Additional Increase in Medicare Anesthesia Conversion Factor Applicable to All 2012 Claims

Through ongoing discussions between ASA and the Centers for Medicare & Medicaid Services (CMS), ASA has clarified that the previously announced changes to the Medicare anesthesia conversion factor resulted from an error in the original calculations of the CY 2012 Anesthesia Conversion Factor.  CMS has instructed its contractors to update their claims processing files to use the updated locale-specific conversion factors by March 15, 2012.  Claims paid using the originally published conversion factors will not be automatically reprocessed; contractors will reprocess such claims brought to their attention. 

ASA members are highly encouraged to analyze their Medicare claims activity for January 1, 2012 through March 14, 2012.  If increased revenue offsets the administrative costs, they should request reprocessing of Medicare claims for this time frame.

The updated locale – specific conversion factors are all slightly greater than the originally published figures.  The increases range from $0.08 to $0.13 per unit which corresponds to an additional increase of 0.42 percent to 0.59 percent above the originally posted figures for 2012. 

With this revision, the total increase in the unadjusted anesthesia conversion factor from CY 2011 to CY 2012 is 2.0 percent.

Supreme Court Start Hearings on PPACA

Beginning March 26, the U.S. Supreme Court will hear six hours of oral arguments spread out over three days regarding the constitutionality of the Patient Protection and Affordable Care Act (PPACA) and its provisions.

In November, the court agreed to hear the lawsuit brought forth by 26 states, the National Federation of Independent Business (NFIB) and two individuals. The main issue at hand and the subject of the lawsuit is the claim that Congress exceeded its constitutional power by instituting the “individual mandate,” sometimes called the “minimum coverage provision,” which requires that most Americans buy health insurance starting in 2014 or face a fiscal penalty.