There is still time to register for MSNJ and Cooper University Health Care's 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.

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.  

United HealthCare (UHC) Terminations of Physicians in Medicare Advantage Plan

In mid-October, UHC began terminating physicians in their Medicare Advantage plan. We immediately reached out to UHC when it appeared that the terminations were not isolated, but rather part of a   broad initiative. This week, UHC responded to some of our questions. We are disappointed that there was no warning of this termination initiative which appears to be a significant redesign of the UHC Medicare Advantage network, nationwide, and that information is sparse. For example, UHC would not tell us how many physicians in New Jersey were terminated or whether any specialties were immune to the termination initiative. Yet, UHC assured us that the network had been "tested and retested" for network adequacy and that there would not be a specialty access issue.

Read more for MSNJ's coverage of network adequacy, lack of transparency, continuity of care, discussions with CMS and what to do. 

Save the date for MSNJ's UHC Termination Update webinar on Tuesday, October 29 at 7:00PM. Details to follow on www.msnj.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

News & Notes

Look for a Q&A with MSNJ President Ruth Schulze, MD, in this weekend's Star Ledger coverage! Dr. Schulze was also featured this week on NJ.com's "Take Five" feature.

MSNJ members had the opportunity to talk with Governor Chris Christie at a recent political event.  MSNJ President Dr. Ruth Schulze has offered the Governor an invitation to discuss healthcare priorities with our membership after the election.  We hope to continue this dialogue.

MSNJ's 7th Annual Golf Outing

More than 70 people came out this week to support MSNJ's public health foundation, the Institute of Medicine and Public Health of New Jersey at the annual golf outing at Mercer Oaks. MSNJ would like to thank all the participants and sponsors for making this year another great success for our foundation!

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. 

Disease Awareness

Governor Christie signed two resolutions regarding disease awareness.  He signed SJR-51/AJR-50 (Whelan/Conaway), which designates November of each year as "Chronic Obstructive Pulmonary Disease Awareness Month." And, he signed AJR-65/SJR-64 (S. Kean, Angelini, Giblin/Beck), which designates February as "Turner Syndrome Awareness Month."

Truth in Advertising

Governor Christie signed A732.  This bill creates a crime for those who engage in the practice, exceed the scope of practice, hold themselves out to be licensed or falsely impersonate a licensed practitioner of the following professions: psychology, marriage and family therapy, chiropractic, social work, or psychoanalysis.   The bill's prime sponsor is a chiropractor (Assemblyman Eustace).  MSNJ supports "truth in advertising" bills and is working on its own legislation regarding physicians.

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.

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.

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  
• Physician Payment Sunshine Act: Listing of Resources

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"

Photocopiers can be a HIPAA Violation

With the new HIPAA rules in place starting September 23, 2013, physicians and practice managers should be aware of the HIPAA Privacy and Security issues related to protected health information (PHI) maintained in a computer or transmitted over the internet. What some may not realize is that photocopiers can also contain PHI. Affinity Health Plan, Inc. has settled potential violations of the HIPAAA Privacy and Security Rules with HHS for $1,215,780. Affinity failed to incorporate the electronic PHI stored in the copiers' hard drives in its analysis of risks as required by the Security Rule and failed to implement policies and procedures when returning the hard drives to its leasing agents. 

Make sure your information security plans cover digital copiers. Use all of the copiers' security features and securely overwrite the entire hard drive at least once a month. Plan now for how you will dispose of the copier securely. Click here for more information.

Code-A-Thon: Professional Coder Volunteer Sign-Up and Survey

NJHA and the NJ DOBI have been hosting stakeholder ICD-10 planning meetings to help the industry prepare. From this group, a plan has been created to conduct a Code-A-Thon to provide them with valuable information prior to go-live. Coders who have been trained in ICD-10 are urged to help by volunteering and participating in a survey. Click here for more details.

Are you Ready for ICD-10?

A study of 20,000 physician notes was released by the American Academy of Professional Coders (AAPC). Coders and practice managers are showing great concern that their physicians' documentation will not support the new code set. Accurate coding and proper payment will not be possible without improved clinical documentation. The following are steps to prepare your doctor:

1. Share the results of the AAPC's 20,000-record study
2. Show your physician an example of ICD-10 readiness documentation 
3. Ask them to consider ICD-10 Documentation Training.
4.  Watch the 2 minute video.

November 30 Deadline for Hospitals to Attest to Receive Payment for 2013 EHR Incentive Program

Eligible hospitals and critical access hospitals (CAHs) have until November 30, 2013 to register and attest in fiscal year 2013 for the Medicare EHR Incentive Program. Hospitals must attest each year to receive an incentive and avoid a penalty, which will be applied beginning October 1, 2014 to Medicare eligible hospital that have not successfully demonstrated meaningful use. The penalty is determined by the hospital's reporting period in a prior year. Medicaid eligible hospitals should refer to their state deadlines for attestation. View more resources.

PQRS Reporting is Easier than you Think

The last day to submit to the PQRS data registry is February 28, 2014. There are four easy steps to submit your PQRS data.

1. Use your current data
2. Choose one Measures Group relevant to your practice
3. Enter data for 20 patients
4. Receive your incentive payment and avoid penalties. More information. 

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
• GE Healthcare's whitepaper "ICD-10: A Dose of Reality, a Plan for Success"

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

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.