MSNJ and Cooper University Health Care will host a Medical Practice Management Seminar on Friday, November 1, 2013 from 7:30 A.M. to noon. Listen to presentations on HIPAA, Sunshine Laws, ICD-10, Communication Skills, and a Legislative Update. To register call 1.800.8.COOPER (1.800.826.6737). For more information view the agenda.

Last Live Training for 2013!

Federal Motor Carrier Safety Administration (FMCSA) Certified Medical Examiner Training.   

As a courtesy, NJAOPS is providing MSNJ members a $100 discount-off the registration fee - please click here to obtain your promotional discount code. Click here for further information and registration.

"Keeping it Legal and Safe in the Medical Community," a symposium with NJ's medical community on the epidemic of prescription drug abuse and your professional responsibilities will take place on October 30, 2013. Registration 7:00 A.M.-8:00 P.M., Program 8:00 A.M.-1:00 P.M. Location: Hackensack University Medical Center.  

This live activity has been approved for AMA PRA Category 1 Credit™.  This activity is jointly sponsored by the Partnership for a Drug-Free New Jersey and the American Academy of CME, Inc.® There is no cost to attend this symposium. Register online.  

University Medical Center of Princeton at Plainsboro (UMCPP) presents the First Annual Snider Symposium:

"Updates in Medicine for the Older Adult"
November 22, 2013
8:30 A.M. - 4:30 P.M.

UMCPP Education Center, Conference Rooms A-E
One Plainsboro Road, Plainsboro, NJ 08536

This activity has been approved for AMA PRA Category 1 Credit™.
This symposium is free of charge. Seats are limited.
Click for details and registration.  

Physicians Say Ability to Provide Quality is Top Job Satisfaction Driver

According to a RAND Corporation study released this week, physicians rank the ability to provide valuable care to patients their top reason for job satisfaction. Among the job's challenges, physicians said ineffective payment models, excessive costs and inefficiencies associated with EHR systems and a long list of rules and regulations remain near the top of the list. Read the full study sponsored by the AMA. 

Take Action NOW to Avoid PQRS & Value-Based Modifier Penalties in 2015 (deadline extended to 10/18/13)

The following penalties will be implemented in 2015, if certain measures are not taken by October 18, 2013:

• PQRS: Individual eligible professionals (EPs) are subject to a 1.5 percent penalty in 2015 if they do not submit data on PQRS quality measures to CMS in 2013. Individual EPs can submit data through PQRS methods such as claims, registry and EHR to avoid the penalty and potentially earn a 2013 incentive payment of 0.5 percent. EPs, who have not yet participated in PQRS, can also request that CMS calculate their quality data from administrative claims by registering for the CMS-calculated administrative claims reporting mechanism by October 18, 2013. The deadline was recently extended; however, this information will not be updated on the CMS website due to the current government shutdown.   

• Value-Based Payment Modifier- Physicians in groups of 100 or more EPs are subject to an additional 1 percent penalty in 2015 if they submit claims to Medicare under a single TIN and fail to report under PQRS in 2013. Group practices should identify how many EPs they have billing Medicare under their TIN. If the number of EPs in the group is under 100, the group is not subject to the value modifier for 2015. Groups with 2-99 EPs may register to report under the PQRS Group Practice Reporting Option (GPRO) to avoid the 2015 PQRS penalty and potentially earn a 2013 PQRS incentive payment of 0.5%, but it is not required. Groups with 100 or more EPs must register to avoid the penalty. Reporting options include the web-interface GPRO and registry. Groups can also request that CMS calculate their quality data from administrative claims by registering for the  CMS-calculated administrative claims reporting mechanism by October 18, 2013.

Visit CMS' website for more information on how to get started with PQRS. For specifics on what groups and individual EPs have to do to avoid the PQRS penalty, contact the Quality Net Help Desk by phone at (866) 288-8912 (TTY 1-877-715-6222), Monday - Friday: 8:00 A.M. to 8:00 P.M. EST, fax (888) 329-7377, or e-mail qnetsupport@sdps.org.

Do No Harm: Keeping it Legal and Safe in the Medical Community

MSNJ has partnered with the DEA to educate physicians on best practices for opioid prescribing and the epidemic of prescription drug abuse. 

Register online. This live activity has been approved for AMA PRA Category 1 Credit™. This activity is jointly sponsored by the Partnership for a Drug-Free New Jersey and the American Academy of CME, Inc.®

There is no cost to attend this symposium; However, seating is limited to the first 200 registrants.

LOCATION:
Hackensack University Medical Center
John Theurer Cancer Center
92 Second Street
Hackensack, New Jersey
Croonquist Conference Rooms 1 & 2

SAVE THE DATE:
October 30, 2013
Registration 7am - 8am
Program 8am - 1pm

Marketplace Information for Patients

CMS has developed a number of guidance documents explaining the Marketplace for physicians to give their patients:

• Patient brochure about the health insurance marketplace
• How the marketplace works:: Simple steps for using the insurance marketplace
• Patient pocket card of websites and phone numbers

Marketplace Tools for Physicians

The AMA recently published new tools to help physicians assist their patients with navigating the marketplace. The tools include:

• FAQs regarding how to obtain coverage
• Fact sheet: Coverage under the ACA
• Flier to post in your office

Horizon Exchange Product

Horizon notified MSNJ that participating physicians should expect to receive letters regarding participation in their exchange product, Horizon Advance EPO. Physicians should be on the lookout for a letter from Horizon that indicates whether the practice will be participating in the plan.  If you have questions or concerns regarding the letter your practice received, please write to us at info@msnj.org, put "Horizon Advance EPO" in the subject line, and we will ask a Horizon representative to get in touch with you.

Physicians Foundation Webinar on Medical Practice Innovation

On Wednesday, October 2, the Physicians Foundation hosted a webinar on "Practice Innovation: New Models for the 21st Century." The webinar focused on three new practice models being tested and used around the country. View the California Medical Association's Best Practices toolkit. Watch the webinar.  

Is Your Practice Being Audited by a Payer? Take Heed!

Payers are auditing practices more frequently with an eye toward recovering overpayments, detecting fraudulent, wasteful or abusive billing practices, or simply correcting billing and coding errors. Services that are not documented are deemed to not have occurred and payers are monitoring for these deficiencies. All payers, government and private, have developed post- and pre-payment audits to detect coding errors, correct billing practices, and recover payments.  

MSNJ is concerned that many physicians may not be aware that they are in a post- or pre-payment review. When coding errors continue through a post-payment audit the practice will be placed

If you are currently in a payment review please write to info@msnj.org, put "Payment Review" in the subject line, and describe your situation. We have been working with payers in an effort to make these reviews more transparent and meaningful to physician practices. We plan a series of webinars in the fall to provide further information.

Sunshine Act Resources  

• MLN Matters article provides an Overview for Physicians and Teaching Hospitals.
• CMS' FAQs on Open Payments  

Free CME on Sunshine Act   

Certified CME activities for physicians to learn more about the Sunshine Act are now available online via Medscape:

• "Are You Ready for the National Physician Payment Transparency Program?"

• "The Physician Payment Transparency Program and Your Practice"

Practice Alert!  October 1 Notice Requirement under the Affordable Care Act

Employers covered by the Fair Labor Standards Act were required to provide notice to employees of the existence of the Health Insurance Marketplace (previously Exchange) by October 1. Any business with gross revenue of $500,000 or more is covered, so virtually all medical practices will be required to give the notice. Read the Department of Labor's (DOL) FAQ. The DOL has two recommended forms, one for employers who provide health insurance and one for employers who do not provide health insurance. While some advisors have warned of a per day penalty for failure to report, there is no penalty. This notice is required by the labor laws even though other employer obligations to report and make payments under the Affordable Care Act have been delayed for a year.

Read the DOL guidance document. The purpose of the notice is to inform all employees of the Health Insurance Marketplace; indicate if the employer plan's share of the costs of benefits is less than 60% then the employee may be eligible for a premium tax credit; and that if the employee purchases a plan in the Marketplace that he/she may lose the employer's contribution to the plan offered by it.

Did you know that the MSNJ has a Medical Practice Managers Section (MPMS)?

At MSNJ, we know that managing a medical practice is a daily challenge. We are here to help. Practice Managers and Office Staff can join MPMS to stay up to date on important information through e-News, participate in educational events, get complicated questions answered through our Member Resource Center, and take advantage of our many member benefits. In addition, MSNJ advocates on behalf of all the practice managers in the state of New Jersey. Have your office staff join today! 

NJMGMA Payor and ICD-10 Update

NJMGMA will host a half-day educational Payor and ICD-10 Update on Friday, October 18 from 7:45 A.M. to 12:30 P.M. at the Holiday Inn East Windsor. Listen to a presentation on ICD-10 that focuses on what physician practices should be doing to ensure that they are prepared for the ICD-10 implementation on October 1, 2014. End-to-end testing, clinical documentation improvement as well as training requirements will be discussed in detail so that organizations can access where they are in their preparations. Updates from Novitas, Aetna, United Healthcare, and Horizon BCBSNJ will also be presented. Register online!

ICD-10 Implementation Guide and Helpful Tools

To help prepare for ICD-10, CMS has created an online ICD-10 Implementation Guide. This web-based tool includes a basic overview of ICD-10 as well as a step by step guidance on how to transition to ICD-10 for small, medium and large practices, small hospitals, and payers. Links to other CMS ICD-10 resources are included in the online guide. (https://implementicd10.noblis.org/) Other helpful ICD-10 tools include:

• The ICD-10 Transition: An Introduction
• ICD-10 FAQs
• ICD-10 Basics for Medical Practices
• ICD-10 Basics for Small and Rural Practices
• Talking to Your Vendors About ICD-10: Tips for Medical Practices
• National ICD-10 Provider Education Teleconferences

CMS worked with Medscape to produce ICD-10 videos and articles, along with an opportunity for physicians to earn CME credits. CMS has recently released two new videos:

• ICD-10: A Roadmap for Small Clinical Practices
• ICD-10: Small Practice Guide to a Smooth Transition

EHR Incentive Programs: Stage 2 Guide Available

CMS has released a new resource, "An Eligible Professional's Guide to Stage 2 of the EHR Incentive Programs." The guide provides eligible professionals with a comprehensive overview of Stage 2 of the EHR Incentive Programs, including criteria for Stage 2 meaningful use, 2014 clinical quality measure reporting, and 2014 EHR certification. View the guide.

New CMS Interactive Tools for eHealth Programs

CMS has developed an interactive tool that allows eligible professionals to determine if they are subject to a future eHealth program penalty. This "eHealth Payment Adjustment Tool" shows what penalties to expect based on the eligible professionals' past, current, and expected future participation in eHealth programs. EPs will be asked a series of questions about their participation and eligibility status for the: eRx Incentive Program, Medicare EHR Incentive Program, and PQRS.

CMS also released a new resource that will help health care professionals determine their eligibility for eHealth programs. This tool outlines eligibility for eHealth programs based on your area of practice. View the eligibility tool. 

Earn CEU's at Novitas Solutions' Medicare Fall Symposium

Novitas Solutions will host a free JL Medicare Fall Symposium at Cape May Regional Medical Center on October 23, 2013. This one day workshop consisting of four sessions will help you remain compliant with the Medicare program. The program will also be presented in Pennsylvania, Maryland, and Delaware. All sessions are approved for CEUs by the American Academy of Professional Coders (AAPC). For more information and registration, visit the Novitas Solutions website.

CMS 1500 Claim Form Revised

The CMS-1500 Claim Form has been revised () to more adequately support the use of the ICD-10 diagnosis code set. The form will now give physicians the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes. ICD-9 codes must be used for services provided before October 1, 2014, and ICD-10 codes should be used for services provided on or after October 1, 2014. Only physicians who qualify for exemptions from electronic submission may submit the CMS 1500 Claim Form to Medicare. Medicare will start accepting the revised form on January 6, 2014 and will only accept the revised version of the form starting April 1, 2014.