Hardly a week goes by without news of the loss of a computer containing thousands of patient records.  It is all too easy for medical practices and health systems to suffer data breaches, and the financial consequences can be severe.  When a breach of patient data is found and reported, healthcare providers and legal business associates can be liable for penalties of up to $1.5 million for violations of a single HIPAA provision. The Department of Health and Human Services’ Office of Civil Rights (OCR) recently made it clear that an actual breach and disclosure of electronic Protected Health Information (ePHI) is not necessary—there may be liability for not having policies and procedures in place to address the breach notification provisions published in the HIPAA Omnibus Rule in January 2013.  The Breach Notification Rule requires covered entities (healthcare providers, health plans, healthcare clearinghouses) to notify individuals and OCR (and in some cases...

It is time for us to begin to familiarize ourselves with the role of telemedicine in anesthesiology.  The concept is not entirely new; there have been several articles published on preadmission anesthesia or critical care consultations conducted through telemedicine.  The results of a Canadian pilot study that appeared in Anesthesiology in 2004 showed “that preadmission anesthesia consultations using telemedicine technology can be successfully performed. Patients and consulting and attending anesthesiologists are very satisfied with telemedicine consultation.” Tele-ICU systems are now able to monitor remotely about 10 percent of intensive care unit patients nationwide, as reported in the New York Times on April 14, 2013.  We suspect that there may be more extensive applications right around the corner, and we hope to lay the groundwork for understanding these new applications as they arrive. “Telemedicine” is commonly defined as the delivery of medical services and the sharing of medical knowledge between different locations using telecommunications systems.  According...

Anesthesiologists and other physicians who provided out-of-network services to Aetna patients for part or all of the period from 2003 to 2013 may be eligible for a share of the $120 million settlement agreement in the Aetna usual-and-customary (UCR) class action lawsuit. This litigation arose out of the use by Aetna and other health plans of the Ingenix claims database and certain other reimbursement practices with respect to out-of-network services and supplies, allegedly resulting in artificially reduced payments.  The settlement agreement received preliminary approval from the federal district court in Newark, New Jersey in August 2013.  A final hearing to consider the “fairness, reasonableness and adequacy” of the agreement is scheduled for March 18, 2014. Physicians have three choices with respect to the Aetna UCR litigation: File a claim and share in the ultimate distribution of the Net Settlement Fund; or Request exclusion from the Class by the deadline of February...

  Just like the physical universe, the anesthesia practice universe continues to expand with increasing speed—or at least that is how it seems.  The number and breadth of the challenges we face are larger than ever.  To the familiar concerns such as disappointing payment rates, declining hospital income support and growing service demands, we can add the confusion and worries created by Obamacare and explosion of work occasioned by information technology.  In most challenges, we know, there are also opportunities, some more accessible than others, of course. ABC senior staff keep their eyes on practice management trends in order to help our clients (and our readers) understand and do well in the changing landscape.  The most important challenges and opportunities that we see for 2014 include the following: Rollout of the Affordable Care Act (ACA).  Expect more business uncertainty.  Fifteen of the 16 key provisions of the ACA will take effect in...

  Clinicians in the specialty of anesthesiology have much for which we should be proud. Advances in our specialty have made the anesthetic experience both safer and more convenient even as we have advanced the care of our patients both in terms of who can safely receive anesthesia and where it is delivered. In fact, the rest of medicine and health care generally views us as pioneers in the patient safety movement. Anesthesiology blazed the patient safety trail utilizing a variety of approaches: prudent adoption of improved technology, advances in pharmacology, advanced monitoring techniques, adoption of clinical practice guidelines and standards and by adopting some basic system theory and team-based behavioral principles and models to name just a few. Today, patients with even significant underlying health issues have higher expectations of successful surgical experiences than was thought possible a generation ago. These advances, embraced by us and persistent in our application,...