Medicare Issue

  1. Did anybody see the news release that the ASA put out? If not here it is.

    HHS Suspends Clinton Anesthesia Supervision Rule; Doctors Will Be There for Seniors-
    The more than 40 million seniors on Medicare will continue to have a doctor involved in their anesthesia care for surgery, now that the Bush administration has suspended a rule change put through by the Clinton administration.

    The American Society of Anesthesiologists (ASA) today congratulated President George W. Bush and Secretary of Health and Human Services (HHS) Tommy Thompson on the decision to retain the 35-year-old Medicare requirement that anesthesia nurses be supervised by a physician.

    Just days before leaving office, President Bill Clinton had issued a new rule that would have allowed anesthesia nurses to administer anesthesia to Medicare and Medicaid patients without physicians being involved.

    Now, HHS has made the determination that the rule will not go into effect as scheduled, and the department will soon introduce a proposal that addresses two new points:

    A state Governor could apply to HHS for a waiver of the supervision rule, provided it is consistent with state law and following consultation with the state's boards of medicine and nursing. The Governor would also have to determine that removal of the supervision requirement is in the best interest of the citizens of that state.

    A prospective patient outcomes study, as long advocated by ASA, would be undertaken to compare different anesthesia practices by state.
    According to ASA president Neil Swissman, M.D., "This is a great day for seniors everywhere. For more than three years, ASA has been arguing that patient safety was at stake, and now someone has listened."

    Under federal law, HHS must seek public comments on the new rule before making it final. The long-standing supervision requirement thus remains in effect, and Medicare and Medicaid beneficiaries will continue to be guaranteed a physician's involvement in their care. Suspension of the Clinton rule will continue for at least the next six months, HHS has announced.

    "We are absolutely confident that when the new rule from the Bush administration takes effect and when the scientific facts are known to the individual governors, they will do what is best for the people of their states retain the supervision requirement for their senior citizens," Dr. Swissman continued.

    "Consistently, over 80 percent of seniors have said in several nationwide surveys that they want a physician involved in their anesthesia care -- and I know the governors will heed that message," Dr. Swissman said.

    Since January 2001, more than 100,000 e-mails, faxes, postcards and letters have poured into HHS and the White House asking the administration to retain physician involvement in Medicare patients' anesthesia care.

    Virtually all state laws and regulations require a physician to be involved with nonphysician providers in the delivery of anesthesia care. "I cannot imagine," Dr. Swissman said, "that the governors will not adhere to this pattern in the case of the most vulnerable class of patients, our senior citizens."

    To ensure that their safety would not be jeopardized, Dr. Swissman explained that ASA has been fighting the no-supervision rule since it was first proposed by the Clinton administration in December 1997. He expressed gratitude on behalf of the more than 36,000 ASA members for the seriousness with which the Bush administration approached the issue of whether to overturn the Clinton rule.

    "This administration has proceeded with the utmost caution and has wisely left in place a federal requirement for physician supervision," Dr. Swissman said. " The nation's seniors owe this administration a big vote of thanks for protecting their anesthesia safety."

    Any comments?

    I'm not annoying you guys am I?
    If so, Sorry, just let me know
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    About meandragonbrett

    Joined: Jan '02; Posts: 2,593; Likes: 1,418


  3. by   fergus51
    Just docs protecting their bottom line. Nothing really shocking to me.
  4. by   BRobison
    FWIW: I feel we should always take a news release from the ASA with the proverbial "grain of salt," and, for our best mental health, visit the same issue at the AANA website ASAP. Our buddies at the ASA seem to have a knack for presenting a rather skewed look at the CRNA/safety issue.

    Where is Joe Friday when we need him? ("Just the facts, ma'am.")
  5. by   BRobison
    In follow up to my own comments....those of you that are concerned about this issue might like to visit Type in "anesthetists" in the search option there, and you can actually send your local elected officials your opinion as to whether this requirement for supervision be dropped or not.
  6. by   meandragonbrett
    Thanks for the link!

  7. by   nilepoc
    I had a feeling this would occur, but I am not sure exactly what it means.

    Basically this is a fight over money. MDA's don't want their pie cut any smaller than it is, and CRNA's would like to expand their roles. Depending on what kind off slanted research comes out in the next few years, we will see the result of all of the ASA's FUD (for he non computer savy of you that stands for Fear, Uncertainty and Doubt, Its long been a marketing practice of Microsoft).
  8. by   nrw350
    Do you all think that seniors need an physician over-seeing their anesthesia? I can truly see cases where that would be necessary. But I can imagine there are cases where it is not necessary.


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