New Pro MDA resident training bill

[MmacFN]

If you didn't see this please read

>> 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.

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From AANA:

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.

[BeatOU]

thanks for keeping us abreast, i'll let mine know today that this is no bueno

[jwk]

Why don't I ever see any posts such as "The AANA announced today that Senator John Doe has introduced legislation to increase reimbursement for cases done by student nurse anesthetists" ?

Really - just curious.

[MmacFN]

Hmm

I have never actually seen any announcements about something like that. However, i am not in the loop AANA wise I just look for this stuff in the news and online.

Has there been much of that?

[jwk]

Hmm

I have never actually seen any announcements about something like that. However, i am not in the loop AANA wise I just look for this stuff in the news and online.

Has there been much of that?

Nope - exactly my point. Instead of rallying against the ASA bill, why does the AANA not propose it's OWN bill? It goes back to the ThoughtBridge collapse. The AANA wanted the ASA to do it's work for them, and propose one big bill and ride along on their coat-tails, instead of doing the legwork themselves, promoting their own profession, which is what the AANA is supposed to do.

[MmacFN]

In regards to thoughtbridge

Ive finally educated myself about that idea. I understood that it is still meeting and still in progress?

[RobCPhT]

There is a form somewhere that allows you to just fill in your name and a few details and then e-mail it to the parties involved. If anyone knows where to find these they really help spread the message.

[sc17]

This attitude is exactly why there are conflicts between anesthesiologists, anesthesiology residents, and CRNA/SRNA. Why are crnas against a bill that would help anesthesiology training programs? The competitive nature of the aana is not beneficial to the crna profession, it only fosters more and more resentment and further increases the divide between the two groups - mds and crnas.

[MmacFN]

Hey sc

Well I dont know if its that black and white.

Do you think the ASA would not be against a bill by the AANA which gave SRNAs a higher reimbursement or abolished the need for any physician involvement in CRNA practices?

The ASA has the same agenda as the AANA: " To protect their economic interests". I hardley blame either of them.

If you were the AANA leadership and saw a bill proposed that would provide an economic incentive to train MDAs over CRNAs to the hospital wouldnt you see this as a threat? While i appreciate the fact that this would not happen overnight and MD residents would not double the next day, it sets a trend for the future and says that this is "acceptable". Basically, a slippery slope.

No matter how you look at it these sortof bills suggest that an MDA is worth more than a CRNA to the hospital. Clearly, this isnt born out in the research when we talk about outcomes and patients, so its only about money. Under the managed care umbrella hospitals are looking for anyway to increase reimbursement and/or cut costs. Offer up something like this and they will be all for it for all the wrong reasons. The ASA isnt proposing a bill like this in the interests of making the hospital more money.

Could the AANA propose a bill as well? Sure. All of that costs money. Fighting against a bill is cheaper than fighting to put one on the table.

This attitude is exactly why there are conflicts between anesthesiologists, anesthesiology residents, and CRNA/SRNA. Why are crnas against a bill that would help anesthesiology training programs? The competitive nature of the aana is not beneficial to the crna profession, it only fosters more and more resentment and further increases the divide between the two groups - mds and crnas.

[DebbieSue]

Maybe they are trying to get twice as much reimbursement because it is twice as hard to teach anything to an anesthesiology resident ;)

JUST KIDDING, people, REALLY.

[MmacFN]

BWhahhaa

That was a good one!

[Brian_SRNA]

GREAT ONE. AND i must agree, most doc are harder to teach.

Brian