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Medical Society of New Jersey e-Newsletter
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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.
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Cocktail Reception to Support Nancy Pinkin
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MSNJ Past President Niranjan Rao, MD, will host a cocktail reception to support Nancy Pinkin, candidate for assembly in district 18.
The reception will take place Wednesday, July 31 at 6:00 P.M. at Dr. Rao's office:
78 Easton Ave., New Brunswick, NJ 08901
(Maximum individual contribution is $2,600)
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Applications 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.
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Verizon Wireless Discount Validation
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If you are taking advantage of this discount, you may be receiving an email or letter from Verizon asking you to validate your information. We are working with Verizon Wireless to streamline this process. To validate, please click here. Log into our website and follow the instructions listed. For assistance, please e-mail info@msnj.org.
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News
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License Renewal Applications due July 15
The license renewal application is comprised of several parts: mailing address, address of record, additional information, education, employment, questions, additional renewal information, and the workforce survey. While the workforce survey is optional, the remaining portions of the application are mandatory. MSNJ asks that physicians complete the workforce survey. 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. Read more for tips and information needed to complete the application.
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| Presidential Updates
MSNJ President Ruth Schulze, MD, spoke at the Middlesex County Medical Society annual meeting last week. Dr. Schulze also spoke at the monthly Cumberland County meeting - she met many members of the south Jersey physician and provider community and was grateful for the opportunity to speak. |
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"HIPAA Minutes" - New Educational Tool
In response to the iHealthBeat article, which explains how medical societies should pursue new ways of sharing HIPAA guidance, MSNJ worked with Helen Oscislawski, Esq. to produce two-minute videos on the HIPAA changes due to the Final Omnibus Rule. Our Part 3: Breaches: Presumption of Breach video on "If a health care provider accidentally sends, faxes or e-mails patient information to the wrong place, is that a 'Breach' which has to be reported to the affected patient?" is now available for viewing.
 | | Part 3: Breaches: Presumption of Breach |
About the Speaker:
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Federal Government Unveils Health Insurance Marketplace Educational Tools
The US Department of Health and Human Services has announced the launch of a Health Insurance Marketplace education effort with a new website and consumer call center at 800-318-2596 to help Americans prepare for open enrollment and ultimately sign up for private health insurance.
The website will add functionality over the summer so that, by October, consumers will be able to create accounts, complete an online application, and shop for qualified health plans. For Spanish speaking consumers, CuidadoDeSalud.gov will also be updated to match HealthCare.gov's new consumer focus.
Key features of the website include integration of social media, sharable content, and engagement destinations for consumers to get more information.
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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.
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Read this week's full legislative update online.
Step Therapy
The Senate Commerce Committee passed S2088, which would limit step therapy requirements for pain medication by insurers. MSNJ supports this bill, which has already passed the Assembly. Didier Demesmin, MD, President of the Middlesex County Medical Society testified with Mishael Azam and Tim Martin.
Medicaid Expansion
The Governor vetoed the Legislature's effort to expand Medicaid eligibility. S2644 would have increased the Medicaid income eligibility limit to 133 percent of the federal poverty level for all non-elderly adult citizens and lawful residents in New Jersey, effective January 1, 2014, as allowed by the ACA. The administration is still moving forward with Medicaid expansion, but it will be done through the State budget and the Executive Branch.
Hospital Tax
As reported earlier, the Legislature was trying very hard to pass a bill in June that would create a tax on urban hospitals in order to raise revenue for municipalities. A4092/S2466 has died for now, but MSNJ will keep an eye on it. We opposed the bill, as we oppose any taxes on health services.
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HIPAA Resources
"HIPAA Minutes"- New Educational Tool
MSNJ and Helen Oscislawski, Esq. present two-minute videos on the HIPAA changes due to the Final Omnibus Rule. Part 3: Breaches: Presumption of Breach is now available.
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:
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:
- July 17 (1:00 P.M.) - Breach and Enforcement under the HITEC Omnibus Rule
- July 28 (1:00 P.M.) - Business Associates and the HITECH Omnibus Rule
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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. |
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View July's Coding Tip of the Month on Add-on Codes in CPT. 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.
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Billing and Coding:
CMS has released new MLN Matters articles on billing and coding:
- SE1313: Place of Service Coding for Physician Services in an Outpatient Setting
- Some physicians were incorrectly reporting place of service as office (11) when the services were provided in an outpatient hospital (22) setting, resulting in incorrect reimbursement.
- SE1314: Duplicate Claims-Outpatient -
- Recovery Auditors continue to conduct automated reviews of claims to identify duplicate services billed and reimbursed under Medicare.
- SE1315: Pulmonary Procedures and Evaluation & Management (E/M) Services -
- Recovery Auditors have identified overpayments associated with Evaluation and Management (E/M) Services (Common Procedure Terminology (CPT) 99211-99213) for Pulmonary Diagnostic Procedures. These overpayments occurred due to claims billed without Modifier 25 on the same date of service as a pulmonary diagnostic, therapeutic, or monitoring procedure (94010-94799).
- SE1322: Co-Surgery Not Billed with Modifier 62 -
- When two or more surgeons with different specialties submit claims for the same operative session for the same beneficiary and same date of service, all providers must use the co-surgeon modifier. When two different providers bill the same CPT code, same patient and same date of service and one of the providers bills with modifier 62, the other provider must also bill with modifier 62. Note, however, that modifier 62 may only be used when the co-surgeons are of different specialties and are working simultaneously.
- SE1323: Additional/Subsequent Procedures Performed During the 90 Day Global Period for Major Surgeries -
- Recovery Auditor reviews have determined that providers are incorrectly billing E/M services provided by the surgeon the day before major surgery, the day of minor surgery, 0-10 days after minor surgery, and up to 90 days after major surgery. The GSP was established by CMS to ensure that all components of surgery (including pre- and post-operative services) were bundled into one payment.
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AMA's Prescription for a Healthier Practice: Use updated eligibility request and response electronic transactions
For this month's practice checkup, take a look back at some of the resources that have been featured in the "Prescription for a healthier practice" check-up series so far this year. In January, AMA featured electronic eligibility as a way for your practice to determine patient financial responsibility in order to receive payments from patients before they walk out of the door.
Due to recent operating rules, health insurers must send robust eligibility information to physician practices regarding a patient's eligibility, including coinsurance, remaining deductible, and copay amounts. These new enhancements provide more than a "yes" or "no" response, and offer your practice the opportunity to determine detailed patient eligibility information.
Start with www.ama-assn.org/go/eligibility to learn more about using electronic eligibility verification, and join the AMAAdministrative Simplification LinkedIn group for additional helpful resources.
If your practice management system software vendor doesn't offer the enhanced eligibility transaction as an integrated solution, talk to your vendor about other solutions it may offer to reduce administrative costs in your practice. Be sure to ask if there are any future plans to offer an integrated solution or associated functionality. 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.
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IACS Accepting PTANs Less than Ten Characters Long
CMS reported that physicians in group practices and individual eligible professionals (EPs) whose Provider Transaction Access Numbers (PTANs) are not 10 characters long should wait to request an Individuals Authorized Access to the CMS Computer Services (IACS) account with a Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System role or modify an existing account to add a PV-PQRS Registration System role until further notice from CMS. Request a new IACS account or modify an existing account of the CMS Applications Portal.
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Corporate Partners
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athenahealth, Inc. - Bronze Level Partner
Contact: Jason Loeb
Phone: 888.402.6942
E-mail: jloeb@athenahealth.com
Website
What makes athenahealth's services different?
athenahealth helps physician practices to get paid more, faster, with less work and hassle by optimizing your workflow, evaluating productivity and monitoring cash flow. With a growing network of more than 22,000 providers, athenahealth continuously researches and seeks out new insurance rules, builds them into their patented revenue cycle rules database, and makes them available to all clients on their network, resulting in fewer claim denials. athenahealth's Intelligence Team also tracks new government and Pay-for-Performance (P4P) rules to help make sure you receive the incentive payments you're eligible for. And while some vendors may send you software you need to update at your own time and expense, athenahealth constantly updates their software and rules database for you, giving you faster access to insurer coding changes - all free of charge. For more details on athenahealth's services, please click on the links below. And if you'd like to learn more about the HITECH Act and athenahealth's Federal Stimulus Guarantee Program, click here.
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.
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Member Benefits
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Take advantage of your in-store, Macy*s Business Smart Pass until July 31, 2013. As an MSNJ Member, save 15% all day, as many times as you want. See Pass for further details. Save on designer brands, such as Calvin Klein, Lauren Ralph Lauren, Jones New York, DKNY, Michael Kors, Ann Klein, Polo Ralph Lauren, Tommy Hilfiger, etc. Download your pass today.
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Rutgers Football is offering discount tickets for some of the 2013 home games at Rutgers Stadium in Piscataway. Health Professionals Day is September 14. For more information, contact Rutgers Athletics at 866-445-4678 or tickets@scarletknights.com.
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Save the Date:
Federal Motor Carrier Safety Administration (FMCSA) Certified Medical Examiner Training.
This training course has been approved for AOA Category 1A credit, as well as AMA PRA Category 1 Credit™ .
Two Dates are offered:
- Saturday, September 21 - Westin Mount Laurel, Mt. Laurel, NJ (8:30 AM- 4:00 PM Training)
- Saturday, October 26 - Parsippany Hilton, Parsippany NJ (8:30 AM- 4:00 PM Training)
Please Let Us Know
It would help us to know if this certification is of interest to you and you will consider participating in this training by sending an email to info@msnj.org. Thank you!
* doctor of osteopathy, doctor of medicine, advanced practice nurse, doctor of chiropractic, physician assistant, or other medical professional authorized by applicable State laws and regulations to perform physical examinations.
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Events/Training/Resources
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MSNJ Past President Niranjan Rao, MD, will host a cocktail reception to support Nancy Pinkin, candidate for assembly in district 18.
The reception will take place Wednesday, July 31 at 6:00 P.M. at Dr. Rao's office:
78 Easton Ave., New Brunswick, NJ 08901.
(Maximum individual contribution is $2,600)
Health Literacy Resources: First Book
First Book works directly with leading health professionals to ensure that low-income kids have access to the brand new, high-quality books that speak to the things that will positively impact their lives, including topics surrounding going to the doctor/dentist and being physically active. Check eligibility and sign up to start receiving books today.
Prescribers' Clinical Support System for Opioid Therapies (PCSS-O) is a three year grant funded by Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT). The online modules are designed to increase your understanding of the current state of opioid-dependence treatment, increase your understanding of treatment issues for special populations, and lastly to increase your ability to assess and treat patients. Access the modules.
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.
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Medical Society of New Jersey
2 Princess Road, Lawrenceville, NJ 08648
(o) 609-896-1766 e-mail:
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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"
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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.
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