the final regulation on the Stage 2 Meaningful Use requirements on August 23, 2012.
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New Technology Enables Anesthesiologists and Pain Management Specialists to Attest to Meaningful Use
August 27, 2012
A web-based electronic health record that allows anesthesiologists to satisfy the Meaningful Use requirements for the Medicare EHR incentive program is now available from ABC. ABC is very pleased to announce F1RSTUse, the first complete EHR platform built exclusively for anesthesiologists and pain management specialists to satisfy easily Stage 1 of Meaningful Use as required to earn the Medicare EHR incentive payment. Stage 1 requirements remain in effect for the next several years; one of the major changes of the August 23rd final rule was to extend the deadline to meet Stage 2 criteria until 2014. Other changes contained in the 672-page rule (PDF) will be reviewed in future Alerts.
