Gasline Newsletter March 2003

Volume 4, No. 4


Due to strong advocacy by organized medicine, Congress found a way to correct a defect in the formula used to determine Medicare conversion factors. Instead of a reduction of 4.4%, Medicare carriers will implement a 2.7% increase in the anesthesia conversion factor, which includes modest anesthesia work value adjustments previously approved by CMS. The official announcement can be viewed at the NHIC (California Medicare Carrier) web site. All other services will get a 1.6% increase.

Following are the new participating physician conversion factors for anesthesia. Non-participating limiting charges are calculated simply by multiplying the participating fee by 1.0925.

Anaheim/Santa Ana, CA $17.92
Los Angeles, CA $18.08
Marin/Napa/Solano, CA $17.45
Oakland/Berkeley, CA $17.77
San Francisco, CA $18.65
San Mateo, CA $18.32
Santa Clara, CA $18.35
Ventura, CA $17.45
Rest of California $16.92
The 2003 Participation Enrollment Period is extended to April 14, 2003, for physicians and providers to make their 2003 Medicare participation decision. The new fees will be effective for services on or after March 1.


The state Division of Workers Compensation is continuing its effort to convert the fee schedule from the old patchwork CRVS system to the RBRVS. DWC Administrative Director Richard Gannon emphasizes that the Medicare fee schedule conversion factors would not be adopted, only the codes and unit values from Medicare RBRVS. However, many physician groups are concerned that adopting the unit values would lead to payments linked to Medicare rates. SB 228, introduced by Senator Alarcon, proposes a mandate that workers' compensation fee schedules not compensate any single code at a rate greater than 120% of the Medicare RBRVS rate. This would significantly reduce payment for anesthesia services; workers' compensation is currently paying almost 200% of Medicare for anesthesia codes.

The California Medical Association hosted a meeting with specialty society representatives March 6 to explore options for reforming the fee schedule that would take into account the increased work and administrative cost of treating work injuries. Mr. Gannon has encouraged development of alternatives. However, the final product must be easily updated. If the new fee schedule continues to use the ASA anesthesia codes and base units, a consultant to the DWC anticipates that overall payments to anesthesiologists would decrease 2%, but individual anesthesiologists could experience greater losses if their service mix includes substantial pain management services.


The CSA's joint meeting with the UCSD Annual Meeting and Anesthesiology Review Course takes place June 5 - 8 at the Disneyland® Hotel in Anaheim. The successful collaboration with the UCSD Department of Anesthesiology is continued this year with workshops on Practice Management, Difficult Airway, TEE, and Regional Anesthesia and Pain Control as well as the UCSD Review Course. Other CSA activities include the House of Delegates, CSA/Abbott Laboratories Resident Research Competition, the Leffingwell Lecture delivered by Robert K. Stoelting, M.D. CSA Past President Stephen H. Jackson, M.D., will be honored with the Distinguished Service Award. See the CSA web site at for the entire program and on-line registration. Daily registration is available.


CSA members are urged to submit resolutions for the House of Delegates' consideration. Resolutions should include introductory "whereases" that give background and "resolveds" that describe the action sought by the author. Call Barbara Baldwin at the CSA office if you want help in crafting your resolution.


All delegates and alternate delegates, please notify Linda Herren at the CSA office of your plans to attend the reference committee, House of Delegates, and the educational program.


This year the ASA brings its Regional Spokesperson Training Program back to California and will hold a one day training session Friday, June 7, at the Annual Meeting in Anaheim. This intensive workshop gives prospective spokespersons for the ASA and CSA tools and training to deal with the media effectively. Space is very limited, but if a member has a burning desire and is willing to be a spokesperson when necessary, every effort will be made to accommodate that member. Contact Barbara Baldwin for information.


On April 30, CSA will join with the California Medical Association, county societies and other specialty societies for the annual Legislative Conference in Sacramento. CSA members are urged to attend. Those attending as CSA representatives (not for their county societies) will be reimbursed mileage costs or 14-day advance coach airfare.

Patricia A. Dailey, M.D.