Texas Society of Anesthesiologists

TSA Member Alerts

posted 4/2020 ASA TAKE ACTION: Oppose Nurse Anesthetists Replacing Anesthesiologists in VA

The Department of Veterans Affairs (VA) has acted unilaterally to replace physician anesthesiologists with nurse anesthetists in VA facilities. Please contact your lawmakers immediately to share your concerns and oppose this change.

      •   ASA Campaign Take Action

 

posted 4/2020 TMB Waiver for Chronic Pain Patients Extended by Governor Abbott

 

posted 3/2020 Albuterol Shortage Prompts Change in Preferred Status

On March 21, VDP changed the preferred drug list status of certain Albuterol products from non-preferred to preferred. This is a temporary change to address reported drug shortages for short-acting agents in the bronchodilators, beta agonist drug class. The full list of drugs is available on the VDP website.

This change allows providers to prescribe these drugs without requiring a non-preferred prior authorization and allow people on Medicaid continued access to necessary medication. VDP will continue to update providers on the status these drugs.

Contact vdp-formulary@hhsc.state.tx.us for questions or more information.

 

posted 3/2020 BCBSTX to repay consumers for out-of-network ER claims

Blue Cross Blue Shield of Texas (BCBSTX) has agreed to repay consumers after a Texas Department of Insurance review found delays in handling out-of-network emergency claims and incorrect information in consumer notices and marketing materials.

BCBSTX also will pay a $10 million fine.

      •   News release and information for consumers

 

posted 2/2020 ASA Survey Shows Health Insurers Abruptly Terminating Physician Contracts, Dramatically Cutting Payment Rates Forcing Physicians Out of Network

A new national survey from the American Society of Anesthesiologists (ASA) finds physician anesthesiologists are being forced out of network as insurance companies terminate their contracts, often with little or no notice. Initial results find 42% of respondents had contracts terminated in the last six months. Additionally, 43% of respondents experienced dramatic payment cuts from insurers, both mid-contract and at renewal, in some cases by as much as 60%. Some of the impacted contracts were signed less than six months ago.

      •   ASA Survey

 

posted 2/2020 Coronavirus outbreak causes first drug shortage in U.S., FDA says

The U.S. Food and Drug Administration is warning of shortages of at least one drug as the spread of the coronavirus disrupts the pharmaceutical industry's global supply chain. TSA suggests you talk to your facilities and pharmacists about potential drug shortages and preparations.. 

      •   CBS News Article

 

posted 2/2020 Coronavirus: ASA Information for Health Care Professionals

The recent outbreak of respiratory illness, first detected in Wuhan City, Hubei Province, China, is caused by a newly detected corona virus named "2019-nCoV." To date, health officials have reported thousands of infections with 2019-nCoV in China, and infections are being reported in a growing number of international locations, including the United States.

      •    ASA Information for Health Care Professionals

 

posted 10/2019 Suspicious Orders Report System (SORS)

New centralized database required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act, Pub. L. 115-27)   Read More.

On October 23, 2019, DEA launched the Suspicious Orders Report System (SORS) Online, a new centralized database required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act, Pub. L. 115-27). Reporting a suspicious order to the centralized database established by DEA (SORS Online) constitutes compliance with the reporting requirement under 21 U.S.C. 832(a)(3). The 12 registrant business activity classes affected by this SUPPORT Act requirement are:

  • Distributor
  • Manufacturer
  • Importer
  • Pharmacy
  • Hospital/Clinic
  • Teaching Institution
  • Practitioner
  • Mid-Level Practitioner
  • Mid-Level Practitioner-Ambulance Service
  • Researcher
  • Analytical Lab
  • Narcotic Treatment Program (NTP)

Reverse distributors and exporters are not affected by this SUPPORT Act requirement.

The SUPPORT Act states the term "suspicious order" may include, but is not limited to: an order of a controlled substance of unusual size; an order of a controlled substance deviating substantially from a normal pattern, and; orders of controlled substances of unusual frequency as per 21 U.S.C. 802 (57) and 21 C.F.R. 1301.74(b). Reporting to SORS Online satisfies the requirement to report such orders to the Administrator of the DEA and the Special Agent in Charge of the Division Office of the DEA for the area in which the registrant is located or conducts business.

DEA registrants that are already ARCOS Online and ARCOS EDI reporters should utilize their current ARCOS log on information to access the system. DEA registrants that are not currently ARCOS reporters will need to register on the website in order to report to SORS. The registration process is as follows:

  1. Go to https://apps2.deadiversion.usdoj.gov/arcos-online and click on "SORS Registration (for Non-ARCOS Reporters)" hyperlink.
  2. After completing the initial registration, a confirmation e-mail will be sent to the e-mail address provided.
  3. Once DEA approves the registration, another e-mail will be sent with a temporary password.
  4. Go to https://apps2.deadiversion.usdoj.gov/arcos-online and type in your username and the temporary password. The system will require you to change the temporary password.
  5. Upon successfully changing the password, the account will be fully registered to report to the SORS Online system.


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posted 8/2019 Joint Statement on Pediatric Dental Sedation

Joint Statement from the American Society of Anesthesiologists, the Society for Pediatric Anesthesia, the American Society of Dentist Anesthesiologists, and the Society for Pediatric Sedation Regarding the Use of Deep Sedation/General Anesthesia for Pediatric Dental Procedures Using the Single-Provider/Operator Model.

      •    Joint Statement on Pediatric Dental Sedation

 

posted 10/2018Statement on the Anesthesia Care Team

 

posted 10/2018Anesthesia Drug Shortage Info & Links

Anesthesiologists face an unprecedented number of drug shortages. For physician anesthesiologists, drug shortages directly impact patient safety and care. Having a diminished supply, or no supply of critical drugs at all, can cause suboptimal pain control or sedation for patients, in addition to creating complex workarounds for healthcare staff, leading to potential errors. Shortages have also resulted in delays and even cancellation of care.

      •    ASA information on Drug Shortages
      •    Report a drug shortage to ASA
      •    FDA Drug Shortage Information and Database

 

posted 3/2018Physician Delegation of Anesthesia

The Texas Medical Board has updated their Frequently Asked Questions (FAQs) section of their website with a question on physician delegation of anesthesia to a midlevel provider (Anesthesiologist Assistants or Nurse Anesthetists). The guidance provided by these FAQs are critical to not only the way physician anesthesiologists practice but also to any physician which delegates to a nurse anesthetist. We urge you to read them and to encourage all your physician colleagues who may be delegating anesthesia to read them.  Read More.

The FAQs are explicit that a physician may delegate the administration of drugs and devices but any mid-level provider is still under the supervision of the physician with the physician remaining "ultimately responsible for the medical management of the patient." The Texas Medical Board makes it clear there is NO independent practice by a Certified Registered Nurse Anesthetist (CRNA) and the delegating physician remains subject to liability for violations of the standard of care by the CRNA if the physician fails to properly supervise them.

The FAQs are also explicit on the permissible use of an Anesthesiologist Assistant (AA) in a care team. In short, a physician may delegate to either a CRNA and/or an AA the administration of anesthetic drugs. An anesthesiologist must provide specifics in an order for an AA on the selection of drugs, dosage, and administration technique. Only a physician may delegate to a CRNA or an AA anesthesia care and thus, the hand-off or step-down process may only be delegated by a physician either through a standing or patient-specific order. Thus, a physician may delegate to either a CRNA or an AA and those physician extenders may, through a physician's order, relieve each other in the process of patient care.

The Texas Society of Anesthesiologists has long advised that CRNAs could not practice independently in Texas and that physicians need to supervise anyone they delegate tasks to including CRNAs. We appreciate the leadership of the Texas Medical Board on this issue.

The Texas Society of Anesthesiologists urges each member to review these FAQs and to share with your physician colleagues and your hospital or facility administrators.

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posted 1/2018The Council on Patient Safety in Women's Health Care Maternal Safety Bundles

The Alliance for Innovation on Maternal Health (AIM) is a national data-driven maternal safety and quality improvement initiative. AIM maternal safety bundles

 


The Texas Department of Public Safety (DPS) and the TMB are still working to implement this synchronized registration. In the meantime, if your CSR expired in April, 2014 or later you can find information on renewals on the TMB’s site.

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