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    Medicare Law Enactment Benefits Anesthesiology

    By Jennifer Huddleston, staff writer     

    In what the American Society of Anesthesiologists (ASA) called “a historic triumph,” the United States House of Representatives and Senate overrode a presidential veto to enact a law that will reverse the 10.6 percent Medicare payment cuts that went into effect July 1, 2008. [1]

    “The enactment of H.R. 6331 marks a tremendous victory for the medical specialty of anesthesiology and all of organized medicine,” said Jeffrey L. Apfelbaum, M.D., president of the ASA. “Anesthesiologists help make modern medicine possible, and this new law will help ensure seniors’ access to their life-saving medical care.”

    The Medicare Improvements for Patients and Providers Act will provide a 1.1 percent positive Medicare payment update for 2009 and block Medicare payment cuts through Dec. 31, 2009.

    In addition to reversing the cuts, the law will also extend the 1.0 floor on the work geographic price cost index (GPCI) through 2009, which, according to a 2007 analysis by the Association of American Medical Colleges, could translate to many millions of dollars worth of savings for medical practices.

    The new law increases the physician quality reporting initiative (PQRI) bonus to 2 percent for participating physicians in 2009 and 2010 as well as restores full Medicare payments to anesthesiology teaching programs starting in 2010.

    Funding of anesthesiology teaching programs that treat Medicare patients has been an important issue for anesthesiologists and academic medical centers, and the restored funding could mean up to $40 million annually in additional payments to hospitals that currently lose approximately $400,000 each year under the old teaching rule policy.

    “Restoration of funding is essential to the survival of teaching programs,” said Apfelbaum. “The threat of extinction looms large. Without restoration of funding, it’s entirely possible that my children and grandchildren will not have anesthesiologists to care for them, and that’s a frightening possibility.”

    Charles A. Vacanti, M.D., anesthesia professor at Harvard Medical School, president of the Society of Academic Anesthesiology Chairs and anesthesiologist-in-chief at Brigham and Women’s Hospital, anticipates that teaching hospitals will see positive effects from the law in the near future. He said the funding “will help us offset some of the impact that we’re seeing from decreases in compensation from third-party payers.”

    Anesthesiologists in practices not affiliated with teaching organizations should also see benefits of increased funding for residency programs. Vacanti noted that when funding is reduced like it has been, residency programs generate fewer elite anesthesiologists who can then demand greater compensation. A larger pool of top candidates from better-funded residency programs will make it easier for practices to be able to add additional physicians.

    President Bush vetoed the bill July 15, just hours before the House and Senate each voted by more than a two-thirds majority to override the veto. The Senate had passed H.R. 6331 six days earlier with a vote of 69-30.

    [1] “VICTORY: Medicare Bill Becomes Law!” July 15, 2008.
    [2]  Ibid.
    [3]  Ibid.
    [4] Marcus, Adam. “Congress Bucks Bush to Pass Medicare Bill.” Anesthesiology News. Volume 34:08. August 2008.
    [5] “VICTORY: Medicare Bill Becomes Law!” July 15, 2008.
    [6] Marcus, Adam. “Congress Bucks Bush to Pass Medicare Bill.” Anesthesiology News. Volume 34:08. August 2008.
    [7]  Ibid .
    [8]  Ibid .
    [9]  Ibid .
    [10] “VICTORY: Medicare Bill Becomes Law!” July 15, 2008.

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