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 Should Register for the Medicare EHR Incerntive Now
January 10, 2011
Registration for the Medicare incentive bonus for “meaningful use” of an electronic health record (EHR) is now open. CMS is encouraging all eligible professionals (EPs) to register promptly even if they do not have a qualifying EHR system in place. -
Medicare Anesthesia Conversion Factors, 2010 and 2011
January 3, 2011
Medicare pays for anesthesia services through geographically-adjusted dollar conversion factors. Through the latter half of 2010, the national average anesthesia CF was $21.57. Vigorous lobbying by ASA and all of organized medicine prevented a 25% reduction attributable to the Sustainable Growth Rate (SGR) formula from taking effect in 2011. On December 8, Congress passed the Medicare and Medicaid Extenders Act of 2010, blocking the SGR cut and freezing payment rates at 2010 levels through 2011 except for changes driven by the Medical Economic Index and the Affordable Care Act. -
Anesthesiologists and Other Physicians Exempt from Complying with the Red Flag Rule
December 27, 2010
For more than two years, physicians, including anesthesiologists and pain management specialists, have been monitoring the status as to whether or not the Federal Trade Commission’s (FTC) Identity Theft Regulations, commonly referred to as the “Red Flags Rule,” would actually be enforced against health care providers. In the FTC’s final regulations published in November of 2007, the Red Flags Rule required “creditors” “to develop and implement an Identity Theft Prevention Program for combating identity theft in connection with new and existing accounts.” Because of the strong opposition to the Rule’s application, especially from the American Medical Association (AMA) (who, ultimately, filed a law suit against the FTC), the enforcement date was delayed on numerous occasions with enforcement slated to take effect December 31, 2010.
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ACOS, Anesthesiologists and the “Surgical Home”
December 20, 2010
Clarifying issues such as quality measurement, patient attribution and payment models in ACOs
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Congress Acts at Last; No Cuts in Medicare Payments to Anesthesiologists in 2011
December 13, 2010
Congress agreed last week to freeze Medicare physician payments at current levels through December 31, 2011. On Wednesday night, December 8, the Senate voted unanimously to stop the projected 25 percent SGR-based cut from going into effect on January 1. The House of Representatives followed suit on Thursday morning. President Obama is expected to have signed the bill into law by the time you read this Alert.
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Anesthesia Economics – The Big Picture
December 6, 2010
The suspense over whether Congress will allow the automatic 25 percent reduction in Medicare payments to physicians on January 1st increases within the larger economic context. Will the federal government find a way to put people back to work? Will taxes for those making $250,000 or more go up next year? Will the health care reform changes survive the new Congressional majority’s promises to repeal or at least withhold the funds needed for implementation? We don’t have any better answers than others, but a summary of the data will help inform the debates we are inevitably going to be having with family members and friends during the holiday festivities.
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Physician Quality Reporting System (formerly PQRI): No New Anesthesiology Measures for 2011
November 29, 2010
More often than not, our Alerts tell you that you should plan to either start or stop doing something. It comes as something of a relief to be able to report that the 2011 Physician Quality Reporting System (“PQRS,” the new name for the Physician Quality Reporting System [PQRI], as announced in the Federal Register notice containing the final Fee Schedule rule) does not contain any new anesthesia measures.
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PQRI Changes for Anesthesia Practices in the 2011 Medicare Fee Schedule
November 15, 2010
Last week’s Alert included the single most important item in the finalized CMS regulation (“Final Rule”) on the 2011 Medicare Fee Schedule: the 24.9 percent decrease in the respective conversion factors for anesthesia and for all other services. In this issue we will summarize changes regarding the Physician Quality Reporting Initiative (PQRI) incentive program.
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Medicare Fee Schedule for 2011 Published: A 25 Percent Pay Cut for Anesthesia and Other Physician Services
November 8, 2010
The final rule on the 2011 Medicare Physician Fee Schedule turns out not to be very different from the proposed rule that was published last July.
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Fair Payment for Anesthesiology Services, Today and Tomorrow
November 1, 2010
The elections will at last be over tomorrow, but that does not mean that any member of the anesthesia community should cease his or her efforts to move Congress to avert a catastrophe in physicians’ continued participation in the Medicare program.
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The 2011 OIG Work Plan: Anesthesiologists, Pain Physicians and Hospitals
October 25, 2010
For the first time in several years, the Office of the Inspector General (OIG) has issued its annual prospective Work Plan without including any reference to interventional pain procedures.
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2010 ASA Survey of Commercial Fees for Anesthesia
October 18, 2010
If you haven’t already looked at the October issue of the American Society of Anesthesiologists’ Newsletter, you will want to make sure you have a copy.
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ABCs of ACOs for Anesthesia Practices
October 11, 2010
ACO? Yes, another three-letter abbreviation is wending its way into our awareness. Although it sometimes seems as though healthcare will soon have used up all 17,576 (26³) possible three-letter combinations, that is far from the reality.
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Proposed Rule: Issued On September 23, 2010, Which Sets Forth The Core Elements That Should Be Included In Anesthesiologists’ Compliance Plans
October 4, 2010
The time is now to focus on compliance! Having an effective compliance program has never been more important. While previously, the adoption and implementation of a compliance plan was “voluntary” for physician practices and other providers in most states, The Patient Protection and Affordable Care Act of 2010 (“PPACA”), mandates that from a federal standpoint that providers and suppliers adopt a compliance program containing certain “core elements” as a condition of Medicare enrollment.
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Using Post-Anesthesia Data to Improve and Demonstrate Value
September 27, 2010
Current anesthesia records tell us rather little about the postoperative phase of a patient’s experience, and less about the quality of post-anesthesia care in a hospital generally.
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Using Your Inner Child to Negotiate Anesthesia Contracts
September 13, 2010
It is medical society meeting time again across the country, and many of those meetings are going to include presentations on negotiating. Hospital contracts, payer participation agreements, employment status and changes are among the most common negotiation topics at anesthesiology conferences. Practice leaders and managers also enter into contracts with various business vendors, including billing companies and financial consultants.
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Make Sure the Signature on Your Anesthesia Claim Is Acceptable
September 20, 2010
One of the many reasons for which Medicare may deny your claims is the form of your electronic or handwritten signature. A number of ABC clients have recently had claims rejected allegedly because of missing information; follow-up by telephone has revealed that the anesthesiologist’s signature did not meet Medicare requirements.
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Next Year’s Medicare Payments to Anesthesiologists: Not Quite as Dire
September 7, 2010
As shown in last week’s Alert, anesthesia – and other medical and surgical services – are facing hefty decreases on December 1, 2010 and again on January 1, 2011. The bulk of these decreases are attributable to the Sustainable Growth Rate (SGR) problem, which everyone laments but no one is wiling to pay to fix.
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Renewed Efforts to Improve Medicare Payment for Anesthesia and Pain Medicine Services
August 30, 2010
On July 13, 2010, the Centers for Medicare and Medicaid Services (CMS) published its in the Federal Register.
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Pain Practices May Qualify for Medicare’s E-Prescribing Incentive Payments
August 23, 2010
A number of ABC pain medicine clients use e-prescribing technology and perform a sufficient number of evaluation and management (E/M) services to qualify, at least potentially, for Medicare’s eRx Incentive bonus. This aspect of the practice of pain medicine has evolved a good deal in the last several years. We suspect that the overall number of pain practices who are eligible for the eRx bonus is growing fast. A review of the Medicare incentive payments and program requirements is in order.
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Anesthesia Quality Institute – Preferred Vendor Status for ABC
August 16, 2010
We are pleased and proud to announce that ABC is one of the first companies to meet the criteria for designation as an Anesthesia Quality Institute (AQI) Preferred Vendor. As stated on the AQI web site, www.aqihq.org
