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.   

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

US Supreme Court Affirms Physicians' Right to Arbitrate Payment Disputes as a Class--

Decade Long Battle Ends  

Clearly, the reluctance of Walgreens pharmacists to fill prescriptions for pain killers in New Jersey is related to this enforcement activity and Walgreens corporate compliance efforts to address the problem. MSNJ is working with the New Jersey Pharmacists Association to agree upon appropriate guidelines for pharmacists to follow when they are concerned about the validity of a prescription for pain killers. We are concerned that patients will not be able to get the medications that they need if individual pharmacists are not provided with meaningful guidelines.  

If you have a patient who has been refused a prescription for pain medication, please complete MSNJ's Pharmacy Issue Reporting Form. so that we can discuss the issue with Walgreens. Walgreen's has agreed to work with us on a case by case basis to address our concerns. Read the press release. Read the settlement agreement.

To the Editor:

I expected more from the New York Times. Rosenthal goes to the four corners of the globe in a comparative shopping excursion for colonoscopy services. (The $2.7 Trillion Medical Bill, NYT June 1, 2013).  There are two driving factors of medical costs in America that are inexplicably missing from the analysis. 

First, is the significant career risk to a highly trained physician from a missed diagnosis or a mis-communicated result.  In the US we hold physicians to a standard of perfect practice . . . anything less you face a litigation threat than can end your career.  Factored into the price of every product in America, including colonoscopy, is litigation risk - a risk not present in other countries to the extent it is in the US.

Second, is our uniquely American system of financing healthcare. US domiciled health insurance companies are some of the wealthiest on Wall Street. While the Times chose to point out physician incomes, the article neglects to look at the booming corporate profits (and executive salaries) of healthcare giants.  It's a perspective that is noticeably absent.

Lawrence Downs, Esq.

CEO, Medical Society of New Jersey

Read this week's full legislative update online.    

Yellow Dot Program - New Law

The Legislature accepted a conditional veto by Governor Christie, thus establishing a law to create a Yellow Dot Program in New Jersey.  Yellow Dot programs are designed to provide emergency responders with health and emergency contact information to better assist program participants who are involved in motor vehicle emergencies.  A program participant places a yellow dot in their vehicle's rear window which alerts emergency personnel to check the glove compartment for additional health information.  Yellow Dot programs are in place in more than twenty states. Read more.

Sudden Cardiac Arrest

The Assembly Appropriations Committee passed a bill creating the "Children's Sudden Cardiac Events Reporting Act."  The bill requires a health care professional who makes a diagnosis of a sudden cardiac event in a child, or who makes the actual determination and pronouncement of death for a child, to report the event to the Department of Health.  The bill specifies that the report must be provided in writing, and must include the name and address of the health care professional submitting the report; the name, age, and address of the child; and certain other information required by the Commissioner of Health. Read more.

Pertussis Vaccine

The Assembly Women and Children Committee approved the Chairwoman's bill that would mandates that the Department of Health (DOH) prepare and make available informational literature on the pertussis vaccine for adults, including, but not limited to, information on the risks of pertussis, the morbidity and mortality rates among infants suffering pertussis, the availability and efficacy of the Tdap booster vaccine, etc. 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.  

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 info@msnj.org 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.

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.

Take Brach Eichler's 2013 NJ Healthcare Monitor Survey for a Chance to Win an iPad Mini! 

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.  

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.

• Read the NJBIZ article about the fund. 
• Read more in the Hudson Reporter. 

MSNJ Practice Management Community

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.

"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.

Prescription for a healthier practice: Automate prior authorization

The AMA's 2012 National Health Insurer Report Card (NHIRC) found that medical services requiring prior authorization from a commercial health insurer were reported on 4.7 percent of all claims, a 23 percent increase since 2011. Stay tuned for full results of the AMA's 2013 NHIRC on June 17. In the meantime, for this month's practice checkup, take advantage of automated solutions for prior authorization, to reduce the time your practice spends on these processes. Start by visiting the AMA's payer policies web page for links to many of the major payers' prior authorization automated solutions, and join the AMA Practice Efficiency and Management LinkedIn group for additional helpful resources.
 

This tip is a part of the AMA's "Prescription for a healthier practice" series to help physicians and their staff examine how their practices are performing in key administrative processes.

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, you may be receiving an email or letter from Verizon asking you to validate your discount. To validate, please click here.