The Centers for Medicare and Medicaid Services recently updated the interpretive guidelines for hospital participation in the Medicare program. Several changes impact the delivery of anesthesia services within the hospital and will probably impact the practice of most anesthesiologists. The important revisions involve timing of a preoperative assessment, post-operative note, and a redefinition of labor neuraxial blocks as analgesia services, eliminating physician supervision requirements for nurse anesthetists and anesthesia assistants. ASA is currently reviewing these revisions and will provide additional information when available.

For additional information, please see this ASA posting.

The Oregon Medical Board has instituted a new administrative rule related to continuing medical education requirements and demonstration of ongoing competency as a prerequisite for renewing an Oregon medical license. The rule requires:

1. Ongoing participation in re-certification by an American Board of Medical Specialties board, the American Osteopathic Association's Bureau of Osteopathic Specialists or the National Commission on Certification of Physician Assistants;
   
   OR
   
   
2. 60 hours of continuing medical education per two years relevant to the licensee's current medical practice as follows:
• American Medical Association Category 1;
• American Osteopathic Association Category 1-A; or
• American Academy of Physician Assistants Category 1 (pre-approved)

If you are not participating in re-certification by the ABMS board, the AOA-BOS board, or the NCCPA board, you must complete the applicable credit hours by October 2011 (for the next renewal period 2012/13).

Thanks to the OMA for bringing this to our attention. For further information, see the specific Oregon Medical Board administrative rule OAR 847-008-0070 .

For those with ties to Oregon anesthesiology, we look forward to seeing you this weekend in New Orleans.

2009 Oregon Anesthesiology Reception

Saturday, October 17, 2009 from 5:30 ? 7:30 p.m. CDT at:

ACME OYSTER HOUSE
French Quarter
724 Iberville
New Orleans, LA 70130

Sponsored by the OHSU Department of Anesthesiology and Perioperative Medicine and the Oregon Society of Anesthesiologists.

A number of those attending requested links to the references cited at the Oregon Perioperative Quality Summit presentations.

• Oregon Patient Safety Commission White Paper on Glycemic Control as cited by Dr. Sheppard
• Hall BL, Hamilton BH, Richards K, Bilimoria KY, Cohen ME, Ko CY. Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals. Ann Surg. 2009;250:363-376. as cited by Dr. Ko
• ASA Newsletter Critical Care focus issue September, 2009 as cited by Dr. Brambrink
• Norm Cohen's presentation on national quality initiatives

The Food and Drug Administration has announced that a new reference standard resulting from the heparin contamination issue last year will lead to about a 10% reduction in actual potency. This may affect your dosing of heparin in the perioperative period for vascular, cardiac and other procedures.

For more information, see this press release at http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm184502.htm.

The brochure for the Oregon Perioperative Quality Summit will be in your mailbox in the next few days. If you can't wait, you can download it here.

Make your reservations today and help us define our own future when it comes to quality in perioperative medicine and surgery.

To learn more about the meeting, please see this article.

The ASA will be hosting a webinar focusing on pain coding. If you deliver chronic pain services or you have staff who must determine the codes for these procedures, you should consider attending. This will be an excellent opportunity to improve your knowledge base and help assure compliant coding that will possibly improve your collections AND keep you out of trouble with regulators.

For more information, visit this ASA Webinar page.

The Oregon Society of Anesthesiologists and the Oregon Chapter of the American College of Surgeons invite you to the first Oregon Perioperative Quality Summit in Bend, Oregon the weekend of October 3-4, 2009. With so much attention being paid to healthcare reform, a focus on cost over quality seems to be dominating. This joint meeting is open to anesthesiologists, surgeons and others with an interest in perioperative care. The goals are to provide background information on national and local efforts in quality improvement, the role of registries, electronic medical records (EMR) and other tools to collect and analyze outcomes data, and to review recent improvements in intensive care that may be applicable to the spectrum of perioperative care.

With this background in hand, the attendees will participate in wide-ranging discussions to identify opportunities for perioperative quality improvement in Oregon and then help establish priorities for future efforts tailored to the needs of Oregonians. Based on these decisions, the course organizers will be preparing a "white paper" summarizing the results of this meeting. As opportunities present, we will use these findings to help assure that policymakers understand the needs and assessments of those of us directly involved in patient care.

The Board of Directors of the American Society of Anesthesiologists held its annual meeting in Chicago the weekend of August 22-23, 2009. Norm Cohen from Portland and Chuck Anderson from Bend represented Oregon as your Director and Alternate Director respectively.

While much of the hallway talk at the meeting centered around healthcare reform proposals circulating in Congress, including the perils that a Medicare-based public option holds for the specialty, the Board addressed a number of items of business that are important to ASA members. The ASA Speaker divides the business of the Board into four categories, each heard by a separate Board Committee. Board members and others may testify on any item of business during the Board Committee hearings held on the first day of the meeting. These committees then recommend to accept, accept with modifications or reject each action item. The Board Committee chairs present these recommendations to the full board on the second day of the meeting. The Board can accept, accept with modifications or reject each Board Committee recommendation. Usually, only a few items lead to significant debate during this session. Final approval for all items rests with the ASA House of Delegates, which meets each October.