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Budget Reconciliation Law contains single anesthesia fee cuts
AANA Journal
|October 1, 1993
Summary
The Omnibus Budget Reconciliation Act of 1993 (OBRA93) will reduce payments for anesthesia care teams but includes AANA victories like phased reductions and retained Medicare billing practices. Future lobbying will address remaining concerns.
Area of Science:
- Healthcare Policy
- Anesthesiology
- Nursing
Background:
- The Omnibus Budget Reconciliation Act of 1993 (OBRA93) introduced significant changes to healthcare reimbursement.
- Certified Registered Nurse Anesthetists (CRNAs) and anesthesiologists faced potential payment reductions within the anesthesia care team model.
Purpose of the Study:
- To analyze the impact of OBRA93 on CRNAs and anesthesiologists.
- To identify both the adverse effects and the key victories achieved by the American Association of Nurse Anesthetists (AANA) within OBRA93.
Main Methods:
- Analysis of legislative text and its implications for anesthesia providers.
- Review of AANA's advocacy efforts and outcomes related to OBRA93.
Main Results:
- OBRA93 mandates phased payment reductions for anesthesia care teams over several years.
- Key AANA victories include the defeat of RAP DRGs, retention of actual anesthesia time for Medicare billing, and restored payment parity for new physicians and CRNAs.
- Teaching anesthesiologists' supervision payments were standardized for residents and nurse anesthesia students.
Conclusions:
- OBRA93 presents a mixed outcome for anesthesia providers, with some financial reductions offset by significant AANA successes.
- Unaddressed AANA concerns, including TEFRA conditions and clinical privileges, will be pursued in future legislative efforts.