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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The Anesthesia Quality Institute is Open for Business!
March 22, 2010
ABC encourages all readers of our Alerts to familiarize themselves with the Anesthesia Quality Institute, established by the American Society of Anesthesiologists last year and now enrolling practices that wish to compare their clinical and business management performance data to national benchmarks.
We believe that the AQI and its database, the National Anesthesia Clinical Outcomes Registry, will become vitally important to anesthesia practices as hospitals, health systems, the American Board of Anesthesiology, large groups and payers begin to credential and compensate medical professionals using performance metrics.
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Anesthesiologists and Medicare's Electronic Prescribing Bonus
March 15, 2010
A number of our clients have asked about the medicare electronic prescribing (eRx) bonus, which allows qualifying physicians and certain allied health providers including nurse anesthetists to earn a second, separate bonus on top of the potential PQRI 2 percent bonus. This year, the eRx bonus is 2 percent of estimated allowable charges for Medicare patients. In 2011 and 2012, the bonus will be 1 percent, and in 2013 it will drop to 0.5 percent.
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Risks to Anesthesiologists Who Remain Out of Network
March 8, 2010
Although we have discussed out-of-network billing issues in past Alerts, today’s issue highlights other out-of-network challenges facing physicians and facilities. For those anesthesia groups that have strategically remained out-of-network providers, we anticipate continued challenges as insurance companies explore new strategies for reducing costs associated with paying for out-of-network services rendered to patients.
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21.2 Percent Medicare Payment Cut Postponed Again
March 3, 2010
On Tuesday night, legislation postponing the 21.2% SGR-driven cut in Medicare payments to physicians passed the Senate and was quickly signed into law by President Obama. Medicare will continue to pay at 2009 rates for another 30 days, as it did throughout January and February 2010.
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After the Summit: Health Care Reform Update for Anesthesiologists
March 1, 2010
President Obama took over the lead on health care reform (HCR) legislation last week, on Monday releasing a set of changes to the bills adopted by the Senate and the House of Representatives in 2009 and on Thursday February 25th holding an unprecedented seven-hour televised “Bipartisan Health Care Reform Summit” meeting with Congressional leaders. No new compromise agreement emerged and the pundits do not see many prospects for bipartisan legislation.
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Common Compliance Risks for Anesthesiologists in 2010
February 22, 2010
Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), Program Safeguard Contractors and other agencies including the Department of Justice are becoming more aggressive in their auditing activites. To help you stay out of their viewfinders, we offer an updated list of some top compliance risks.
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Anesthesia Patients and Out of Network Penalties
February 15, 2010
When a patient follows their payer guidelines and has surgery by an in-network surgeon at an in-network hospital, why should they be assessed an out of network penalty if their anesthesiologist is non-contracted with the payer? The answer might surprise you – technically, they shouldn’t.
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Making Pain Medicine Profitable
February 8, 2010
1. What makes pain medicine different?
2. What defines profitability for a clinical service?
3. What distinguishes successful practices?These three linked questions were the focus of the talk presented by ABC Vice President Jody Locke at the ASA Practice Management Conference in Atlanta on January 30, 2010.
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Medicare Will Not Pay Anesthesiologists for "Meaningful Use" of EHRs
February 1, 2010
Anesthesia practices have raised new questions about the availability of Recovery Act funds to incentivize providers to adopt electronic health records (EHRs) since CMS issued proposed regulations on December 30, 2009. The Cliff Notes answer is that Medicare will not pay anesthesiologists or other hospital-based physicians to deploy EHRs. For a review of the brief history and status of the EHR incentive program, please read on.
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RAC-Region D to Review Anesthesiologists' Claims for Evaluation and Management Services
January 25, 2010
Our outside counsel, with whom we work on anesthesia compliance matters, among others, has brought the following development to our attention: Pursuant to Section 302 of the Tax Relief and Health Care Act of 2006, CMS’ Recovery Audit Contractor (RAC) Program was made permanent and was expanded nationwide. At this point, the RAC contractors are in place for all 50 states.
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Anesthesia Conversion Factors If There Is No Legislation
January 19, 2010
When anesthesiologists begin receiving their Medicare payments for services provided in January 2010, they should see no change from their 2009 conversion factors. On March 1st, however, Medicare rates will drop 21.2 percent- unless Congress passes legislation correcting the impact of the Sustainable Growth Rate on which the calculation of the annual fee schedule is based.
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2010 PQRI Requirements and Anesthesiologists' Choices
January 11, 2010
Do you have any questions about the Physician Quality Reporting Initiative now that we are into 2010? Judging by our e-mail, telephone calls, and client meetings, many anesthesia groups still have basic questions, and the most sophisticated PQRI participants are identifying new gaps in the official PQRI information released by CMS.
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Whats New for Anesthesia Practices in 2010
January 4, 2010
There will be many more changes for anesthesia practices in this new year than we can report here – which is just as well, since we are looking forward to keeping you up to date with 51 more Alerts in 2010.
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Anesthesia Groups as Employers and Health Care Reform
December 28, 2009
There is not going to be any final federal health care reform (HCR) legislation in 2009 – but such legislation may be adopted as early as next month. If it does pass, it will have a significant impact on employers as well as on patients and providers. This Alert will preview the impact on anesthesia groups, as employers, of the massive overhaul of the United States health care system entitled the "Patient Protection and Affordable Care Act" (H.R. 3590) passed by the Senate on Christmas Eve, December 24th.
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COMPLIANCE UPDATE: Teaching CRNAs and Concurrent Student Cases
December 21, 2009
The new Medicare payment rules for teaching anesthesiologists and for teaching CRNAs will go into effect in less than two weeks. Recent written guidance from CMS on the reporting of time by teaching CRNAs has been confusing – contradictory, in fact. We contacted CMS and found out how CRNAs are to report their time while supervising students in two concurrent cases...
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Reporting Anesthesia PQRI Measures In 2010
December 14, 2009
Beginning on January 1, 2010, anesthesiologists, nurse anesthetists and anesthesiologists assistants will have a new measure to report under the Physician Quality Reporting Initiative: perioperative temperature management. This addition to the PQRI brings the number of anesthesia measures to a total of three.
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Anesthesia Practice Benchmarks - Did You Know?
December 7, 2009
Do you use CRNAs? How many? Do you employ them, or does the hospital? Do you receive a stipend from the hospital, and what does it cover? How many cases do your anesthesiologists perform? What are your salaries like?
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What Anesthesiologists Need To Know About Medicaid’s Contracted Auditors
November 30, 2009
Although there has been a lot of discussion on the Medicare Recovery Audit Contractor (“RAC”) program, little attention has been paid to the first national Medicaid audit program resulting from the creation of the Medicaid Integrity Program (“MIP”).
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What Will Tort Reform Do for Anesthesiologists?
November 23, 2009
Senate Majority Leader Harry Reid released his long-awaited healthcare reform (HCR) package on Wednesday, November 18, 2009.
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The Public Option in the House Healthcare Reform Bill: What Does it Mean for Anesthesia Practices?
November 16, 2009
In the debate over health care reform, no issue has produced more fury and sound bites than the question of whether to include a government-run insurance plan.
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The Impact of the 2010 Medicare Fee Schedule on Anesthesiologists
November 9, 2009
As expected, Medicare physician payments are set to drop by one-fifth beginning on January 1, 2010. More precisely, the “Final Rule” on the Physician Fee Schedule released by the Centers for Medicare and Medicaid Services (CMS) on October 30th calculates the reduction at 21.2 percent. The good news is that Congress will most likely stop the Sustainable Growth Rate (SGR), the gross-domestic-product based formula that has required CMS to announce conversion factor cuts year after year, from having a negative impact in 2010. A bill that is now expected to come before the full House of Representatives next week, the Medicare Physician Payment Reform Act of 2009 (H.R. 3961), would avert the 21.2 percent cut and create a framework for future positive updates to the Medicare Fee Schedule. A similar bill, S. 1776, failed to win the 60 Senate votes needed for fast-tracking on October 21st, but the 47 votes in favor are grounds for hope. Even without eliminating the SGR for good, the odds are that Congress will at least prevent a cut from taking effect on January 1, as it has done each year since 2003.
