AAOS Now, September 2008
CMS issues final IPPS rule
Three conditions added to HAC payment policy Under the final inpatient prospective payment system (IPPS) rule updating Medicare payments to hospitals for fiscal year 2009, the Centers for Medicare and Medicaid Services (CMS) added three new conditions to the list of hospital-acquired conditions (HAC) for which Medicare will not pay at the enhanced complication/comorbidity payment level.
Getting paid for taking call
Hospital responses vary, but trend is clear The crisis in emergency care coverage isn’t going away—and neither is the need to compensate those physicians who take call. That was the consensus of the participants in a Webinar sponsored by HealthLeaders Media on June 17, 2008. But developing the right on-call compensation model is tricky and requires a collaborative effort by medical staffs and hospital administrators.
To pay or not to pay
By Kathleen L. DeBruhl, Esq., and David D. Haynes, Jr., Esq. Structuring compensation to on-call physicians The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 in response to concerns that hospital emergency departments were improperly transferring or refusing to treat indigent patients.
Managing the call schedule
Challenge is to balance the needs of patients, physicians Throughout the nation, patients are finding it difficult and sometimes impossible to obtain emergency care services in a timely manner. At the same time, physician practices are finding it difficult—and sometimes impossible—to provide the depth of emergency care services that are required.
Clinical competence and the aging surgeon
Patient safety, ethical considerations must be respected When is a surgeon too old to operate or a physician too old to practice medicine? We could pose the same query about any profession. The question is difficult to answer because it involves a person’s sense of self-worth, society’s needs and expectations, and many complex legal issues. Some surgeons have successfully practiced medicine and surgery into their 80s and beyond.
What can I do about my medical liability insurance?
Five steps to reducing your current premiums Even if you haven’t considered alternatives to your current medical liability policy, hundreds of other physicians have moved well beyond the consideration stage. According to a 2005 article in The Wall Street Journal (“Doctors’ Creed: Insure Thyself,” Aug. 17, 2005), the size of the alternative medical liability market is between $9 billion and $18 billion—out of a total market of $30 billion in premiums.
Coping with Medicare Advantage fee-for-service plans
By Steve Gillies and Sarah Gretch From enrollment to reimbursement: Tips you can use Medicare Advantage (MA) plans are second-generation “Medicare + Choice” plans, which were created under the Balanced Budget Act of 1997. This act gave Medicare beneficiaries the option to receive their Medicare benefits through private health insurance plans (Part C), instead of through the original Medicare plan (Parts A and B).
Coding for pediatric spine deformity procedures
By Mary LeGrand, RN, MA, CCS-P, CPC Coding for pediatric spine deformity procedures requires a clearly dictated operative note defining the components of the procedure as well as the roles of the co-surgeon or assistant surgeon. This can best be seen by applying key coding concepts to several pediatric surgical case scenarios. Note: In all cases, the 2008 relative value units (RVUs) shown are calculated without Geographic Practice Cost Index or Budget Neutrality adjustments.
Enroll now in upcoming practice management course
Would you like to manage your practice more effectively? Are you looking for ways to position it for greater growth? Make the 3rd Annual AAOS Orthopaedic Practice Management Course: Building Essential Skills a key component of your business plan. The course, directed by Kevin J. Bozic, MD, MBA, and David A.