Another 886 black box edits developed under the current contract with McKesson HBOC were scheduled to go into effect on July 1. The ASA Washington Office would like to repeat its request that ASA members help identify edits that we may be able to challenge by providing us with all the necessary information on the procedures and payers involved. The proposals would not affect professional fees. Since they would either reduce or eliminate payments to ASCs and HOPDs for many of the epidurals and nerve blocks, however, anesthesiologists might no longer have access to the facilities in which they provide those services. The theory behind the change is that these procedures can be performed safely in physicians' private offices, but ASA argued that the underlying data are flawed for several reasons.
Questionable data are also behind the low proposed payment rate for HOPD procedures.
HCFA grouped procedures that it deemed clinically homogeneous in more than 300 classes and then used the median cost of procedures in each classification as the prospective allowable for all related procedures. HCFA has announced that it will not finalize the rules or implement changes in payment policies until after all Y2K issues are satisfactorily resolved some time after the first quarter of next year. There is reason to believe that the final policies will vary from the proposals. Thank you to the committee members, consultants and individual anesthesiologists who provided ASA staff with the clinical and financial information that went into our comments. Both letters are posted on the ASA Web site .