COVID-19 and the Anesthesia Department (part2)

COVID-19 and the Anesthesia Department, Part 2

So now, you as an anesthesiologist, have been asked to assist with providing patient care in the hospital ICU (or elsewhere in the facility). Most anesthesiologists haven’t provided E/M services since medical school, much less critical care services and need guidance as to how to document and bill their care. Below are some general guidelines with resources for additional important information. Please note the guidelines for critical care are complex (critical care medicine occupies 10 pages in the CMS Manual) and is beyond the scope of this brief introduction. However, a broad understanding is foundational for additional learning. Please take the time to review the materials provided by way of links included. 

Anesthesia Groups Response to COVID-19 (part1)

Impact on Manpower and Staffing

Right-sizing the staff of an anesthesia practice is probably the greatest challenge you will face during this COVID-19 outbreak.  Since your staffing must be proportionate to the volume of anticipated surgical work, this virus poses a huge problem on two levels.  First, what is the right staffing for anticipated case volume for the next few months and how does one change the staffing model so quickly?  Nothing is more painful than having to lay off staff, especially if they will be needed later in the year.  Unfortunately, not many practices can carry unneeded personnel for more than a few weeks.

Surprise Medical Billing Legislation

The surprise medical bill issue is at a key juncture in Congress.  The insurance industry is lobbying aggressively for a solution that is based on an artificially low “benchmark payment” to physicians set by and controlled by local insurance companies.  In contrast, ASA is working with our coalition of medical specialty organizations in support of a payment mechanism based on a market-based interim or automatic payment to physicians and a fair appeals or arbitration “backstop” model to contest unfair insurance practices.  Only one side will prevail.  It must be medicine, not insurance companies. What should you do to make your voice heard? Do the following things:

MIPS report cards now on Physician Compare Website

As part of CMS’s continued phased-in approach to public reporting on Physician Compare, the agency recently published a subset of 2017 QPP information submitted under MIPS and APMs. The information added on profile pages for MIPS eligible clinicians and groups includes select quality measure and CAHPS survey data.

To learn more about Physician Compare and the 2017 QPP data publication, review CMS’s fact sheet. MGMA Government Affairs encourages members to share feedback with us regarding their experiences with Physician Compare.

Call to action: Tell Congress to hold health plans accountable for surprise billing

In recent months, Congress introduced a number of bills that address the issue of surprise billing. There is widespread agreement that patients should be protected from surprise medical bills and taken out of the middle of payment disputes. However, the current legislative “solutions” give too much power to health plans.