Home E-Weekly November 29, 2016

How to Save $20 Billion (Without Repealing and Replacing Obamacare)

Published: November 28, 2016

ANESTHESIA BILLING Reimbursing for medical direction is wasteful, says Jay Horowitz, CRNA.

A nurse anesthetist has a suggestion for the Trump administration that could save $20 billion in healthcare spending without, he says, impacting patient safety: stop paying for medical direction of certified registered nurse anesthetists (CRNA).

In a guest column in The Hill, Outpatient Surgery Magazine editorial board member Jay Horowitz, CRNA, makes his case for eliminating reimbursement for medically directed anesthesia claims and recognizing both anesthesiologists and CRNAs as independent practitioners.

"One anesthetic, one provider, one payment. Period," Mr. Horowitz, of Sarasota, Fla., writes in the political website.

Anesthesiologists can bill for medically directing as many as 4 CRNAs — even though no state requires supervision by an anesthesiologist and even though CRNAs can practice independently without physician supervision in many states. Mr. Horowitz says this "Medicare billing scheme" lets anesthesiologists recoup twice as much revenue by "medically directing" as many as 4 CRNAs or anesthesia assistants than they would by personally administering an anesthetic.

Dan O'Connor

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