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The Value of Chronic Pain to an Anesthesia Practice: What Is It and How Is It Best Realized?

Anesthesia providers distinguish themselves by virtue of their ability to manage all types of pain. While most of their time and energy is focused on the acute pain related to surgical procedures and deliveries, many providers also consider themselves qualified to manage chronic intractable pain. The result can be two very distinct types of practice. […]

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BCBS To Discontinue Physical Status Payments

Last week, we sent out a special alert advising our readers of a change in Aetna’s payment policy in connection with physical status (PS) modifiers on anesthesia claims. The payer announced it would no longer provide additional payment for PS 3-5, effective July 15 of this year. Not to be outdone, several of the “Blues” […]

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2025 IPPS Proposed Rule: Highlights for Hospitals

On April 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2025 Medicare hospital inpatient prospective payment system (IPPS) proposed rule. While these provisions are not final, they do give current insight into the agency’s thinking in terms of a host of issues concerning the inpatient hospital setting, including […]

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Virtual Visits: Providers Grapple with Telehealth Issues

We’ve come a long way since the days when the milkman would make his deliveries at the door and the doctor would make house calls, black bag in hand. Now, we order our goods online and we can even see our healthcare professional via the latest telecommunications technology. Americans love convenience, and it is certainly […]

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Aetna to Stop Physical Status Payments

According to an April bulletin published by Aetna, the payer will no longer reimburse additional unit value(s) for anesthesia physical status (PS) modifiers, effective July 15, 2024. Aetna gave as a reason for the decision its desire to align with similar Medicare guidelines. It should be noted that this change will only affect Aetna’s commercial […]

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Medicare Advantage and Part D: CMS Issues Final Rule

We recently brought an alert dealing with allegations against Medicare Advantage (MA) to the effect that MA plans were more prone to deny claims or delay payments when compared to Medicare or third-party payers. Medicare Advantage is back in the news—but, this time, for another reason. Last week, the Centers for Medicare and Medicaid Services […]

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Navigating the Anesthesia Manpower Shortage

There is clearly a shortage of anesthesia providers in the country today. This a a result of a variety of factors including the pandemic, dramatic increases in the number of anesthetizing locations and provider lifestyle choices. According to various sources, by 2033, the anesthesiology workforce may experience a shortage of approximately 12,500 anesthesiologists, representing nearly […]

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The Meaning of Consent: The Government Provides New Clarification

In the opening lines of Pink Floyd’s trippy hit, Comfortably Numb, the doctor instructs the patient to provide a response, saying: “just nod if you can hear me.” While not an exact example of what the medical industry means by “informed consent,” it does help us to think about what that term means. What are the […]

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Fading Away: Anesthesia for Chronic Pain

It was one of those end-of-an-era moments. Standing in the well of the House, before a joint session of Congress, was the “American Caesar,” General Douglas McArthur, bidding farewell to the nation after 52 years of service. First in his class at West Point, winner of the Congressional Medal of Honor and Military Governor of […]

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