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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Anesthesiologists, Be Careful with What You Say About One Another
October 31, 2011
Two recent court decisions combine to offer anesthesiologists an important warning about expressing their opinions regarding colleagues. In certain circumstances, if an anesthesiologist knows that a colleague poses a risk to patient safety, he or she may have an affirmative duty to say so. In other situations, stating on the record that there is something wrong with another physician may amount to defamation.
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Do the Finalized ACO Regulations Help Anesthesiologists?
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.
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A Major Change to the Perioperative/Anesthesia IT Integration Landscape
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.
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1 Anesthesia Group + 1 Anesthesia Group > 2 Anesthesia Groups
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.
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Anesthesiology and Pain Medicine Patient Satisfaction Surveys
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.
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Federal Budget Proposals and Medicare Payments for Anesthesia Services
September 26, 2011
The Medicare eRx Incentive Program is turning out to be the Full Employment for Healthcare Writers program. Last week we described how anesthesiologists, pain physicians and nurse anesthetists with prescribing privileges could apply for a hardship exemption using a new CMS web page, the Communication Support Page. Our September 19th Alert also stated that “Most anesthesiologists … will not qualify for either the eRx bonus or the eRx penalty because they submit very few electronic prescriptions and report very few of the outpatient visits encompassed by the eRx measure.”
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E-Prescribing by Anesthesiologists and Pain Physicians: Web Portal to Request Exemption is up and Running
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.
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HIPAA Privacy Rule Update for Anesthesiologists
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.
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Electronic Prescribing: Anesthesiologists Will Soon Be Able to Request Their Exemptions
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.
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The Medicare Bundled Payment Initiative and Anesthesia Services
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.
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Anesthesia Providers: Plan to Revalidate Your Medicare Enrollment When Your Carrier Asks
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.
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Medicare’s eRx and EHR Incentive Programs?Clearing Up the Confusion for Anesthesiologists
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.
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The Debt Ceiling Deal Contains Little for Anesthesiologists to Like
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. -
Anesthesia and Social Media
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.
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A Manual for All Anesthesiologists
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. -
The IPAB Threat to Anesthesiologists and All Other Physicians
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). -
Anesthesiology and the Proposed Rule for the 2012 Medicare Fee Schedule
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 released on July 1st. -
Anesthesia Practices Must Use the New Medicare ABN Form as of November 1, 2011
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. -
When is an Anesthesiologist’s Signature Good Enough for Medicare?
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. -
Health Plans Tighten the Belt – Around Anesthesiologists’ and Others’ Midsections
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 “I am confident about.” -
Information from ASA on (1) Joint Commission Requirements and (2) Anesthesia Information Management Systems
June 13, 2011
American Society of Anesthesiologists members have access to an up-to-date set of policy templates and implementation forms that will help their hospitals satisfy The Joint Commission’s requirements for anesthesia services. More precisely, the templates will be useful in ensuring compliance with Medicare’s Conditions of Participation for hospitals, which TJC has “deemed authority” to enforce. The Conditions of Participation themselves are broad principles made operational through the instructions to surveyors known as “Interpretive Guidelines.”
