Medical Society of New Jersey e-Newsletter
 
June 7, 2013

   
In This Issue
ICD-10 Workshop
.
FEATURES
-Medicare Payment Reform
-Maintenance of Certification
LEGISLATIVE UPDATE
.
NEWS
-License Renewal Survey
-Patient Appeal Rights
-CDS Prescription Fill Refusals
-More
-ICD-10
-ICD-10 Workshop
-HIPAA Resources
.
MEMBER BENEFITS
-Coverys
.
CORPORATE PARTNERS
-STI Computer Services
.
EVENTS/TRAINING
 

ICD-10 Workshop 

"ICD-10 and Coding for Difficult Diagnosis"
June 21, 2013 from
9am-12pm at
MSNJ Headquarters in Lawrenceville, NJ
 

Learn about: ICD-10-CM and guidelines, key coding conventions for the ICD-10-CM, differences between ICD-9 and ICD-10, and diagnosis coding in ICD-10 by body part.

Target Audience: Small Practices  

Register online


Find Medical Society of New Jersey on Facebook
 
Follow Medical Society of New Jersey on Twitter
 
Connect with Medical Society of New Jersey on LinkedIn
FeaturesTOP

Senate Finance Committee Considers Physician In-Put on Medicare Payment Reform

Last week, in response to three questions from the Senate Committee on Finance, the AMA provided specific information on how to design Medicare payment reform. The thirteen page letter to the ranking members of the committee includes many items for which MSNJ and the AMA have advocated for many years, including:

  • Medicare should pay for coordination of care services, such as non-face-to-face coordination of care activities
  • Expand availability and types of alternative payment models (APMs); allow incremental transition into APMs with a portion of the physician's practice remaining in fee-for-service; reward APM participants that significantly reduce overall Medicare spending with higher FFS payment updates
  • Medical liability reform
  • Establish guaranteed loans to small, independent practices to help them cover the costs of infrastructure investments and lost cash flow necessary to implement new payment methodologies

Notably, the AMA points out to the Senate Finance Committee that physicians have played a key role in the decline in overall Medicare spending and utilization growth over the past few years.

 

The AMA believes that we are closer to the repeal of the SGR and Medicare payment reform than ever. However, the repeal and payment reform will not occur without some significant changes including new payment models that result in cost reductions to ensure the program's long term fiscal viability. MSNJ urges members to read the letter to the Senate Committee on Finance.   

American Board of Medical Specialties under Fire for Maintenance of Certification™ Program

Criticism of the American Board of Medical Specialties' (ABMS) Maintenance of Certification™ (MOC) program has escalated over the past year. This has manifested in a number of ways. A national specialty society and at least two states have introduced resolutions that will be heard by the AMA and one national association has filed a lawsuit.

 

The AMA has already developed a number of policies on maintenance of certification and maintenance of licensure issues which address the cost, disruption to practice, and possible negative impact on access to care. In response to a joint resolution introduced by Camden, Mercer, and Passaic counties, the MSNJ Board of Trustees considered a resolution during its meeting on Sunday, June 2. After extensive testimony from the proponents of the resolution, county leaders, board members, and fellows, the Board took action on the resolution. Read more

Legislative Update 

Read this week's full legislative update online.    

 

Out-of-Network Reform

The Assembly Financial Institutions & Insurance Committee held a hearing on Thursday regarding A-3603, a bill that would create an All Payer Claim Database (APCD) and require the Department of Banking & Insurance to use information from the database to set a payment range that would be used in arbitration of charges submitted by out-of-network physicians in in-network hospitals. MSNJ CEO Larry Downs testified about the database and about out of network issues, stating that transparency through a database is needed, but that the bill provides an imperfect solution to the out-of-network issue as in-network payment and adequacy issues must be reformed, too. Read more

Bills Introduced in Both Houses of Congress to Repeal ICD-10

The Senate has introduced a bill, "Cutting Costly Codes Act of 2013," that would prohibit the US Secretary of Health & Human Services from replacing ICD-0 with ICD-10.  There is a similar bill pending in the House. Without congressional action, the compliance date for implementation of ICD-10 is in October of 2014. MSNJ and the AMA support these bills. Read more.  

News

MSNJ Evaluates Medicare Advantage Plans' Payment Reductions Due to Sequester

MSNJ has received reports of Medicare

Advantage plans (MAs) providing notice of payment reductions as a result of the sequestration. So far, members have received notice from Aetna and United Healthcare. CMS published a guidance document for MAs to advise how the sequestration affects the plans.  

 

In the document, CMS explains that MAs, "are not permitted to modify the currently-approved benefit or cost sharing structure in any way;  [. . .] includ[ing] increases in premiums or cost sharing, or reductions in benefits in an attempt to offset the lower payments due to sequestration."  Likewise, MAs may only make changes to contracted physician payments in accordance with the terms of the contract.  

 

MSNJ is currently investigating whether the MAs are abiding by contract terms, when making these changes. If you believe that the change in fee schedule violates your contract with the MA, please email us at [email protected] with "MA Sequester Reduction" in the subject line and provide a copy of your contract.

License Renewal-MSNJ Asks that Physicians Complete the Workforce Survey

Participation in the accompanying workforce survey is voluntary. MSNJ is urging our members and all physicians in the state to participate.  

 

The information will assist the state in its evaluation of physician demographics and access to care. Applications are due on or before July 15, 2013. Please see the MSNJ FAQ and BME Guide  for more information.

 

If you have access issues or need clarification on a specific question, please contact the MSNJ Member Resource Center at [email protected].

Medical License Renewal Overpayments

Physicians who had medical license renewal submission issues that resulted in overpayment of the license renewal fee should contact the MSNJ Member Resource Center for assistance (609.896.1766 ext. 0). We will put you in touch with the appropriate Board contact for refunds.

 

MSNJ Supports Notice to Patients of their Appeal Rights

Last week, MSNJ filed comments in support of the form of a notice that must be posted in offices advising patients of their rights to appeal from insurer denials of coverage for medical necessity under state law. The notice points out that not all claims are covered by the state law and urges the patient to confer with their employer or plan representative about appeal routes for self-insured plans.  We previously provided in-put on the form of the notice and we will assist our members with the posting requirement.

Pharmacies Refusing to Fill Prescriptions for CDS

MSNJ has received several complaints from members concerning pharmacies refusing to fill prescriptions for controlled dangerous substances (CDS). We have been in contact with the New Jersey Pharmacy Board, Board of Medical Examiners and the AMA about this issue. Throughout the U.S., several retail pharmacy chains have conducted pharmacist training to avoid CDS diversion, abuse, and fraud.

As a result, some pharmacists are overreacting to the liability risk and are making extraordinary demands on physicians, ranging from requests for previous treatments to copies of medical records. MSNJ met with the New Jersey Pharmacists Association, who agreed to work  with us to develop guidelines for pharmacists to follow when concerned about fraud, abuse, diversion and their potential liability. In the meantime, we are asking members to report issues with getting prescriptions filled by using MSNJ's Pharmacy Issue Reporting Form
.

Horizon Recruiting Practices to Join Medical Home Program

Horizon Blue Cross Blue Shield of New Jersey is recruiting primary care practices to join their Patient-Centered Medical Home (PCMH) Program. For a brief overview of the program, Horizon has prepared a three-minute video to introduce the program to practices that may be interested. For more information, you can also contact Horizon via e-mail.  

Prescription Drug Donation Repository Program

The Assembly and Senate Health Committees passed A-2188/S-2615, which would establish a prescription drug donation repository program in the Department of Health (DOH).  This program will provide for the donation of unused prescription drugs and supplies by persons, health care facilities, and pharmacies to a central repository for redistribution to authorized medical facilities and pharmacies in order to re-dispense these medications, which would otherwise be destroyed, for use by individuals who meet eligibility criteria specified by the Commissioner of Health. MSNJ supports the bill, as it is in line with our goal to reduce abuse and diversion of drugs, particularly opioids.  Amendments have been made to add provider immunity pursuant to a MSNJ request. The bill is poised for a full vote in both houses.

 

The Dispensary of Hope is a national not-for-profit working to ensure no medication goes to waste while millions of uninsured Americans go without the medications they need. They do this by recovering surplus medications from drug manufacturers, distributors and physicians and redistributing them to charitable clinics and pharmacies. Read more

Free AMA Webinar on Preparing for Sunshine Act

The AMA has archived a free webinar on "Physicians Preparing for the Sunshine Act: What You Need to Know and How to Prepare." Learn which financial exchanges and ownership interests must be reported, steps to take to prepare for public disclosure of this information, ways to be able to challenge false, inaccurate or misleading reports, and which types of information are excluded from reporting. View more information on the Sunshine Act. Register online.

AMA has congratulated MSNJ on our success on the New Jersey Assembly Bill 3095, "Concerning Opioid Antidotes and Overdose Protection." MSNJ appreciates the AMA's support on this important issue.

Save the Date: MSNJ Policy & Strategy Panel Meeting

Thursday, July 18, 2013 at 5:30 P.M.

MSNJ Conference Room

 

This will be a working meeting. Council on Legislation reports will be considered for approval. At the direction of MSNJ Board of Trustees, we will be working on maintenance of certification policy development.   

Read MSNJ's Board of Trustees draft minutes from June 2, 2013.

Applications Still Accepted for Hurricane Sandy Relief Grant 
The Physicians Foundation announced a grant in the amount of $350,000 each to the Medical Society of New Jersey and the Medical Society of the State of New York. Grantees do not have to be MSNJ Members. Download the application today.

 

Practice Management

MSNJ Practice Management Community

A community has been created on MSNJ's website for all Medical Practice Manager Section (MPMS) members. Here you will find blogs, forums, events, polls and links to important information regarding practice management. All MPMS members are automatically subscribed to the community and forum as part of membership. An email will be sent when a forum is created. You may unsubscribe at any time, using the unsubscribe link at the bottom of the email or through the community website.

View June's Practice Tip of the Month on Compliance. If you would like your questions addressed in an upcoming edition of e-News or you have a coding question specific to your practice, please email your questions. We will work with a certified professional coder to help answer them.

CMS Webinar on Transitioning to ICD-10

CMS will host an informative webinar on "Transitioning to ICD-10" on Thursday, June 20, from 10:00 A.M. to 11:00 A.M. Learn about: the background and Impact of ICD-10; CMS Internal ICD-10 implementation; how CMS is working with the States and partnering with Industry; and best practices. Registration coming soon.

ICD-10 Tip:

When submitting claims on or after the October 14, 2014 ICD-10 deadline, if the date of service was before the deadline, the ICD-9 code must be used. If the date of service is on or after October 14, 2014, ICD-10 must be used. For more information about ICD-10, join MSNJ for an informational workshop. See details below.


Registration Now Open: ICD-10 Workshop:

"ICD-10 and Coding for Difficult Diagnosis."  

 

Friday, June 21 from 9:00 A.M. to 12:00 P.M. at MSNJ Headquarters, Lawrenceville, NJ.

 

Join MSNJ for an ICD-10 workshop on "ICD-10 and Coding for Difficult Diagnosis."

Presented by: Tina Cressman, MALS, CPC, CPC-H, CPC-P, CEMC, CPMA, CPEDC, CPC-I, CCS-P, MCS-P, MCS-I, CPAT, CCAT, CCT, CMC, Assistant Director, Health Information Management, Cooper University Hospital.

 

Learn about: ICD-10-CM and guidelines, key coding conventions for the ICD-10-CM, differences between ICD-9 and ICD-10, and diagnosis coding in ICD-10 by body part.

Target Audience: Small Practices  

Register online

June 30th Deadline to Avoid the 2014 eRx Penalty

CMS has re-opened the Quality Reporting Communications Support Page until June 30, 2013, allowing physicians to request a hardship exemption for 2014. In order to avoid the 2 percent penalty in 2014, physicians must meet the requirements of the Medicare e-prescribing (eRx) program; meet one of the limited exemption categories, or obtain approval for a hardship exemption. Individual physicians who do not meet one of the exemption or hardship categories must report the eRx measure 10 times via claims between January 1, 2013 and June 30, 2013.

 

Groups using the group reporting option must report at least 75 times (2-24 Eligible Professionals), at least 625 times (25-99 EPs), and at least 2,500 times for groups of 100 plus. Physicians can also avoid the penalty by registering for the EHR Incentive Program by June 30, 2013, or achieving meaningful use under the EHR Incentive Program during the January 1, 2013 to June 30, 2013 reporting period. For a complete list of hardship exemptions and more information, view CMS' Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.

HIPAA Resources

  • Templates- Available Online: MSNJ and Weber Gallagher Simpson Stapleton Fires & Newby LLP's HIPAA Business Associate Agreement and Notification of Privacy Practice templates are now available on MSNJ's website.  
     

  • The Office of Civil Rights (OCR) recently launched three modules on HIPAA compliance:

-Patient Privacy: A Guide for Providers 

-HIPAA and You: Building a Culture of Compliance  

-Examining Compliance with the HIPAA Privacy Rule

  • Videos on the HIPAA Security Rule are also available on the OCR's YouTube Channel. These videos are designed for small practices and offer an overview of how to establish basic safeguards to protect patient information and comply with the Security Rule's requirements.
     
  • The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the Workgroup for Electronic Data Interchange (WEDI) will host a series of free 90-minute webinars specifically designed for small healthcare providers, with a focus on practical strategies for implementing the Omnibus Rule changes within a small clinical practice. These virtual sessions will be held on:
    • June 14 (1:00 P.M. to 2:30 P.M.) - HITECH Omnibus Overview of the Rule
    • June 28 (1:00 P.M. to 2:30 P.M.) - Drill down on the new HITECH Privacy Rule
    • July 17 (1:00 P.M. to 2:30 P.M.) - Breach and Enforcement under the HITEC Omnibus Rule
    • July 28 (1:00 P.M. to 2:30 P.M.) - Business Associates and the HITECH Omnibus Rule
Member Benefits

 

Verizon Wireless Discount

Members of the Medical Society of New Jersey may save up to 22% off monthly plans $34.99 or higher, up to 25% on individual accessories, and great savings on phones. Discount information.

 

Please note: If you are taking advantage of this discount and your contract is up, you may be receiving an email or letter from Verizon asking you to validate your discount. To validate, please click here.  

Corporate Partners

 

STI Computer Services, Inc. -

Bronze Level Partner 

 

 

Contact: Joseph Cerra, Sales Manager
Phone: 800.487.9135
E-mail: [email protected]
 Website  

 



 

 

 

The ChartMaker� computerized patient-records software is a complete, pen-based, template-driven system for personal computers using Microsoft Windows Operating systems. Computerized patient records comply with the new E&M coding guidelines. Also ChartMaker Practice Manager� - billing/scheduling software. A 10% discount on software is available to members.


 

 
It is important to note that MSNJ does not endorse any vendor, service, or product. However, we encourage members to please consider our Corporate Partners first as the financial support received from these organizations is vital to our association. It is our hope that their investment in MSNJ will help keep your membership dues and programming affordable. Click for a complete listing of our Corporate Partners and other Member Benefits.
Events/Training/Resources

NJ-HITEC, EMRX-SJ, and South Jersey area hospitals invite you to attend a free educational event on "RX to Healthcare IT Success" on Monday, June 17 from 4:00 P.M. to 9:00 P.M. at Stockton Seaview Hotel & Golf Club, Galloway, NJ. Learn more about EHRs, Stage 2 of Health IT Meaningful Use, Patient-Centered Medical Home, and ACOs. Register online or call 973-642-7883 by Friday, June 7.

 

The Surgery Center Coalition (SCC) will host a free seminar on "HR for ASCs: When to Cut and When to Call It" on Wednesday, June 19 from 4:00 P.M. to 7:00 P.M. at Brach Eichler headquarters, Roseland, NJ. Presentations include:Benchmarking - It's a Must; Infection Control; Pharmacy Issues; Legal Updates; & NJAASC Updates. A light dinner and refreshments will be provided. RSVP to Alan Levine at [email protected], or (973)364-8389.

 

The AAP/NJ Annual Conference & Exhibition

Pediatric Challenges: Preparing for the Unexpected will take place on June 18 & 19, 2013 at the the Palace in Somerset, NJ.

Visit the AAPNJ website for the agenda and registration information. 

 

Attend the 2013 NAMI National Convention, "Together We Can Make A Difference" in San Antonio, Texas, June 27 through June 30, 2013.
Register online.

AMA Webinar: Urine Drug Testing in Chronic Pain: A Patient Centered Approach
June 25, 2013 1:00 pm - 2:00 pm ET
This webinar will provide an overview of the benefits and limitations of urine drug testing in patients with chronic pain. Speaker: Douglas L. Gourlay, MD, FRCPC, FASAM The Wasser Pain Management Centre, Mount Sinai Hospital Toronto, Ontario. Register.
 

National Ovarian Cancer Coalition (NOCC) 15th Anniversary Run/Walk

2013 will be a very special event as we celebrate our 15th Anniversary Run/Walk. Please join the thousands of ovarian cancer survivors, their families and friends, medical and health professionals, and the local community in support of the NOCC. Read more.

 

 
Medical Society of New Jersey
2 Princess Road, Lawrenceville, NJ 08648
(o) 609-896-1766 e-mail:
 

About the Medical Society of New Jersey:

Founded in 1766, the Medical Society of New Jersey (MSNJ) is the oldest professional society in the United States. MSNJ promotes the betterment of the public health and the science and the art of medicine, to enlighten public opinion in regard to the problems of medicine, and to safeguard the rights of the practitioners of medicine.  The organization and its members are dedicated to a healthy New Jersey, working to ensure the sanctity of the physician-patient relationship. In representing all medical disciplines, MSNJ advocates for the rights of patients and physicians alike, for the delivery of the highest quality medical care.  For more information visit our website or send us an e-mail.

"Your Partner in Practice... Your Voice in Trenton"  

2013 � Medical Society of New Jersey. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the written permission of the Medical Society of New Jersey.