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Anesthesiologists Oppose Medicare Opioid Rx Changes

Summary Changes to the rules regarding opioid prescriptions through Medicare Part D for 2019 include a "hard edit" for opioid prescriptions at or above a cumulative daily equivalent of 90 milligrams of morphine; no more than a seven-day supply of opioid medication for opioid naïve patients; and restrictions on concurrent prescribing of opioids...
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A Refresher for Anesthesia Practices on Business Associate Agreements: Are Your Contracts in Order?

​SUMMARY Covered entities, including anesthesia practices, are required under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to execute a contract with business associates to safeguard the privacy and security of protected health information (PHI). As the holder of the PHI, anesthesia groups should make sure they under...
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Sweat the ‘Small’ Stuff: A Checklist for More Thorough Anesthesia Documentation

Summary We review some aspects of clinical documentation to which anesthesia practices should pay close attention. No other specialty has a clinical document like the anesthesia record. The anesthesia record must serve as superbill, clinical record, quality tool and medical-legal document. In addition, each anesthesia practice has its own cust...
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American Association of Nurse Anesthetists Challenges Anthem on New Anesthesia Policy

The American Association of Nurse Anesthetists (AANA) has joined the ranks of healthcare organizations that have come out in opposition to a clinical guideline issued in February by insurance company Anthem that directs ophthalmologists to assume responsibility for anesthesia administration and patient monitoring during routine cataract surgeries....
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Anesthesia ‘Decision Aids’ to Engage Patients When There is No ‘Best’

Summary Anesthesia decision aids are brochures that are specially designed to walk patients through the process of determining whether they would prefer a regional or general anesthetic technique for surgery. Designed for use only when there is no medically "best" option, these aids can help anesthesia providers engage patients in the shared d...
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Attend AIAPM 2018:Stay on Top of the Latest Anesthesia Practices

​How do you keep your team informed on the latest topics of interest to anesthesiologists, practice administrators, CRNAs and others in the anesthesia marketplace? The Advanced Institute for Anesthesia Practice Management (AIAPM) will focus on practice management issues with the goal of enlightening attendees on broader group strategy issues, ...
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State Bill to Simplify Credentialing: What Anesthesia Groups Should Know

Summary Legislation introduced in Virginia would direct health plans to develop protocols for paying physicians for services performed when their credentialing applications are received. The legislation could help streamline a frequently lengthy process that impacts revenue and impedes access to care. We encourage ABC clients to contact their ...
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News for Anesthesia Groups: ACA Repeal, ADRs, Opioid Prescribing and Medicare ID Cards

​SUMMARY This eAlert offers news briefs of interest to anesthesia practices on: the Republicans' latest attempt to repeal and replace the Affordable Care Act; the new Medicare ID number initiative and what practices should be doing now to prepare; a primer on additional documentation requests (ADRs) and why a timely response is essential; and ...
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Expanding Value in Anesthesia: Bundled Payments and the Perioperative Surgical Home

Summary Bundled Payments for Care Improvement Advanced (BPCI Advanced), a new initiative from the Center for Medicare and Medicaid Innovation, was among topics of discussion at the American Society of Anesthesiologists' practice management conference in New Orleans. We provide an overview of this program and links to resources. As in the past ...
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Anesthesiologists: Innovate and Anticipate the ‘Next Play’ to Lead the Specialty’s Move to Value-Based Care

SUMMARY Anesthesiology is in the midst of a 'Blockbuster-Netflix moment,' according to Daniel Cole, MD, immediate past president of the American Society of Anesthesiologists. By focusing on innovation and opportunities for system performance improvement, and with insight into their own leadership styles, anesthesiology leaders can help the pro...
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Anesthesia Services for Cataract Surgery ‘Not Medically Necessary’: Insurer Anthem

Summary Managed healthcare organization Anthem has released a clinical guideline stating that monitored anesthesia care and general anesthesia are not medically necessary for the majority of patients undergoing cataract surgery. We summarize the healthcare community's response, including efforts by the American Academy of Ophthalmologists to r...
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Conflicts and Kickbacks: Risks for Hospital-Based Physician Groups

Frank Carsonie, JD Chair, Health Care & Life Sciences Practice Group Benesch, Friedlander, Coplan & Aronoff LLP, Columbus, OH Nathan Sargent, JD Associate, Health Care & Life Sciences Practice Group Benesch, Friedlander, Coplan & Aronoff LLP, Cleveland, OH Hospitals and hospital-based physician groups enter various types of service ...
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Documenting Medical Necessity in Anesthesia: Think Comorbidities

Summary In ABC's experience, issues around proper documentation of medical necessity represent the leading cause of anesthesia claims denials. While medical necessity may be thoroughly shown in the anesthesia record, we encourage anesthesia practitioners to ensure that they share this information with their billing and coding partner. ABC clie...
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What Is the Value of Data and What Data Has Value? Today’s Anesthesia Management Challenge

Jody Locke, MA Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MI What is it that makes today's anesthesia providers so good at managing patients safely through the trauma and discomfort of surgery? While many will cite the value of experience, the most critical factor is the availab...
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Building High-Performing Teams in Anesthesia

Summary Effective teams, including high-performing teams spanning departments, disciplines and services, are central to the development of a "culture of safety." Hallmarks of high-performing teams include an aligned vision, complementary skills, achievable goals and metrics, participative leadership, a culture of trust and a preoccupation with...
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Staying Focused in Ambiguous Times

For Carmel Schacar and I. Glenn Cohen of Harvard Law School, writing in Health Affairs, "uncertainty" was 2017's word of the year for health law and bioethics.1 In many ways, that capsule summary suits a description of healthcare in general and anesthesia in particular during the past 12 months as the frenetic pace of change continued unabated and ...
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It’s Time to Measure Patient Satisfaction with Anesthesia Care: PRACTICE MANAGEMENT™ 2018

Summary The benefits of surveying patient satisfaction with anesthesia care are becoming increasingly evident in a competitive environment of quality reporting in which anesthesia groups can use reports of outstanding service and communication to help demonstrate value to institutions and payers. We offer highlights of a presentation on measur...
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Disrupting the Disruptive Physician

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNOne would think (or hope) that by the time anesthesiologists complete their training and begin practicing, they have mastered not only their clinical field, but also the ability to work well with others and behave appropriately. If you've spent any time as a member of an anes...
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Anesthesia Drug Shortages Persist: What Groups Can Do

Summary Drug shortages remain a serious problem, and anesthesia providers are particularly vulnerable, with anesthesia drugs often among those in short supply. We offer a glimpse of current trends, advocacy initiatives by the American Society of Anesthesiologists and others, research on causes and potential solutions, and programs at individual ins...
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How (Others’) Stupid Compliance Mistakes Can Save Your Life

Mark F. Weiss, JD The Mark F. Weiss Law Firm, Dallas, TX, Los Angeles and Santa Barbara, CASome inner desire stronger than my willpower beckoned me to stare at them through the glass. I was nine years old. It was both titillating and embarrassing.There were 10 photographs in gritty black and white, arrayed in order behind glass on the post office w...
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