The SCSA is the only organization in South Carolina that advocates expressly for your specialty. Unlike many medical societies and organizations, your staff does not represent any other specialties or clients. This keeps the focus squarely on the issues affecting you, your partners and your patients.
The goal of the SCSA is to ensure the survival of the medical specialty of anesthesiology by applying its resources towards legislative, regulatory and reimbursement advocacy.
The South Carolina General Assembly has the power and authority to change laws, including of course laws and regulations relating to the practice of medicine, nursing, optometry, chiropractic providers, and any group that is licensed in any capacity by the state of South Carolina. This vests enormous power in the legislative branch to'award legislative medical licenses' to anyone who makes a good enough argument that they should be the equivalent of a medical doctor. The Governor, who has the authority to issue certain executive orders, is also an important player among those who can change the practice of medicine, essentially over night.
The departments of Insurance, Medicaid, DHEC, Workers Compensation, among others, also have great influence over how you get paid, who gets paid, how much each provider gets paid, and these agencies even have some limited discretion in which providers can do what. These government agencies must also be a target of our advocacy. With the growing percentage of South Carolina's citizens on the Medicaid rolls, this payer is vitally significant to your bottom line. The SCSA worked for 10 years to get a much over due and deserved increase in the unit rate and the labor epidural rate from Medicaid. The labor epidural rate was one of our most financially significant achievements. One Medicaid labor epidural pays for your annual dues. Our relationship with the Medicaid Program also prevented us from being cut as much as the other physicians in the recent (2011) Medicaid budget crisis.
Our efforts with DHEC also saw the change in the regulations over ambulatory surgery centers. Before our efforts, there was unclear language in the ASC regulations that related to the physician supervision of nurse anesthetists. This was an oversight in the DHEC regulations and a conflict with the Nurse Practice Act. Your SCSA saw it, addressed it and got it fixed!
The SCSA was the lead organization in the development and passage of the first Office Based Surgery Regulations for the state of South Carolina. As the leaders of a task force which included the Board of Medical Examiners and the SC Medical Association, your SCSA wrote the original draft regulations and ensured that the proper patient safety standards were always front and center to the process and in the final regulations.
The SCSA had introduced a bill licensing the practice of Anesthesiologists Assistants (AAs) and was one of the earliest states in the south to see the passage of this legislation. (2001).
Reimbursement issues are perhaps the most difficult because the economic pressures are great for both the payer and the payee. Your SCSA works constantly to prevent commercial payers from using Medicare as the benchmark for their own reimbursement schemes. As you all know, the Medicare rate is enormously out of parity with the conversion factor for anesthesiology. The 33% problem (which is quickly moving to more like the 30% problem) is a grave concern to your ASA and your SCSA. This is an area of constant vigilance.
Your SCSA was invited, for the first time ever, to serve on a Medical Provider Payment Committee of the Workers Compensation Commission. This put our voice at the table, loud and clear!
Q: Why Should I Join the SCSA?
A: Because if you are not at the table, you're on the menu!