ow quickly a year passes! It seems like only yesterday that the ASA Executive Committee, Vice-President for Professional Affairs Alexander A. Hannenberg, M.D., and ASA Executive Director Ronald A. Bruns handed me the keys to the Washington Office and gave me my initial marching orders. And what a privilege it has been to get to know so many of you this past year as we have met, worked and triumphed together to advance this wonderful physician-driven Society dedicated to anesthesiology and the patients it treats.

Looking back, I am proud to say that 2005 saw able new personnel and vigor pumped into the ASA Washington Office, complete with the general counsel and other legal functions being brought in-house and strengthened. This has allowed for obvious economies and more direct attention to such items as our ASA expert witness testimony review program and working with the appropriate ASA committees to protect our copyrighted and trademarked products, which Mary Kuffner, J.D., has undertaken in her new role as Associate General Counsel.

As part of our internal Washington Office reorganization, the hard work and loyalty of Manuel E. Bonilla, M.S., and Karin Bierstein, J.D., M.P.H., were appropriately rewarded. They now serve respectively as ASA’s Associate Director of Governmental Affairs and Associate Director of Professional Affairs. In like manner, Lisa Percy, J.D., was elevated to State Legislative and Regulatory Issues Manager. Of special interest to this NEWSLETTER issue and its content, Ms. Percy is now the lead ASA staffer to our revitalized ASA Committee on Governmental Affairs. Along these lines, specific innovations, based on well-received changes in our ASA Legislative Conference and in other areas, will continue into next year in close consultation with this committee and its able chair, Patricia J. Davidson, M.D.

Finally, the ASA Washington Office hopes to soon welcome a new Advocacy Communications Manager, with dedicated responsibility to translate our lobbying work and practice management information on a daily basis to our ASA membership.

Among ASA’s work with the federal government, 2005 was a year of marked successes. On the congressional front, ASA was a key player in the passage and enactment of a landmark law that will allow us to become a certified “patient safety organization (PSO).” ASA was honored by 2005 ASA President Eugene P. Sinclair, M.D., being present when President George W. Bush signed the measure. As we move through the regulatory process with the Agency for Healthcare Research and Quality (AHRQ) on this new law, we will continue positioning ASA to remain a leader in patient safety. As described earlier this year, the new patient safety law will allow for voluntary, confidential reporting to PSOs. Exciting developments on this topic will be reported through these pages and electronic media in the new year.

In another coup, ASA kept the federal prescription drug monitoring bill (NASPER) on track, through enactment, to ensure that it will help pain physicians help patients who have gotten themselves into trouble by seeking multiple prescriptions from multiple physicians. ASA was the leading force in keeping this bill from becoming a “law enforcement” bill, which would have invited state law enforcement into physician offices inappropriately.

Along these lines, ASA also continued in 2005 to work very closely with the American Medical Association (AMA) and the Pain Care Coalition, building a positive dialogue with the Drug Enforcement Agency (DEA). Together, we have started important discussions with the DEA administrator that will enable ASA to help anesthesiologists and other pain physicians help their patients and keep big government out of legitimate medical practice.

In terms of promoting academic anesthesiology research and securing more National Institutes of Health grants, ASA also has been very active. Earlier this year the U.S. House of Representatives passed its Labor-Health and Human Services (HHS) bill, and ASA’s proposed language on “anesthesiology research” was included in it, thanks to the wonderful efforts of Representative Dave Weldon, M.D., (R-FL) and the House Appropriations Committee. Drawn from the key concepts in the Foundation for Anesthesia Education and Research mission statement, this language will go far to advance anesthesiology research as it moves to become law in the final FY 2006 Labor-HHS Conference agreement.

In both Congress and with the Administration, ASA has emerged as the leading voice for anesthesiology and pain medicine on possible pay-for-performance (P4P) measures. Three starter measures, tied to coding and billing, were among many recently considered for a voluntary demonstration project at the Centers for Medicare & Medicaid Services. ASA continues to be involved in this difficult matter because the federal government has told us it would dictate measures to anesthesiology and any other medical specialty that fails to engage.

In the meantime, ASA has kept fighting, along with AMA and the rest of medicine, to fix the sustainable growth rate formula and stop negative Medicare updates in 2006 and beyond, while insisting that there be no firm link to P4P without a revamped payment system tied to the Medicare Economic Index.

Throughout 2005, our top issue has remained fixing the Medicare anesthesiology teaching rule. Despite continued resistance from CMS, ASA nonetheless engineered solid support from many in Congress and worked side-by-side with the Society of Academic Anesthesiology Chairs/Association of Anesthesiology Program Directors to get nearly every academic anesthesiology program in the United States to weigh in on the urgent need for a fix. As we move into December, ASA remains adamantly committed to achieving its policy goals on the teaching rule, and we continue to work assiduously toward this goal.

This past year ASA also saw tremendous progress on the locked cart issue and the 48-hour rule, thanks to tireless ASA lobbying of the federal agencies. The proposed rule from CMS, issued earlier this year, deferred completely to ASA guidance on these matters, and we are pushing for the final rule to be issued in the very near future.

While remaining and new issues will continue to occupy ASA through the end of this year, into 2006 and well beyond, we are collectively stronger and better positioned to advance anesthesiology than ever before. With strong member and leadership support, much additional good work will be achieved.

On a personal note, it has been a special privilege and honor to have worked so closely with ASA Immediate Past President Eugene P. Sinclair, M.D., this past year — a modern giant of anesthesiology among us.

Ronald Szabat, J.D., LL.M., is ASA Director of Governmental Affairs and General Counsel.