American Society of Anesthesiologists

State Component Society News- October 2014

Message from NMSA President

Greetings! 

Having just returned from the ASA national meeting in New Orleans,  I must report that there is a lot to be optimistic about in the field of anesthesiology.  Despite the plethora of challenges our specialty is facing due to the changes brought about by the Affordable Care Act, the ASA and its members are continuing to fight for our patients and its caregivers. The physician anesthesiologist is becoming the leader of the rapidly growing Perioperative Surgical Home as the obvious choice of the future of patient-centered, high standard medical care. Further, the incentives in anesthesia care delivery are being redrawn and will include outcome indicators for the reimbursement model. Physician-led team care models look like they are here to stay and will be the preferred choice of anesthesia care delivery under the new health care agenda where midlevels practice. The ASA continues to work so that our voices are heard in all arenas of public opinion.

Our state society, the NMSA, has seen changes in the landscape as well with large changes in group administration both in Farmington and Las Cruces. These changes are happening nationwide and may continue for the immediate future.  We may not always have the power to determine who our administrators are, but we do have the power to protect our patients and administer the highest quality of anesthesia delivery to them.  The NMSA continues to work hard to protect these interests. 

Success in these endeavors will require our full attention, at every level, in each practice and hospital, and of course through your generous participation in the PACs at both the national and state levels.  I want to congratulate the 70 plus members of New Mexico in a what was a banner year for the national ASAPAC.  Our state was recognized with the Alabama Cup for distinguished performance in improvement, up nearly 38% in donations from last year!  The ASA certainly uses these funds to advance our cause, and we need your efforts here close to home as well for our state PAC.  Recently you each received an email on how to donate to the our state PAC, Patient Safety Advocates of New Mexico.  Until the website is up and running, please just submit a check to your state PAC. The NMSA board of directors and those serving on the PAC are passionate about each of these fundamental issues and are working tirelessly to protect the mission of its society and members. Be mindful of what it costs to be an active physician anesthesiologist in this day and time.  The BOD is considering carefully this issue and hopes to share its insight in the near future. in the meantime, please contribute today and continue to make a difference. With your generous financial donations and the efforts of many working hard in this state for the safe delivery of anesthesia in all arenas, we do make a difference.  Thank you.

Best, 

Cameron Burrup, MD
President, NMSA 

 

News from the Office

The New Mexico State Society of Anesthesiologists (NMSA) and the AmericanSociety of Anesthesiologists (ASA) will be providing unified dues billing beginning in 2015. Membership dues including BOTH ASA and New Mexico dues will be sent out beginning in November 2014. Please make any necessary arrangements to accommodate these new billing processes as soon as possible so that your 2015 dues invoice can be paid in full on time. We hope that this change will streamline dues payment and membership for NMSA members,and we thank you for the continuing support of your state association! Please contact Rachel Rusch at 847-268-9103 or r.rusch@asahq.org with questions. 

Federal Affairs Update  

Federal Legislative Update

·      Meet with Your Lawmaker During the Fall Recess on the VHA Nursing Handbook!

·      Rep. Tammy Duckworth Attends ASA Ribbon-Cutting Ceremony at Schaumburg Headquarters

·      ASA Welcomes New VA Secretary, Urges Halt to Nursing Handbook

Federal Regulatory Update

·      ASA Thanks CMS for Reversing Pain Code Cuts in Proposed 2015 Medicare Physician Fee Schedule

·      ASA Sends Formal Letter to FDA Supporting Development of Appropriately Sized Vials

·      CMS Finalizes Rule on Postponing MU Stage 3

·      AMA Releases Fact Sheet Describing New Requirements for Hydrocodone Combination Products

·      DEA Publishes Final Rule Rescheduling Hydrocodone Combination Products

 

Payment and Practice Management Update

·      Submit an Abstract for PRACTICE MANAGEMENT 2015 and Earn a Chance to Win Prizes

·      Open Payments Launches September 30

·      Bundled Payments for Care Improvement Initiative

·      New ASA Payment and Practice Management Articles

o   New Specific HCPCS Modifiers for Distinct Procedural Services (September 2014)

o   ICD-10: Getting Ready for October 1, 2015 (August 2014)

o   Change is NOW: Learn More About Bundled Payments (August 2014)

o   Revalidation (August 2014)

 

Public Relations Update

·      ASA Urges Critical Conversations about Anesthesia Between Patients and Physicians

 Join ASA! Advocate for the Specialty During Inaugural Physician Anesthesiologists Week Jan. 11-17, 2015

The inaugural Physician Anesthesiologists Week 2015 is your chance to alert policymakers, the media and the public that when seconds count, physician anesthesiologists save lives.

There has never been a more important time to advocate for our specialty and our patients.  Join the American Society of Anesthesiologists® (ASA®) for this action-packed week and showcase the role all physician anesthesiologists play in providing the safe, high-quality care all patients deserve. 

During the week, ASA is asking all physician anesthesiologists to illustrate how every one of our members protects patient safety. Schedule meetings with your legislators, talk to local press, engage in social media and connect with colleagues and the community.

Planning for these activities should start in December! ASA has developed materials and resources to help you beginning with a Physician Anesthesiologists Week member engagement webinar in December that will provide specific instructions on how to make the event a success. The webinar will highlight and review the materials contained in the comprehensive support tool kit developed for the week’s activities. Watch ASAP to learn more and get involved in this inaugural event. 

© 2014 American Society of Anesthesiologists

The ASA and AQI partner to provide quality reporting to Physician Anesthesiologists

The National Anesthesia Clinical Outcomes Registry (NACOR), maintained by the Anesthesia Quality Institute (AQI), has been designated as a Qualified Clinical Data Registry (QCDR) by the Centers for Medicare and Medicaid Services (CMS) for Physician Quality Reporting System (PQRS) reporting. NACOR is the only anesthesia QCDR in the market. The American Society of Anesthesiologists® (ASA®) and AQI has partnered to provide this reporting to physician anesthesiologists.

The program’s goal is to move responsibility for collecting data on physician performance from CMS to certified professional society registries. The responsibility of the registry will be to establish performance measures, collect data from providers, score performance, and report the final results to CMS.

To become certified as a QCDR, registries must have experience collecting data from multiple physicians in multiple different locations and practices, must already be providing participants with risk-adjusted benchmarking information for quality management, and must have measures in place for the secure handling of protected healthcare information. At least nine measures must be documented by providers (with at least one outcome) from at least three performance domains in order to qualify for future incentive payments and at least three measures to avoid negative payment adjustments.

One of the most important benefits of a QCDR certification is that registries were asked to nominate specialty-specific measures for performance reporting. AQI’s approved measures for 2014 include our specialty’s previously approved four PQRS measures, four new PQRS measures, and 11 new measures not previously part of any public reporting system. The complete details of these measures as well as QCDR can be found on the AQI website at aqihq.org/pqrs. In 2015, QCDR reporting to CMS will be free for ASA members who are participating in NACOR.  ASA will offer QCDR reporting to non-members in NACOR for a fee. For more information contact Lance Mueller at l.mueller@asahq.org or 847-268-9190.

© 2014 American Society of Anesthesiologists

 

Nurse Anesthetists Approve First Fellowship 

The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) recently announced the first COA accredited fellowship – Hamline University’s Advanced Pain Management Certificate. According to the Hamline University website: “The program is collaboration between Hamline University and the American Association of Nurse Anesthetists (AANA).”

The four semester program requires the completion of 19 didactic credits ($1,200 per didactic credit in addition to $2,500 per clinical semester) and 240 mandatory clinic hours. Didactic credits are completed online while clinic hours are completed at program-approved sites.

According to the COA: “The Council on Accreditation of Nurse Anesthesia Educational Programs has existed since 1978 as an autonomous, multidisciplinary body under the corporate structure of the AANA [emphasis added], representing the various publics within the nurse anesthesia community of interest in which the profession resides.” In 2014, the COA established Standards for Accreditation of Post Graduate CRNA Fellowships (SPGF). The standards permit fellowships in areas including pain medicine, pediatrics, and obstetrics as well as in government affairs and leadership.

In November 2012, CMS published a final rule (77 FR 68892) allowing Medicare funds to be used to pay nurse anesthetists to diagnose and treat chronic pain so long as it is permitted by their state’s laws. The rule effectively charges individual states with determining whether nurse anesthetists may receive payment for these services. ASA strongly opposes this rule and supports efforts at the state and national level to recognize interventional pain management as the practice of medicine and ensure that interventional treatment of pain is provided only by qualified MDs/DOs. 

In 2015, more states are expected to consider legislation or regulations that will determine whether nurse anesthetists may provide pain medicine services to chronic pain patients. It is incredibly important for your patients’ safety that physician anesthesiologists and other pain medicine trained physicians engage their lawmakers and share why medical training is crucial for the comprehensive medical management of such patients.

For more information or questions about this or any state level advocacy topic, please contact Jason Hansen at j.hansen@asahq.org or by phone at or (202) 289-2222.  

© 2014 American Society of Anesthesiologists

  

Cochrane Collaboration Conducts Review Comparing AnesthesiaProviders

In July 2014, The Cochrane Collaboration, an independent, non-profit, non-governmental organization, published a literature review, “Physician anaesthetists versus non-physician providers of anaesthesia for surgical patients.” The review examined existing peer-reviewed literature, therefore no new data were provided. The authors hoped that the review would “lead to an increase in confidence in the skills of nonphysician anaesthetists (NPAs) within the medical community.” Due to the small number of studies examined and their respective biases, the authors properly concluded that it was not possible to provide an answer to the review question. The American Association of Nurse Anesthetists (AANA), however, once again employed the logic fallacy “argument from ignorance” and incorrectly interpreted the review by stating that the researchers found “no differences in care provided by CRNAs and anesthesiologists.”

The lack of evidence comparing physician anesthesiologists to nurse anesthetists should not be used to suggest that physician anesthesiologists and nurse anesthetists provide equivalent care for their patients. In response to the review, the ASA Committee on Health Policy Research (HPR) created a Policy Brief which discusses the authors’ findings and calls for a new perioperative research agenda. For additional questions about the Cochrane review or the HPR Policy Brief, please contact ASA Health Policy Research at ask.HPR@asahq.org.

© 2014 American Society of Anesthesiologists

 

ASA Members Win State Primaries, Prepare for General Election

This year, several American Society of Anesthesiologists® (ASA®) members are taking advocacy to the next level and are running for state elected office. Such ASA members include:

  • Timothy Melson, M.D. - Republican candidate for Alabama State Senate District 1
  • Tim Robinson, M.D. - Republican candidate for Maryland State Senate District 42
  • Ervin Yen, M.D. – Republican candidate for Oklahoma State Senate District 40 
  • Bryan Terry, M.D. – Republican candidate for District 48 of the Tennessee House of Representatives
  • John Zerwas, M.D. (Immediate Past President of ASA) – Incumbent Republican candidate for District 28 of the Texas House of Representatives 

ASA member Timothy Melson, M.D., won a runoff election on July 15 to become the Republican candidate for Alabama State Senate District 1, which includes parts of Limestone, Lauderdale, and Madison counties. If Dr. Melson is successful against his opponent Mike Curtis (D) in November, he will be the first physician anesthesiologist elected to the Alabama State Senate.

On June 24, 2014, ASA member Tim Robinson, M.D., won the Republican primary for Maryland State Senate District 42. District 42 covers part of Baltimore County. On November 4, Dr. Robinson will face incumbent opponent Jim Brochin (D) in the general election.

ASA member Ervin Yen, M.D., won the Republican primary runoff election on August 26 for the Oklahoma District 40 Senate seat. District 40 covers Oklahoma City and is currently represented by Senator Cliff Branan (R), who is term limited from seeking re-election. Dr. Yen will now face John Handy Edwards (D) in the general election on November 4.

On August 7, ASA member Bryan Terry, M.D., won the Republican primary for District 48 of the Tennessee House of Representatives. District 48 covers part of Rutherford County. Dr. Terry will face his opponent, Bill Campbell (D), in the general election on November 4. If elected in November, Dr. Terry will become Tennessee's second physician anesthesiologist lawmaker, joining Steve Dickerson, M.D., former president of the Tennessee Society of Anesthesiologists, who was elected to the Tennessee Senate in 2012. Dr. Dickerson serves Tennessee's 20th District.

Immediate Past President of ASA, John Zerwas, M.D., is currently serving his fourth term as state representative for the 28th District of Texas. Dr. Zerwas (R) was unopposed in the Republican primary on March 4, and is unchallenged in the November 4 general election.

If you are running for state office, or know of another ASA member who is, please contact Jason Hansen at j.hansen@asahq.org or Erin Philp at e.philp@asahq.org or (202) 289-2222.

© 2014 American Society of Anesthesiologists

Anesthesiology Promoted at NCSL

This August, American Society of Anesthesiologists® (ASA®) members and staff represented ASA at the National Conference of State Legislatures’ (NCSL) 40th annual Legislative Summit at the Minneapolis Convention Center. 

During this year’s Legislative Summit, ASA President-Elect John Abenstein, M.S.E.E., M.D., Minnesota Society of Anesthesiologists (MSA) Past President Peter Boosalis, M.D., Former MSA President Charles Rich, M.D., and MSA lobbyist Nate Mussell joined ASA staff in interacting with state legislators and legislative staff at the exhibit booth. 

Since its formation in 1975, NCSL has become one of the largest bipartisan organizations of state lawmakers in the country. It currently serves all 7,383 state lawmakers and more than 20,000 legislative staff throughout the United States with policy research and technical assistance. Each year, the Legislative Summit offers state legislators and staff the opportunity

to meet with each other and exchange ideas on important state issues 

For the past 14 years, ASA has participated in NCSL as an exhibitor. This year, ASA again represented physician anesthesiologists at the joint physician booth “Physicians Advocating for Patients.” The exhibit booth included representatives from the American Academy of Family Physicians, the American College of Surgeons, and the American Academy of Dermatology.  

The NCSL Legislative Summit provides ASA with a great opportunity to increase the visibility of physician anesthesiologists and educate state legislators about physician anesthesiologists and their achievements in advancing patient safety. State legislators and staff stopped by ASA’s booth to speak with ASA staff and MSA representatives, as well as others at the joint booth representing their respective medical specialties. ASA is already planning for NCSL’s 2015 Legislative Summit, which will be held in Seattle from August 3-6, 2015.

© 2014 American Society of Anesthesiologists