Anesthesiology Digest – January 21, 2022

January 21, 2022

Anesthesiology Digest: News from January 2022.

CMS Vaccine Policy Now Enforceable in All 50 States
By Maya Goldman | January 19, 2022

The federal COVID-19 vaccine mandate for healthcare workers can officially go into effect nationwide after a judge tossed out a challenge to the mandate from Texas on Wednesday.

A judge in the United States District Court for the Northern District of Texas granted a temporary block of the Centers for Medicare and Medicaid Services requirement that employees at Medicare and Medicaid-certified facilities be fully vaccinated against COVID-19 in Texas.

But Texas moved to dismiss the case on Tuesday following the Supreme Court’s decision to let the CMS enforce the mandate while appeals are considered at lower courts.

Accordingly, the federal government’s requests to block both the lawsuit’s proceedings and an injunction pending appeal were dismissed as irrelevant.

The Supreme Court’s decision came after hearing arguments on two separate lawsuits against the mandate brought by 24 states. Texas had filed its own challenge against the policy that was not heard by the Supreme Court, so the court’s decision did not impact Texas providers.

CMS on Friday pushed back compliance dates for providers in the 24 states newly subject to the guidance following the Supreme Court decision. CMS officials said at the time that the guidance specifically did not apply to Texas, as litigation was ongoing. CMS did not immediately respond to questions about whether deadlines will be changed for Texas
providers as well.

To read more, go to Modern Healthcare.

Florida Legislation Would Clarify CRNAs’ Authority to Administer Anesthesia
By Patsy Newitt | January 19, 2022

Two bills in the Florida House and Senate aim to clarify that certified registered nurse anesthetists can administer anesthesia in hospital, surgical and clinical settings in collaboration with specified licensed healthcare practitioners.

The bills, SB 986 and HB 437, would clarify language in the existing law that CRNAs would work in collaboration with, rather than under the direction of, licensed physicians. The bills were introduced Jan. 11 and, if passed, would go into effect July 1.

The bills would clear up the misconception that a physician anesthesiologist is the only one who can supervise a CRNA in the delivery of anesthesia in outpatient settings, according to an article by CRNA William Self, published Jan. 19 in Florida Politics.

To read more, go to Becker’s ASC.

MedPAC Hashes Out New Alternative Payment Model Strategy
By Maya Goldman | January 14, 2022

The Medicare Payment Advisory Commission thinks a new model with different risk tracks and administratively-set savings benchmarks could be the way forward for population-based alternative payment models, though commission members noted during a Friday meeting that there are still many details to work out.

MedPAC should recommend that Congress have timeliness and simplicity in mind, Commissioner Brian DeBusk, CEO of medical equipment manufacturer DeRoyal Industries, said during Friday’s meeting. As Medicare Advantage grows each year, population-based alternative payment models like accountable care organizations are left with a shrinking pool of beneficiaries, he added.

In October, MedPAC commissioners discussed developing a single multi-track, population-based payment model to guide CMS’ alternative payment model strategy. CMS set a goal that same month to have all Medicare beneficiaries in a value-based payment arrangement by 2030.

MedPAC followed with a November discussion about developing administratively-set benchmarks for ACOs, which can share in Medicare savings if their beneficiaries’ expenditures come in below an assigned benchmark level. The benchmark is determined based on spending for beneficiaries who would’ve been eligible for the ACO in the baseline years, along with the growth in an ACO’s spending between the baseline and performance years.

Because ACO benchmarks are reset each performance period based on the ACO’s past performance, an ACO that improves the amount of savings it generates each year will have to deal with benchmarks that are increasingly harder to exceed, which puts long-term ACO participation at risk.

MedPAC staff Friday provided commissioners with a blueprint for a hypothetical new three-track alternative payment model. The model would divide providers into three separate categories. Independent physician practices, small safety net providers or rural providers, could be in a track that involves no financial risk. Providers could keep up to 50% of savings generated relative to their benchmark after a minimum savings rate is met.

To read more, go to Modern Healthcare.

United Healthcare to Implement ASA-recommended Changes to Coverage for Pain Treatment
January 14, 2022

Beginning March 2022, United Healthcare (UHC) will implement changes to the coverage of Dorsal root ganglion (DRG-S) stimulation, a procedure effective in the treatment of a variety of painful conditions. The new UHC policy details implanted electrical spinal cord stimulators as proven and medically necessary for treating certain conditions.

In December 2021, the American Society of Anesthesiologists (ASA) and a group of pain medicine societies urged UHC to overturn the lack of coverage for this procedure. ASA applauds UHC for implementing ASA’s recommendations and believes coverage for neuromodulation treatments is essential.

Overall, these treatments reduce the opioid burden in the chronic pain population and are effective in treating a variety of other painful conditions. ASA strongly supports increased access to non-opioid options for chronic pain patients.

To read more go to ASA’s website.

2022 MGMA Compensation and Production Survey Now Open
January 12, 2022

The Medical Group Management Association’s (MGMA) Compensation and Production survey is now open and ASA members are encouraged to participate. This survey collects compensation data for medical practice leadership and support staff, physicians and advanced practice providers and captures productivity by specialty.

The survey will be open through February 11, 2022. To access the survey, go to You do not need to be an MGMA member to participate, but you will need to create an account to access the survey. This is necessary to ensure confidentiality of the data.

To review MGMA resources to help you prepare to participate, please visit:

Questions? Please contact MGMA at 877-275-6462 (ext. 189) or email

Medical Organizations Continue to Fight Surprise-billing Dispute Process: 5 Details
By Alia Paavola | January 11, 2022

A coalition of medical organizations, including the Physicians Advocacy Institute and 16 state medical associations, filed an amicus brief supporting a legal challenge to the No Surprises Act dispute resolution process, according to a news release emailed to Becker’s.

Five things to know:

  1. The groups are supporting a lawsuit filed by the American Hospital Association and American Medical Association. The lawsuit challenges the dispute resolution process outlined in CMS’ surprise-billing rule released Sept. 30.
  2. The lawsuit alleges that the independent dispute resolution process, which requires arbiters to first consider the health plan’s median in-network rate as the appropriate reimbursement amount, unfairly favors health plans.
  3. Specifically, the medical organizations that filed the brief Jan. 4 argue that federal regulators ignored congressional intent of the No Surprises Act by relying almost exclusively on the median in-network billing rate to resolve billing disputes instead of considering a multitude of factors.
  4. “Physicians have an obligation to reinforce for the court just how far federal regulators walked away from the No Surprises Act’s balanced approach to resolving
    payment disputes and explain how bypassing the law will unfairly empower insurers at the expense of patients and their physicians,” said Dustin Corcoran, president of Physicians Advocacy Institute and CEO of the California Medical Association, both of which joined the amicus brief. “If the court allows this damaging example of regulatory overreach to stand, patients and physicians will pay the price.”
  5. There are 26 physician organizations that joined the amicus brief. Read the full list of organizations here.

To read more, go to Becker’s Hospital.

Congressman Andy Harris, MD and the Congressional “Doc Caucus” File Amicus Brief in Support of TMA No Surprises Act Texas Lawsuit
January 7, 2022

On January 3rd, Congressman Andy Harris and members of the U.S. House GOP Doc Caucus filed an amicus brief in Tyler, Texas in support of a pending Texas Medical Association (TMA) lawsuit that challenges the regulations implementing the No Surprises Act (NSA). The TMA suit argues that the responsible federal agencies erred in creating an Independent Dispute Resolution (IDR) process that empowers insurance companies to squeeze financial concessions from physician practices. The Doc Caucus brief filed in support of the TMA suit argues that Congress repeatedly rejected the agencies’ approach to the IDR process and cites multiple versions of Congressional surprise medical bill legislation that were considered and rejected. Previously, thirteen ASA component societies filled a formal statement also in support of the TMA lawsuit.

ASA has a pending NSA lawsuit in Chicago, Illinois. The suit, filed jointly with the American College of Emergency Physicians (ACEP) and the American College of Radiology (ACR) similarly argues that the federal agencies erred in their IDR provisions of the implementing regulations.

To read more, go to ASA’s website.

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