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 August 2007
Note: Questions relating to state legislative activity or any of the items noted in ACS Cross Country may be directed to Mindy Baker, State Affairs Associate, at mbaker@facs.org. Scope Bill in New York Fails To Advance AB 7044, a bill to permit single degree (DDS) oral surgeons to perform cosmetic surgical procedures of the oral-maxillofacial area (that is, head and neck), was effectively quashed in the New York Assembly Higher Education Committee. A coalition of state and national specialty societies, along with the Medical Society of the State of New York and the American Medical Association and its Scope of Practice Partnership (SOPP), worked aggressively with state legislators to stop this proposal. The New York Chapter of the American College of Surgeons participated in this collaborative effort, as did the College itself as a member of the SOPP Steering Committee. (Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal at: http://efacs.org/forum/login?p_url=http://efacs.org/forum/viewforum_45_1.html)
Illinois Passes Statewide Smoking Ban, Stalled on Budget
Last year, Chicago passed an ordinance to ban smoking in most public spaces, but the ban included a clause giving bars and restaurants until July 1, 2008, to comply. The bill signed by the Governor will supersede the city’s ban. In the meantime, the Illinois Legislature is setting records for the longest legislative session since the new constitution was adopted in the 1970s. The Governor and several legislative leaders cannot agree on the budget. The disagreement centers around funding for the Governor’s health care proposal. (Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal at: http://efacs.org/forum/login?p_url=http://efacs.org/forum/viewforum_45_1.html)
From the AMA: Aetna, Inc. Fined Nearly $9.5 Million
The New Jersey Department of Banking & Insurance ordered Aetna, Inc. to stop its limited reimbursement practice charging that the insurer failed to adequately cover some services in their HMO products. The New Jersey regulators fined Aetna nearly $9.5 million after investigating a letter that the insurer sent to health care providers. In the letter, Aetna relayed that providers outside its network would be reimbursed for some services at 125% of the allowable Medicare amount and 75% for lab fees and durable medical equipment. This policy applied to certain cases, such as when it was necessary for out-of-network physicians to treat HMO patients on an emergency basis, physicians were referred by in-network physicians, or physicians treated patients in an in-network hospital. Aetna’s policy resulted in HMO patients being billed for charges in excess of what Aetna was paying the physicians. However, New Jersey regulations state the insurer must pay the full amount so that the patient is required to pay only the appropriate copay or coinsurance. The order declared that Aetna must pay providers based on the billed amount plus 12% interest from the date the claim was initially paid.
From the American Association of Ambulatory Surgery Centers: Understanding the Impact of the New Medicare ASC Payment System on Your ASC
We know you have many questions about the implementation of this new Medicare payment system. The AAASC has developed two approaches to bring you together with your peers and their policy and legal experts via a new FAQ section where you can submit your questions on line to their experts. You can, of course, check this FAQ section to see what questions have been asked that may match your own. The AAASC has also set up a Web-based discussion group specifically on the new ASC rule that will allow you to directly discuss implementation issues with your peers. To learn more about the American Association of Ambulatory Surgery Centers, visit http://www.aaasc.org/ or call 423-915-1001. (Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal at: http://efacs.org/forum/login?p_url=http://efacs.org/forum/viewforum_45_1.html)
Past Issues of ACS Cross Country:
Revised June 28, 2007
by the American College of Surgeons, Chicago, IL 60611-3211 |
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On Monday August 23, Illinois Gov. Rod Blagojevich (D) signed SB 500, which will ban smoking in all public buildings and most businesses in the state. This ban will take effect on January 1, 2008. Later that same week, the Illinois Senate approved a 90-cent increase in the cigarette excise tax.
According to a Special Update from the Private Sector Advocacy Division of the American Medical Association:
The American Association of Ambulatory Surgery Centers (AAASC) has developed a number of resources to help you understand and implement the new Medicare payment system. To access these resources please visit: 