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. 

Speakers include:

• Mishael Azam, Esq., MSNJ - Legislative Update
• Tina Cressman, Cooper University Health Care - ICD-10
• Robin Bilazarian, Cooper University Health Care - Communication Skills
• Victoria A. Pappalardo & Ari G. Burd, Giordano Halleran & Ciesla - HIPAA
• Michael Geiger, Cooper University Health Care - Communication Skills
• Jennifer Searfoss, Esq., Searfoss & Associates LLC - Sunshine Laws

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.  

UHC Medicare Advantage Terminations

MSNJ heard from many members concerned about recent notices from UnitedHealthcare (UHC) regarding termination from the Medicare Advantage Network. We are hearing from practices, large and small, representing almost every specialty. MSNJ is concerned about the reasoning behind the terminations as well as the impact that these terminations will have on network adequacy and continuity of care issues. We contacted UHC for more information on the scope of the terminations, network adequacy, criteria used for terminations, continuity of care, and patient notification. While UHC has not yet answered our questions, they have agreed to speak with us about the terminations on Monday.

Members who received the notice and wish to remain in network are urged to file an appeal in accordance with the letter. Appeal rights will be waived, if the appeal is not filed within 30 calendar days of receipt of the letter. Members may visit MSNJ's website for further resources. MSNJ will keep members apprised of information that we receive from UHC.

Medicaid Primary Care Incentive Payments Set to Begin

The New Jersey Division of Medical Assistance and Health Services (DMAHS) announced in its October newsletter that traditional Medicaid retroactive payments for the primary care incentive will be made in bulk payments and processed by mid-December 2013. Incentive payments will begin processing on a claim by claim basis as of November 4, 2013. Under Traditional Medicaid, physicians had until April 30, 2013 to file attestation forms in order to receive retroactive incentive payments going back to January 1, 2013. Physicians who submit the attestation after April 30th will receive incentive payments starting from the first day of the month the attestation was submitted. For example, if the attestation is submitted on October 17, 2013, then the incentive payments will apply to claims starting October 1st. Please note: the fee-for-service deadline does not apply to physicians in the Medicaid Managed Care Organizations (MCO); a deadline should be provided directly from the plan.

MSNJ has heard reports from members that some MCOs have already begun processing retroactive incentive payments. Once caught up with retroactive payments, the MCO incentive payments will be made in quarterly bulk payments and will not be claim specific. Please let us know if your practice encounters any issues with these incentive payments by writing to us at info@msnj.org with "Medicaid Incentive" in the subject line. 

Special Election for New Jersey's US Senator Seat

Mayor Cory Booker has won the election for the US Senate, replacing Senator Frank Lautenberg.  He beat Republican Steve Lonegan, 55-to-44 percent. He will run to keep his seat in the regular election next year.

Medicinal Marijuana Program Webinar

The New Jersey Department of Health's Medicinal Marijuana Program has developed an introductory webinar for physicians on their Medicinal Marijuana Program. This webinar provides information on the program and how physicians and patients can register. For answers to frequently asked questions, visit the Department's website. Physicians may also find a list of scholarly articles related to medicinal marijuana research on the Program website.

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.

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.

OSHA Training Requirements

December 1, 2013 is the deadline for training staff on the new OSHA requirements. The new Hazard Communication Standard  requirement is applicable to medical practices and was updated in 2012 to make it uniform with the global chemical labeling system that manufacturers follow. The Hazard Communication Standard will be phased in through June 1, 2016. Training can be done in the office by using materials from OSHA. View OSHA's QuickCards on safety data sheets and labeling.

Archived Webinar: Obamacare for Employers

Last week, MSNJ hosted a webinar on Obamacare for Employers - In Detail and In Plain English. Even though there is a delay in employer reporting, the IRS is at work on regulations. Anthony Rainone from Brach Eichler LLC discussed the details of the recently proposed "Shared Responsibility" regulations including: Whether your company is an "applicable large employer"; What is a full time equivalent employee (FTE) for determining applicable large employer status; Whether your company has to pay an "assessable payment" penalty and, if so, how much; and other helpful tips for employers, including Obamacare's amendments to the Fair Labor Standards Act. This webinar is geared towards employers with 100 or more employees. Purchase the archived webinar. 

Webinar on Comparing ICD-9 to ICD-10

MentorHealth will host a webinar on Comparing ICD-9 to ICD-10 on Wednesday, November 20, 2013 at 1:00 P.M. This 90-minute webinar will provide an overview of the changes from ICD-9 to ICD-10 chapter specific guidelines, documentation requirements for ICD-10 in each chapter, and examples using the most frequently reported codes in each chapter. The cost to register is $175 for one participant (group pricing also available). 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

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.