FacebookTwitter

Fun Run/Walk to Benefit TANA-PAC

By on Sep 29, 2015 in TANA Annual Meeting, Uncategorized | 1 comment

Don’t forget to throw in your running shoes when you pack your bags for the TANA 78th Annual Meeting!  We’re kicking off our Saturday schedule of events with a 2-mile fun run/walk, leaving from the front of the conference center. There will be lots of giveaways, as well as prizes for the fastest participants.  It’s sure to be a lot of fun, not to mention a great way to actively protect your profession as all proceeds benefit TANA-PAC!  You can register the morning of the event or any time prior by clicking...

What Has PAC Done for You Lately?

By on Jun 3, 2014 in Making an imPACt, Uncategorized | 1 comment

Let me ask you a question.  Do you have malpractice insurance, health insurance, auto or home insurance, life or disability insurance? While some individual circumstances may vary, I would venture to guess that close to 100% of you have most, if not all, of the listed insurances.  You recognize the value of things like your health, your home, and your income.  Why wouldn’t you want to make sure those important assets were protected from risks beyond your control? Now let me ask you another question.  Why not insure that your profession as a CRNA is equally protected from unforeseen attacks?  Isn’t your investment in your career worth the minimal cost?  I imagine you’d agree that it is. Just to give you an idea of some of the issues that exist to threaten your practice, here are some of the issues that PACs have addressed in the past: CRNAs’ ability to practice under physician supervision, not just anesthesiology supervision CRNAs’ ability to directly bill Medicare for our professional services Defense of CRNAs’ ability to practice using our full scope Ability to Opt Out of supervision Promotion of CRNAs as cost-effective anesthesia providers during this period of healthcare reform And the fight continues.  Here are some of the current issues that PACs are addressing: Ensuring there are enough CRNAs to handle the influx of patients resulting from the Affordable Care Act The threat of Anesthesia Assistants Maximizing CRNAs’ scope of practice, such as: VA hospitals Pain management Prescriptive authority These are all important issues that greatly affect your practice and profession.  They’re also ones that you can’t effectively fight on your own. That’s why TANA-PAC exists…to protect and defend the rights of CRNAs in our state.  By contributing to the PAC, you’re insuring your career against risks like these and many more.  We think that protection, for a recommended donation of $50 per month (or $600 per year), is a great value! Visit www.tncrna.com and contribute by clicking on the “Donate Now” banner.  We hope to raise $10,000 by July 1, 2014, and thanks to the donations we’ve received thus far we’re much closer to that target!  Please help us reach our goals so that we can continue to provide you with the best protection possible. Thank you, David Klappholz CRNA TANA-PAC Chair...

So, Where Do My AANA Dues and PAC Contributions Go Anyway?

By on May 19, 2014 in Making an imPACt, Uncategorized | 0 comments

Ever wonder what all of your AANA dues and contributions go towards or why it seems like you’re frequently being asked to give even more?  Let me take a minute to explain where that money goes. When you pay your AANA dues, a percentage of that money stays at the national level, while the remainder goes to the respective state you practice in.  Most CRNAs believe that those AANA dues help defend their practice. That is NOT the case! Each state has its own PAC, which specifically supports CRNAs in that state in dealing with the issues they face.  This is separate from the Federal CRNA PAC, which deals with issues on the federal level. Both the State and Federal PACs can only address concerns at their defined level, and–here’s the key–both are funded separately.  So, if you’re only contributing to your State PAC, then none of your money is going to your Federal PAC and vice versa.  Additionally, if you are only paying your AANA dues, then you are not contributing to either your State OR Federal PAC. It’s like leaving a large chunk of your assets (your career and livelihood) exposed to the threat of all kinds of risks, with no protection in place to defend your practice.  And while you may have any number of valid reasons for not contributing, the fact remains that these threats are very real. TANA-PAC exists to protect you and your practice, but in order to do so we need your help.  The PAC is funded solely by contributions from CRNAs and SRNAs like you, and thanks to your support we’re just $560 short of reaching our original $5,000 goal. Because of your generous giving, and due to the increased demands of this all-important election year, we have decided to increase our goal to $10,000.  We know that our members can rise to the challenge and raise this amount by our July 1, 2014 deadline. Don’t leave yourself and your practice unprotected.  Visit www.tncrna.com today, click the “Donate Now” banner, and sign up to give the recommended $50 monthly (or $600 one-time) contribution. Thank you, David Klappholz CRNA TANA-PAC Chair...

Want to Know What the ASA Has Been Saying About You?

By on May 10, 2014 in Uncategorized | 2 comments

Have your ears been burning?  Because the American Society of Anesthesiologists has had plenty to say recently about the quality of care we as CRNAs are able to provide to patients.  That’s their right; but it’s also your right to defend your practice. This is a great example of why we need to support the efforts of PACs on both the state (TANA-PAC) and federal (CRNA-PAC) level.  If they don’t have the resources necessary to speak for you and your profession, then who will? Below is an excerpt from a recent piece of correspondence from the American Association of Nurse Anesthetists.   What the ASA is saying about you… As you may have heard, the American Society of Anesthesiologists (ASA) have met with lawmakers on Capitol Hill this week and are up to their same tactics, mischaracterizing the quality care CRNAs provide in order to gain support from Congress. Here are just a few of the statements that the ASA is circulating in Washington: CRNAs do not have the medical education or clinical training necessary to make critical decisions during an emergency; CRNAs cannot ensure the same quality of care, patient safety or outcomes for patients and any changes to VA health care that would allow CRNAs to work independently would cause immense harm and would severely risk patient safety; The only way to keep constituents safe, as well as family and loved ones, is to ensure that a physician is present instead of a CRNA. It is up to each of us to speak up and ensure lawmakers know the truth about the safe, quality, cost-effective care that CRNAs provide. To ensure that our message is heard loud and clear by our nation’s leaders, the CRNA-PAC is launching a four-week campaign today to redouble our efforts for protecting and promoting the nurse anesthesia profession in the interest of our patients. We hope you will play a part by making a contribution to the CRNA-PAC today. We cannot control what others say — but we can and will continue to have lawmakers understand the truth. Now is the time to fight for our profession. Help us have our voice heard bysupporting your CRNA-PAC today. We cannot do this without you. Sincerely, Dennis C. Bless, CRNA, MS AANA President   Paul Beninga, CRNA, MS CRNA-PAC Chairman...

What Opt-out Is and Is Not

By on Mar 7, 2014 in Board Updates, Uncategorized | 4 comments

HISTORY OF PHYSICIAN SUPERVISION OF CRNAS UNDER MEDICARE In 1982 the Health Care Financing Administration (HCFA) that later became know as the Centers for Medicare and Medicaid (CMS) revised the conditions of participation for ambulatory surgical centers (ASCs) to require physician supervision of CRNAs and in 1986 revised the conditions of particiaption for hospitals to require supervision of CRNAs. What are “Conditions of Participation”?  These are the conditions that ASCs and hospitals must meet for reimbursement for providing services and care to Medicare patients under Part A of Medicare. As you know there are three parts to Medicare. 1)    Part A is for facilities such as ASCs, hospitals and critical access hospitals. 2)    Part B is for providers such as physicians, CRNAs and other providers that are allowed to bill Medicare directly. 3)    Part D which is prescription drugs. There are no supervision requirements for physician supervision under Part B of Medicare. In 1990, the President of a state nurse anesthetist association wrote a letter to HCFA regarding concerns about the federal supervision requirement and requested a definition of the term “supervision”.  HCFA responded with a general definition of supervision and a policy interpertation.  This lead to many meetings between HCFA and the AANA in which AANA requested that the physician supervison requirement be dropped, and that the federal government defer to the states. In 1994, legislation was introduced in both the House and Senate providing for fair anesthesia payment and defferal to state law on the issue of physician supervison.  Also in the fall of that year, HCFA issued draft regulation in the Medicare Conditions of Participation for Hospitals which includes the removal of physician supervision of nurse anesthetists. During 1995, AANA continued to inquire of HCFA when the regulations would be released and members continued to lobby Congress for direct reimbursement and removal of the supervision requirement.  Bills were introduced for removal of the supervision requirement, and direct reimbursement for CRNAs, but were not included in the final Medicare package.  In 1995, direct reimbursement was passed to become effective in 1998, but the supervision issue remained unresolved. In December 1997, HCFA issued a proposed rule deferring to the states on the supervison issue.  A comment period was held, and AANA members continued to lobby Congress during the Mid Year Assemblies. On January 18, 2001, two days before President Clinton was to leave office, HCFA  and HHS published the rule to defer to the states in the Federal Register.  The rule was to go into effect March 18, 2001. March 18, 2001, President Bush freezes the rule for 60 days pending further review.  May 18. 2001, the Bush Administration freezes the final rule for 180 days and suggested a new rule be issued that would permit state governors to request a waiver from the Secretary of HHS and require a study of anesthesia outcomes.  There was a 60 day comment period and the final rule on Opt Out was final on November 13, 2001. OPT-OUT Essentials for Each State For a state to opt out of the federal requirement for supervision of CRNAs, the state’s governor must send a letter to the Secretary of HHS requesting that the state opt out of the supervision requirement.  The letter must attest: 1. The state’s governor has consulted with the state boards of medicine and nursing about issues related to the access to and the quality of anesthesia services in the state; and, 2. That it is in the best interest of the state’s citizens to opt-out of the current federal physician requirement; and. 3. That the opt-out is consistent with state law. The consultation with the boards of medicine and nursing is not defined by CMS and gives the governor flexibility and the boards do not have to submit comments.  CMS believes that the governors are best suited to make the determination for an opt-out.  Governors can at any time request that a previous opt-out be withdrawn as well.  This happened in one state, where the governor later after a period of time, decided to continue the opt-out. When a state has opted out of the federal requirement, it does not necessarily change the practice of CRNAs in the state.  The facilities may still require physician supervison of the CRNAs in the bylaws of the facility.  The opt- out would not permit a CRNA to practice outside the scope authority granted by state law. A state opt-out takes a great deal of planning and each state needs to prepare for the battles to follow. It should be noted that lawsuits are most likely going to be filed, and legislation be introduced for strict supervision.  Having a relationship with the Governor’s office is essential to the opt-out process. There are those that would have facilities and others providers to believe that the requirement for physician supervision is a practice requirement, but it is not a practice issue, it is a reimbursement issue for the facility to be reimbursed for those services rendered to medicare patients. To date, 17 states have opted out of the supervision requirement.  Some of the states have been faced with lawsuits being filed to reverse the opt-out but the outcomes have been positive. Iowa 2001 Nebraska 2002 Idaho 2002 Minnesota 2002 New Hampshire  2002 New Mexico 2002 Kansas  2003 North Dakota 2003 Washington 2003 Alaske 2003 Oregon 2003 Montana 2004  A new Governor reversed the opt-out but after...

A Super Hero Update: Shannan and Jessica’s Story of Make-shift OR’s and More

By on Jan 23, 2014 in National Nurse Anesthetist Week, Our Super Heroes, Uncategorized | 1 comment

When we heard about the medical mission trip that Shannan Case and Jessica Ginn went on, we knew we had to include them in our CRNA Week series: Super Heroes. Wow! The things they experienced are, well, we’ll let you make your own opinion on that. Here’s there story:   During our first medical mission trip with Drs. Ed and Olivia Cabigao, we were truly blessed with an opportunity of a lifetime. After many obstacles including a gunman in LAX, a delayed flight for two days, an 18 hour flight, and just dodging the Super Typhoon Yolanda, the people of Baliwag, Philippines welcomed us with immense hospitality. The hospital and surroundings were far from anything we had ever seen. The area was poverty stricken and the hospital was functioning on bare minimum supplies. The anesthesia machine consisted of a five liter flow meter, APL valve, CO2 absorber, circuit, reservoir bag, H cylinder oxygen supply, and scavenging out of the window. There were no ventilators in the entire hospital.  The OR was set up for two simultaneous surgeries with only one suction for the entire room to be shared by all. The only air conditioning in the hospital was in the OR, which was a window unit. Bare necessities included betadine soaked cotton balls for surgical prep, non-adjustable operating room tables, one main OR light and a stand alone light for both operating teams.  We provided general and/or regional anesthetics for a variety of surgeries including hysterectomies, thyroidectomies, cholecystectomies, hernia repairs, several mass removals, an orchiectomy, GI endoscopies, and a nephrectomy. We also did a few pediatric patients with the youngest at five years of age. They were the bravest; IV’s were put in prior to induction and they walked to the OR table without even a whimper. Patients recovered in a room with no continuous monitoring capability, H-cylinder oxygen supply, and a window air conditioning unit. Few of them requested pain meds or antiemetics. Surprisingly, the majority of the patients were relatively healthy. We had a great team of medical professionals that all worked well together in providing a service to an area in desperate need of medical care ranging from health screenings to major surgery. Even though the conditions were less than what we in the United States would consider acceptable, we feel it was an inspiring trip and, hopefully, the first of many more.                       ...