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>> Senate Version of ASA-Backed Teaching Rules Legislation Introduced
A Senate companion measure has been introduced with the backing of the ASA to change the Medicare reimbursement teaching rules to favor anesthesiologists working with medical residents.
The bill, S 2990, was introduced by Sen. David Vitter (R-LA) and ten cosponsors May 23, 2006. Though the text of the measure has not been posted online by the United States Senate, it is believed to be identical to measures previously introduced in the House to change the Medicare anesthesia payment teaching rules in a way favorable to anesthesiology medical residents. The House bills, HR 5246 and HR 5348, introduced by Reps. Clay Shaw (R-FL) and Fortney Pete Stark (D-CA) respectively, would provide additional Medicare payment incentives solely to teach anesthesiology residents.
Unlike current Medicare teaching rules, which treat teaching and student nurse anesthetists and anesthesiologists similarly, enactment of HR 5246, HR 5348 or S 2990 would effectively double current Medicare payment for those instances when a teaching anesthesiologist is involved in two simultaneous cases involving medical residents. If enacted, the bills would increase incentives to teach anesthesiologists and discourage nurse anesthesia education, by providing anesthesiologists twice the reimbursement for cases involving medical residents than for cases involving student nurse anesthetists. The Centers for Medicare and Medicaid Services (CMS) rejected the ASA proposal addressed in these bills in 2003, 2004 and 2005.
CRNAs can take action on this issue by communicating with their members of Congress using the AANA CRNAdvocacy utility at www.aana.com.
If you disagree with this bill, you can write or call your legislators and let them know that their constituents do not support it. Legislators without a clue depend on opinions of those who are familiar with these issue to give them opinions. Every letter or call helps. They do make a difference.
If you are an AANA Member or Student Member it takes about 3 min to send an email, just go to AANA.com, LOGIN, select GOVERNMENT RELATIONS, select FEDERAL LEGISLATIVE LOOKUP, click the link.
Under the Medicare program, healthcare providers who deliver the same services with the same level of quality are generally reimbursed the same.
These bills would provide teaching anesthesiologists TWICE the Medicare reimbursement for cases involving anesthesiology residents than for cases involving student nurse anesthetists.
If there is a change in Medicare payment rules for anesthesia education, it should treat anesthesiologists and CRNAs equitably. HR 5246 and HR 5348 do not. And by setting up major incentives favoring one provider, HR 5246 and HR 5348 both promote disincentives against educating the other. And my area, it's the CRNAs who are providing anesthesia services for the medically underserved, for rural America, the V-A and the military.
Medicare and the bills supporters say HR 5246 and HR 5348 would cost Medicare an additional $34-40 million dollars per year, every year.