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  • SGR Fix for 10 Months...but at a price

    Good news SGR is fixed - for 10months (so more of the same). Bad news facilities will be getting a reduction in Medicare bad debt payments to 65%. Medicare bad debt payments are monies received by facilities to offset the cost of "bad debt" from Medicare recipients who don't pay their deductible or co-pays. IMO even though some large groups continue to tout the ACT (albeit poorly) ... hospitals are going to keep taking a serious look at Anesthesia stipends. The trends continue to favor CRNA heavy or all CRNA models.

    Agreement reached on Medicare physician payment fix
    February 16, 2012

    House and Senate leaders have reached an agreement to provide physicians a 0% Medicare payment update through the end of the year, preventing a 27.4% cut to Medicare physician payments scheduled to take effect March 1. To offset the cost of averting the physician cut, inpatient acute care hospitals would see their Medicare bad debt payments reduced from the current 70% level to 65% beginning in fiscal year 2013; and critical access hospitals would see their payments reduced from 100% to 65%, phased in over three years. The legislation also would extend the current therapy cap and exceptions process to services provided in hospital outpatient departments through Dec. 31, and would reduce Medicaid Disproportionate Share Hospital payments in 2021. Significantly, the agreement does not reduce payments for evaluation and management services provided in hospital outpatient departments, nor does it grant the Centers for Medicare & Medicaid Services new

    authority to make additional across-the-board cuts to Medicare inpatient hospital rates through the use of retrospective coding adjustments for FYs 2010-2012. The agreement also rejects proposed changes that would significantly weaken the current prohibition on physician self-referral to new physician-owned hospitals and loosen the restrictions for growth on grandfathered facilities. The House and Senate are expected to vote on the agreement before the Presidents Day recess. "While we support ensuring that physicians will not see their Medicare payments reduced, we are extremely disappointed that once again Congress is putting seniors' access to hospital services in jeopardy through arbitrary reductions to hospitals," said AHA President and CEO Rich Umbdenstock. "Today's proposal would add an unnecessary strain to hospitals that care for vulnerable populations. … We need thoughtful approaches to improving health care not indiscriminate cuts that
    harm patients' access to care."

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    Surgeon says GO!

    Not an PS 4, this individuals conditions are not a 'constant threat to life', they are a 3. I would not hesitate to do this case at a surgery center.

    MmacFN 50 Minutes Ago Go to last post

    Surgeon says GO!

    Just curious why they are listed as ASA 4? I would have put them as a 3. Am I missing something? Heart failure, liver failure, kidney failure?

    nurserebecca 3 Hours Ago Go to last post

    Surgeon says GO!

    I would decline to do the case as a general anesthesia and on an outpatient basis. This patient would need 24hr monitoring after general anesthesia. The

    wtbcrna 3 Hours Ago Go to last post

    "Block Nurses" - can't tell if this is real or satire

    You forgot "tear off precisely six squares of toilet paper and wipe their ass..."


    squeege 3 Hours Ago Go to last post

    Surgeon says GO!

    Didn't go to big house. My decision was weighed with the higher ups. "They" decided, I voiced. Anesthesia was in my hands, none the less.

    ethernaut 3 Hours Ago Go to last post
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