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We stay up to date on the ever-changing insurance market's impacts on your specialty for you...because it's basically a full time job in and of itself.

November 27, 2023

Defining General Anesthesia: A Moving Target?

Summary For the last several years, anesthesia providers have been able to rely on a clear standard for determining whether or not an anesthesia service should be considered a general anesthetic. That standard may be going away.  It’s something that philologists and etymologists would readily affirm: words and their meaning tend to be a moving […]

November 22, 2023

2024 OPPS Final Rule: Quality Programs

Sometimes we buy on time. That may call for making a few installment payments. Our reporting on the highlights of the 2024 Outpatient Prospective Payment System (OPPS) final rule seems to be working out in similar fashion, i.e., in installments. In this third installment on Medicare’s final rule for the outpatient hospital setting, our focus […]

November 20, 2023

What Makes for an Ideal Relationship Between an Anesthesia Practice and the Hospital Administration?

Summary Not every anesthesia practice has a winning strategy when it comes to the all-important relationship with the hospital. Today’s article addresses the dynamics of that relationship and how anesthesia groups can successfully manage it. Too many anesthesia practices are experiencing a less than collaborative relationship with the administration of the facility where they provide […]

November 15, 2023

2024 OPPS Final Rule: Additional Details

In a follow-up to our previous alert, we would like to provide our readers with additional takeaways from the 2024 Outpatient Prospective Payment System (OPPS) final rule, that was published earlier this month by the Centers for Medicare and Medicaid Services (CMS). Based on a fact sheet provided by CMS that summarizes the key provisions […]

November 13, 2023

2024 Medicare Physician Fee Schedule: Impact on Anesthesia

Summary Every November, the federal government issues its physician fee schedule for the following year. The rule for 2024 contains provisions that will impact all specialties. Today’s alert looks at the possible impact the 2024 final rule will have on anesthesia providers, in particular.  The Centers for Medicare and Medicaid Services (CMS) has released its […]

November 8, 2023

2024 OPPS Final Rule: What Hospitals Need to Know

It’s that time of year again. The Centers for Medicare and Medicaid Services (CMS) has been busy, putting out several new rules in just the last few days, including the 2024 Outpatient Prospective Payment System (OPPS) final rule. In addition to the voluminous OPPS rule, CMS also published a fact sheet that summarizes the major […]

November 7, 2023

Why Anesthesia Practices Should Have an Appropriate Collection Agency

Summary There is a difference between what a billing service can do and what a collection agency can do. There are also differences in agencies. Despite these differences, an anesthesia group must align itself with a collection agency, but it must manage its expectations.  Many anesthesia providers often ask this question: if we have contracted […]

November 1, 2023

Mum’s the Word: Are Hospitals Underreporting Problematic Providers?

It wasn’t an out-and-out lie, really. You just failed to mention a few details; that’s all! This may be representative of the internal dialog taking place within the heads of more than a few hospital managers these days as they attempt to rationalize a reporting “oversight” on their part. On the one hand, hospitals are […]

October 30, 2023

IDR Fees for Anesthesia Providers: The Latest and Greatest

Summary In response to a recent federal court ruling, HHS and other departments have proposed a new fee amount for accessing the IDR process under the No Surprises Act.  The rollercoaster ride continues. Many of us actually enjoy the ride. The ups and downs and the change in direction and acceleration can be quite thrilling. That’s […]

October 27, 2023

CIGNA’s New CRNA Payment Policy Adds Fuel To The Fire

BY KATHERINE BOWLES, RN, ESQ. Hanson Bridgett LLP, Los Angeles, CA This following article describes the Provider Non-Discrimination Law, its potential violation by CIGNA in approximately 36 states and the legal battle that could potentially ensue. THE AFFORDABLE CARE ACT’S ANTIDISCRIMINATION LAW: AN OVERVIEW Since January 2012, the Affordable Care Act (ACA) has prohibited insurance […]