Gasline Newsletter September 2007

Volume 9, No. 4

2007 CSA Hawaiian Seminar in Kauai

Don’t forget to sign up for the 2007 CSA Hawaiian Seminar in Kauai, October 29-November 2, 2007. This year’s featured speakers are Richard L. Applegate, II, M.D., Zeev N. Kain, M.D., MBA, MA (Hon), FAAP, Steven N. Konstadt, M.D., Joseph M. Neal, M.D., and Randolph H. Steadman, M.D. Register online at The topics for the meeting include:

CAD Risk Reduction for Non-Cardiac Surgery
Assessing Cardiovascular Function in the OR: Invasive, Non-Invasive, or None?
Transfusion Medicine Update: Options, Indications and Complications
Neurologic Complications of Regional Anesthesia and Pain Medicine
Virtual Crisis Management: Head to the Simulator!
Management of Perioperative Anxiety in Pediatric Patients
Mechanisms of MR: From Anatomy to Ischemia
Upper Extremity Regional Anesthesia: Essentials of our Current Understanding 
… And more!

CRNA Scope of Practice

William E. Barnaby, Esq., Legislative Counsel, and William Barnaby, Jr., Esq., Legislative Advocate, have done an updated analysis of the CRNA Scope of Practice in California.

This year’s legislative session saw the defeat of four scope-of-practice expansion bills that would have broadened the allowed practices of nurse practitioners, physical therapists, and psychologists.

Home Addresses and Zip+4

If you have not given us your home address and your zip+4, please update your information online at under Members Only/Member Profile Update, or call the CSA office at 800-345-3691. We are upgrading the CSA database and Web Site at this time, and one of the new features will be the ability to give CSA members contact information for their legislators. Legislative districts are determined by home address.

S. 2056 Restore Full Payment to Anesthesiology Teaching Programs

Senators John Rockefeller (D-WV) and Jon Kyl (R-AZ) have introduced legislation, S.2056, which would restore full payment to anesthesiology teaching programs. Please call your Senators and ask that they co-sponsor this important legislation. The bill mirrors H.R. 2053, the Medicare anesthesiology teaching payment reform legislation introduced in the House by Rep. Xavier Becerra (D-CA). Representative George Radanovich (R-19th Congressional district) has just become a cosponsor for this important legislation due largely to the significant efforts of District 5 Director, Paul Coleman. Grassroots lobbying efforts by constituents can make a real difference! Call your elected representatives today!

Write your Senators by clicking here (link no longer valid) for the ASA CapWiz Action Center.
Call your Senators through the Capitol Switchboard, (202) 224-3121. Ask them to help save your anesthesiology teaching programs by co-sponsoring S. 2056.
As academic anesthesiology knows all too well, CMS slashes in half payment to teaching anesthesiologists who work with two residents on cases that overlap—even for a minute. This misguided policy, in place since 1994, affects only anesthesiology and costs programs hundreds of thousands of dollars every year—hindering efforts to recruit and retain high-caliber teaching anesthesiologists, and ultimately weakening programs.

S. 2056 would reinstate full payment to ensure the viability of anesthesiology teaching programs throughout the country.

Balance Billing Legislation & Regulation 

Moves to ban balance billing for non-contracted emergency services by hospital-based physicians continue to surface. DMHC proposed a new set of regulations after the prior package expired in August. A last-minute bill, SB 981 (Perata), was quietly shelved in the final hours of the 2007 legislative session. SB 697 (Yee), prohibiting balance-billing of Healthy Families enrollees, also became a two-year bill. Another try may be made during the formally convened, but presently recessed, special session on healthcare called by Gov. Schwarzenegger. Each proposal calls for “interim” payments of disputed claims at a percentage of Medicare rates (150 percent/DMHC; 190 percent/SB981). Disputes would be resolved by a process under contract with DMHC. CSA is working with CMA, CAL/ACEP and other physician groups in opposing these proposals as unfair to treating practitioners, discouraging fair contracting and, ultimately, impeding patient access.

Excerpts from the Address of the ASA President to the 2006-2007 CSA House of Delegates

Mark J. Lema, M.D., Ph.D., ASA President, addressed the 2006-2007 CSA House of Delegates on June 1, 2007. Go to, to read excerpts from his address.

Virgil Airola, MD