National Surprise Medical Billing proposal is an improvement.
CHICAGO – The American Society of Anesthesiologists (ASA) is pleased that a number of ASA’s priorities were addressed in the most recent COVID-19 stimulus bill; some improvements to the final surprise medical bill provisions and partial relief from the previous draconian Medicare cuts scheduled for January 1, 2021.
“I believe our specialty will be better off in 2021 than was initially anticipated,” said ASA President Beverly K. Philip, M.D., FACA, FASA. “However, the surprise medical bill provisions and the Medicare payment cut relief remain far less than ideal. ASA remains committed to working vigorously on these issues, to ensure that frontline anesthesiologists are in no way disadvantaged.”
Regarding Surprise Medical Bills, ASA worked with other physician stakeholders to secure important additional improvements into the bill that were not included in the December 11, “No Surprises Act” draft proposal, including:
- An explicit prohibition on health insurance companies presenting artificially low Medicare, Medicaid and public payer rates to an arbiter as part of the independent dispute resolution (IDR) system.
- Elimination of unreasonable timelines and other requirements related to patient notification and billing requirements.
- Enhanced physician access to the IDR process by adding clarity to the “90 days cooling-off period”
The language in this bill are improvements to earlier proposals, which included aggressive government rate-setting, administrative burdens on small and medium sized practices, and inaccessible and insurer-friendly dispute resolution processes.
9.6% in 2020 Anesthesia Reimbursement from Medicare
With the publication of the 2021 PFS Final Rule on December 1, the nation’s anesthesiologists and anesthetists were left in dismay, if not disbelief, having been dealt a significant financial setback. The national anesthesia CF for 2021 has been set at 20.0547, down from the 2020 CF of 22.2016. This represents a 9.6 percent decrease in potential anesthesia revenue—from a conversion factor perspective. The exact anesthesia CF will vary based on your practice location. To determine the anesthesia CF in your area, you can visit the following link: https://www.cms.gov/Center/Provider-Type/Anesthesiologists-Center.
This is the second year in a row that Medicare has reduced the reimbursement to the Anesthesia specialty.
