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On Thursday, August 1, Senator Ron Wyden (D-OR) and Senator Johnny Isakson (R-GA), members of the powerful U.S. Senate Finance Committee, introduced S. 1444, the “Medicare Access to Rural Anesthesiology Act of 2013,” legislation to reform the current Medicare rural anesthesia incentive program to include physician anesthesiologists. The legislation would permit certain small, low volume rural hospitals to attract and retain medically-trained anesthesiologist to practice in medically underserved areas.
ASA strongly endorses the Wyden-Isakson legislation as an important mechanism to increase rural patients’ access to high quality, comprehensive, medically managed anesthesia services provided by physician anesthesiologists.
The Medicare program normally pays for the services of anesthesia providers using the Medicare Part B fee-for-service payment schedule. However, low Part B payment levels and low patient volume make attraction and retention of anesthesia providers difficult for some rural hospitals. To provide relief to these hospitals, Congress created a special program that permits certain small rural hospitals toreceive reasonable cost-based Part A payments for the services of certain anesthesia providers - anesthesiologist assistants and nurse anesthetists. Under this program, known as the Medicare Anesthesia Rural Pass-Through program, payments are intended to incentivize rural facilities to continue to serve the Medicare population in their area. Under the current restrictive design of the pass-through program, however, hospitals utilizing the services of physician anesthesiologists are specifically excluded from participation. The Wyden-Isakson legislation grants rural hospitals enhanced flexibility to use the services of physician anesthesiologists, in addition to the services of anesthesiologist assistants and nurse anesthetists, to best serve their patients surgical anesthesia needs.
