ASCA News Digest (May 6, 2014)

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May 6, 2014





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ASCA Highlights


Register On-Site for ASCA 2014

Even though online registration for ASCA 2014 has closed, there will still be room for you in Nashville next week; simply register on-site. On-site registration, located outside the Exhibit Hall of the Gaylord Convention Center, will be open 7:00am–7:00pm on Wednesday, 7:00am–6:30pm on Thursday, 7:00am–5:00pm on Friday and 7:30am–12:00pm on Saturday. MORE
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Ensuring Patient Safety with CapnographyThe RespSense™ and LifeSense® capnography monitors are simple-to-use, cost-effective tools that help you ensure your patients are adequately ventilated during sedated dental procedures. The monitors provide continuous and reliable monitoring to help identify potentially life-threatening ventilation status changes such as respiratory depression during dental procedures on sedated patients.

Already registered for the annual meeting? The ASCA 2014 Community on ASCA Connect is a great place to network with other attendees and submit questions to the speakers. Let people know you are attending and help promote the conference using the hashtag #ASCACONF on social media sites such as Twitter, Facebook and LinkedIn. MORE
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ASCA's 5K Fun Run/Walk, during ASCA 2014 in Nashville, is a terrific way to get your body moving and energized for the rest of the day on Friday, May 16. Regular runners and first-timers alike are welcome to join us for the race, sponsored by SourceMedical. Registration starts at 6:15am and the race begins at 6:45am. All participants, whether running 3.1 miles or walking the 1 mile course, will receive a free pedometer and t-shirt. MORE
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The expense involved with sending staff to conferences, to certification courses or back to school can seem like a large price to pay when the focus is on only the financial end of the request. This investment in staff members, however, produces returns beyond those easily measured on a profit and loss statement. The organization that invests in its employees’ education and development usually reaps the benefits of the additional knowledge, loyalty and employee satisfaction. MORE
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ASCA’s June Capitol Fly-In is less than two months away. Taking place June 17–18 in Washington, DC, the Fly-In offers you the rare opportunity to speak directly with your members of Congress. Register today. Rooms with discounted rates are available—thanks to generous contributions to the ASCA Advocacy Fund—but only a limited number are left. Register today. MORE
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Today kicks off the beginning of National Nurses Week, which is celebrated annually from May 6 through May 12. ASCA would like to recognize all of the nurses working in ASCs today for their contributions to the ASC community and the patients we serve. MORE
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ASCA staff met with representatives from the Centers for Medicare & Medicaid Services (CMS) Survey and Certification Group and Clinical Standards Group recently. ASCA requested this meeting to discuss proposed regulatory changes as well as issues ASCA members are facing during surveys. MORE
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Industry News


Physician Anxieties Linger as CMS Sets Oct. 1, 2015 Conversion Date for ICD-10
Modern Healthcare (05/01/14) Conn, Joseph

The Centers for Medicare and Medicaid Services (CMS) says that the use of ICD-10 diagnostic and procedural codes will be mandatory beginning Oct. 1, 2015, which is the earliest date possible under a law signed by President Obama last month. The compliance date is expected to be included in an interim rule that could soon be issued by the Department of Health and Human Services. That rule will also call for entities subject to the Health Insurance Portability and Accountability Act to continue to use ICD-9-CM codes through Sept. 30, 2015. Meanwhile, experts remain concerned that many of the issues that prompted Congress to delay the transition to ICD-10 last month have yet to be resolved. Physicians are particularly concerned about the possibility that their claims flow could be negatively impacted by the transition.
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New Price Transparency Rules for Hospitals
The Hill (04/30/14) Viebeck, Elise

The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule that aims to force hospitals to be more transparent about the prices of the medical services they offer. Under the proposal, hospitals will be required to release a standard list of prices for these services. Hospitals that allow the public to access pricing data following an inquiry will be considered to have met the requirement. The proposal is an attempt to achieve the Affordable Care Act's goal of encouraging greater transparency about the prices of healthcare products and services so that consumers can be better informed when shopping around for healthcare providers. In addition to the pricing requirement, CMS' proposal calls for reimbursement rates for general acute care hospitals and long-term care hospitals to be raised by 1.3 percent and 0.8 percent, respectively.
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Cyberattack Drill Exposes Healthcare Industry's Vulnerabilities
Health Leaders Media (04/23/2014) Mace, Scott

Department of Health and Human Services (HHS) Chief Information Security Officer Kevin Charest says health care organizations need to better share cyber threat information. Charest presented this assessment in the wake of the health care industry's April 1 cybersecurity drill, CyberRX. "We actually started it off with some fraud, where a physician attempted to have some malicious code written that would allow erroneous images to be created and then they could defraud Medicaid and Medicare," Charest said of the exercise. The drill evaluated how organizations responded to that incident. Jim Koenig of Booz Allen Hamilton, who acted as an observer for the CyberRX drill, said that rapid technological and regulatory change in the health care field makes it necessary that organizations put in place early warning systems for potential cyber threats.
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Medicare's Look-Up Tool for Doc Pay Reveals and Conceals
Medscape (04/29/14) Lowes, Robert

Along with the Web sites of the New York Times and the Wall Street Journal, the Centers for Medicare & Medicaid Services (CMS) has also introduced an online look-up tool to examine Medicare reimbursement to individual clinicians, but there are differences in what information is provided. The CMS tool offers detailed information--providing the number of services, beneficiaries of these services, the average charge billed, the average payment allowed by Medicare, and the average Medicare payment, while the New York Times shows the number of patients who received a particular services, the average amount billed, and the average Medicare payment per service and the Wall Street Journal offers the number of services provided under a single billing code, the average payment, and the total for each service in 2012. In addition, users of the CMS tool must add the totals for services themselves--which, in some cases, can require adding up totals for 20 to 30 individual billing codes. The Wall Street Journal's payment search tool provides extensive search criteria, such as "procedures attributed to a specific physician may have been performed by other people under that doctor's supervision."
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Surgery Center of Oklahoma Leads the Way in Health Care
The New American (05/02/2014) Jasper, William F.

The Surgery Center of Oklahoma (SCO), based in Oklahoma City, is performing surgeries at a fraction of the cost paid by patients at traditional hospitals. The 17-year-old private facility enjoys a high patient satisfaction rate and a very low infection rate. SCO is transparent in its pricing, posting the full cost of surgeries--including surgeon, anesthesiologist, and facility costs--online. The co-founders of the SCO, Drs. Keith Smith and Steven Lantier, are working to help other physicians set up facilities based on their model, and Dr. Smith says there is a very large market "for honest health care pricing and quality."
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Safe Surgery 2015 Intends to Save Lives in S.C. Operating Rooms
Post and Courier (SC) (04/21/2014) Sausser, Lauren

In an effort to reduce medical errors, Dr. Curtis Worthington with Roper St. Francis Healthcare in Charleston, S.C., relies on a team-based approach outlined in the South Carolina Surgical Safety Checklist. The checklist encourages even the least educated and lowest paid person in the operating room to speak up if needed. Worthington verbally reviews details of the upcoming surgery, and he uses the checklist even when performing routine procedures like simple back surgery that he and his team may have performed hundreds of times. South Carolina is participating in the Safe Surgery 2015 pilot program as part of the World Health Organization Surgical Safety Checklist initiative.
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IV Saline and Other Drug Shortages Are FDA Priority, Agency Tells AHA
AHANews.com

Margaret Hamburg, commissioner of the U.S. Food and Drug Administration (FDA), says that although her agency lacks the authority to direct manufacturers' business decisions, the FDA "will take every action within its authority to help alleviate the shortage of IV saline and other drugs and increase supplies in the marketplace." In a letter to the American Hospital Association (AHA), Hamburg said the "prevention and mitigation of drug shortages is a key priority for FDA." AHA's Rick Pollack in March urged the FDA to aggressively search for more supplies and suppliers of normal saline and other intravenous fluids that are essential for patient care in hospitals.
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Residents of Some States Get Larger Health Insurance Subsidies
Wall Street Journal (05/04/14) Radnofsky, Louise

The Obama Administration reports that 85 percent of Americans who purchased health coverage through the online exchanges received subsidies to reduce their premiums. However, subsidies varied by state, with 94 percent of Mississippi enrollees receiving subsidies. The percentage of enrollees receiving subsidies totaled 90 percent or more in Florida, North Carolina, Arkansas, Wisconsin, South Dakota, Wyoming, Idaho, and Maine and around 75 percent in Washington, New York, and Kentucky. However, the figure was only 60 percent in Vermont and Colorado, 38 percent in Hawaii, and 16 percent in the District of Columbia.
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Health Spending Gains as Obamacare Patients Use the Plans
Bloomberg (04/30/14) Wayne, Alex

Higher consumer spending on health services, a rise in prescriptions, and increasing elective surgeries indicate that Americans are using the insurance they obtained under the Affordable Care Act. Consumer purchases of health services rose by 9.9 percent at an annualized rate in the first quarter from the prior three months, the highest rate of growth since 1980, according to the Bureau of Economic Analysis. Health spending contributed 1.1 percentage points to total growth in gross domestic product, the most since quarterly records began in 1947. The growth is being attributed to increased utilization under the ACA because prices have largely remained steady.
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Adherence to Recommended Intervals for Surveillance Colonoscopy in Average-Risk Patients With 1 to 2 Small (<1 cm) Polyps on Screening Colonoscopy
Gastrointestinal Endoscopy (04/14) Vol. 79, No. 4, P. 551 Menees, Stacy B.; Elliott, Eric; Govani, Shail; et al.

Repeat colonoscopy is recommended in average-risk patients five years after one to two small adenomas of less than 1 cm are detected, or 10 years after hyperplastic polyps are found. In a study of 922 outpatient screening colonoscopies with one to two small polyps found, researchers sought to quantify adherence to these recommended intervals and identify factors associated with non-adherence. Of these patients, 90.2 percent were given appropriate recommendations for timing of repeat colonoscopy, including 84 percent of those with one to two small adenomas and 94 percent of those with one to two hyperplastic polyps. The authors concluded that the percentage of recommendations was consistent with the guidelines and that quality of bowel preparation is strongly associated with a deviation from the guidelines.
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Hospital Loses ABN Appeal to Patient Based on Use of Acronym
Health Business Daily (05/01/2014) Youngstrom, Nina

The use of an acronym in a Medicare advance beneficiary notice (ABN) made the ABN invalid, according to Maximus, a qualified independent contractor (QIC). "Abbreviations were used without explanation," Maximus said in the denial letter, adding that ABNs "must be written in lay terms to be understood by the beneficiary." As a result, Olympic Medical Center in Port Angeles, Wash., has to assume the costs of the lab test, even though the beneficiary had signed the ABN, the ruling concludes. This situation marks the second time since January that the facility has been told that signed ABNs were invalid, says Compliance Officer Mic Sager. In a separate case, an administrative law judge ruled that a beneficiary did not have to pay for lab tests even though he signed the ABN because he lacked sufficient time to fully understand the implications of the ABN and was upset about his medical condition.
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Antimicrobial Resistance: Global Report on Surveillance 2014
World Health Organization (04/30/14)

Antibiotic resistance is now a significant threat to public health, the World Health Organization (WHO) is warning. In a new report, the organization's first look at antimicrobial resistance (AMR), the WHO says that surveillance of AMR is inadequately coordinated and many gaps exist in information on pathogens of major public health importance. In addition, there are very high rates of resistance in all WHO regions in common bacteria that can cause health-care associated and community-acquired infections, such as wound infections, bloodstream infections, and pneumonia. The WHO is working to come up with a global action plan that includes the development of tools and standards for harmonized surveillance of antibiotic resistance in humans and collaboration between AMR surveillance networks and centers to strengthen coordinated regional and global surveillance.
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