Save the Date:

NJPA Annual Meeting

Saturday, March 29, 2014 at the NJHA Conference and Event Center in Princeton

Register online.

View February's Coding Tip of the Month on the Use of P Codes

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.

Brach Eichler LLC, in conjunction with New Jersey Monthly, will host a free seminar on "The Private Practice of Medicine in an Obamacare World: Strategic Approaches" on Thursday, March 6, 2014 from 12:00 P.M. to 1:30 P.M. at the offices of Brach Eichler LLC, 101 Eisenhower Parkway, 2nd Floor, Roseland, NJ 07068. Learn how the Health Insurance Exchange impacts your practice. Lunch will be served. RSVP to Lauren Lynch by February 24, 2014 by e-mail or by phone at 973-364-8389.

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.

Urgent: Call Congress Today to Urge SGR Repeal on March 5

Long-awaited and hard-fought legislation to permanently repeal the fatally flawed sustainable growth rate (SGR) formula now is before both chambers of Congress with last week's introduction of the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/ S. 2000).

The three key congressional committees of jurisdiction came to this bipartisan, bicameral agreement in advance of the March 31 deadline to prevent Medicare cuts of 24.1 percent. The bill incorporates many AMA and MSNJ recommendations to reform the health care delivery and physician payment system and improve care for America's seniors.

Use the AMA's toll-free hotline to contact 

members of Congress before March 5! 

1-800-833-6354 

This legislation would provide physicians with positive annual payment updates of 0.5 percent for five years. It also includes medical liability protections and significant funding for resources and tools to help physicians in small practices transition to new payment and delivery models.

Please join your colleagues in maintaining pressure on Congress to act on this vitally important legislation before time runs out.  Join the national call to action day on Wednesday, March 5.  

•  Read the FAQ 
• Visit fixmedicarenow.org
• View the AMA's bill comparison chart  

Legislative Update

NJ Fiscal Year 2015 Budget

Governor Christie gave his budget address this week. He expressed his goal to fund and improve Medicaid. First, he is calling on Rutgers, including Rutgers Biomedical and Health Sciences, University Hospital and Rutgers-Camden to partner with stakeholders, including the Medicaid managed care organizations, to evaluate the state's health care delivery system in Medicaid and FamilyCare. Rutgers is already working on reforms, including a $14 million grant from CMS to study strategies for "super-utilizers" to decrease costs and improve care quality. MSNJ is already reaching out to and working with Medicaid, the managed care organizations and other stakeholders on Medicaid reform and is excited to engage in this process. Our Policy and Strategy Panel on Medicaid this week had a large turn out and was a successful coalition discussion on next steps. Read MSNJ's white paper on Medicaid reform. Regarding funding, proposed funding for children in FamilyCare is increased by $21 million to over $143 million, and will support coverage for over 194,000 children.

The Governor also proposes to reduce charity care funding by $25 million, stating that Hospitals will receive $650 million in Charity Care payments in fiscal year 2015. In recent years, New Jersey has seen an overall decline in documented Charity Care cases. MSNJ will advocate for a corresponding reduction in the ambulatory care facility tax which funds charity care.

Both houses passed a bill that permits adoptees and certain others to obtain adoptee's original birth certificate and other related information. As previously reported, MSNJ supports this bill because it increase access to medical information. The bill passed both houses on the same day this week, with a tough 44-27 vote in the Assembly. The bill heads to the Governor's desk.

Involuntary Outpatient Treatment

The Assembly Human Services Committee approved a bill this week that permits court to order involuntary outpatient treatment in any county; concerns patient compliance with taking medication.  MSNJ and NJPA support IOC and this bill. NJPA's support letter and statement on IOC can be found here.

Graduate Medical Education (GME) funding is flat at $100 million. A new distribution methodology reflecting the successful shift to managed care continues in this budget; it rewards administrative efficiency by using median data on GME program costs rather than individual hospital costs.

U.S. DOT FMCSA Certified Medical Examiner Training 

The National Registry of Certified Medical Examiners (National Registry) is a new Federal Motor Carrier Safety Administration (FMCSA) program. It requires all medical examiners* who wish to perform physical examinations for interstate commercial motor vehicle (CMV) drivers take this training and be certified in FMCSA physical qualification standards. Medical examiners who complete the training and successfully passed the test are included in an online directory on the National Registry website.  CMV drivers must have their required physical examinations performed by a Certified ME starting May 21, 2014.

This live activity is approved for AMA PRA Category 1 Credit™.

As a courtesy, NJOAPS is providing MSNJ members a $100 discount-off the registration fee  - MSNJ members pay the same as NJOAPS members!  MSNJ members, please click to obtain your promotional discount code and link to continue to further info and registration.

Non-MSNJ members and others interested attending this training, please click for further information and registration.

Note: This training is taking place as part of the  Annual Regional Osteopathic Conference (AROC).

*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.

ICD-10 Implementation Delay Sought

From the American Medical Association

Citing new cost estimates that could reach nearly triple those of previous projections, the AMA on Wednesday issued a letter calling on U.S. Department of Health and Human Services Secretary Kathleen Sebelius to reconsider the mandated adoption of the new code set, currently scheduled for Oct. 1.

"Physicians are being asked to assume this burdensome requirement at the same time they are being required to adopt new technology, re-engineer workflow and reform the way they deliver care; all of which are interfering with their ability to care for patients and make investments to improve quality," the letter states.

The letter underscores that ICD-10 implementation will be "financially disastrous for physicians," pointing to an AMA study released Wednesday. The costs for a small physician practice could be more than $225,000, while a typical large physician practice could expect to spend as much as $8 million on implementation.

Register: CMS ICD-10 Testing Week 

To help you prepare for the ICD-10 transition, CMS announced a national testing week for providers and clearinghouses from March 3 through March 7, 2014. The deadline to register for testing is February 28, 2014. The testing week will give trading partners access to the MACs and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. This event will be conducted virtually. Registration is required. Complete the registration form. More information. Read the FAQ. Read the MLN Matters article on CMS' ICD-10 Testing Approach. 

PSP Medicaid Event

On Thursday night, 75 guests consisting of physicians, policy makers, insurers, specialty groups and other stakeholders attended the policy event, Medicaid: Improving Access to Care in a Post-ACA Era. We want to thank our speakers:

• Mark Humowiecki, Esq., General Counsel at the Camden Coalition of Healthcare Providers, which is providing innovative medical care in an ACO model
• View the presentation
• Poonam Alaigh, MD Alaigh Care and Former Commissioner of the NJ Department of Health, who provided New Jersey statistics and recommendations for improvements
• Brian Murray, COO of Amerigroup, which provides Medicaid coverage in NJ and supports increased physician payments and decreased administrative burden and
• Phillip Gring, COO of TreCom System Group, who presented a fraud reduction idea using smart card technology
• View the presentation

  Read MSNJ's memo, 'Medicaid Reform Proposals for the FY 2015 Budget.'

Public Health Alert: New York City Measles Cases

The New Jersey Department of Health (NJDOH) Vaccine Preventable Disease Program would like to make healthcare workers aware that six cases of measles have occurred in Manhattan since February 5, 2014.

The New York City (NYC) Department of Health and Mental Hygiene has issued a Health Alert Network message. No cases have been hospitalized or died. NJDOH is aware of several New Jersey residents who have been exposed to the NYC measles cases and is working with the involved local health departments within NJ to manage the exposures. Read more on the NJDOH website.

Are you an Attractive Target for Merger/Acquisition/Employment?  

Are You the Subject of a Payer Audit?

Physicians, who are the subject of a payer audit, should check their professional liability policies for two reasons: there may be a reporting requirement; and your policy may provide some defense. Even if you are not the subject of an audit, you should review the terms of your policy and consider whether to obtain supplemental audit insurance. MSNJ has provided a variety of resources for our members on how to respond to audits. We are currently half way through a webinar series which included an introduction on the top legal issues, followed by separate webinars with speakers from each of the major payers. There is still time to register for the Cigna webinar on February 26 and the Aetna webinar on February 27. Both run from 12:00pm to 1:00 pm and registration is $25 for MSNJ members. The archived version of our opening audit webinar on the "Top Ten Tips for Physicians Facing RAC and Private Payer Audits" can be purchased on our website. The series will end with a presentation on audit insurance products (more information to come). 

Ezekiel Emanuel, Architect of ACA Healthcare Reform, to Speak on March 6

This event will take place at Philadelphia's National Constitution Center at 525 Arch Street on Thursday, March 6, 2014 at 6:30 P.M. Admission is free but reservations are recommended. Emanuel will offer his reasoning as to why health care in America has become such a divisive social issue what why reform has troubled U.S. presidents like FDR, JFK, and Nixon for more than 100 years. He offers predictions on how the Affordable Care Act will affect health care in the future, laying out the likely areas where further reform will be necessary. A book sale and signing will follow the program.

Resolutions

In preparation for MSNJ's House of Delegates meeting on May 2, all resolutions are due from the counties by March 14. The Reference Committee Hearing will meet via webinar on April 8 from 6:00 P.M.-9:00 P.M. Please review the resolution guidelines and the sample form.

PQRS Reporting: DEADLINE TODAY!

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. 

Revised Fact Sheet on Medicare Coverage of Items and Services Furnished to Beneficiaries in Custody

CMS has revised its fact sheet on "Medicare Coverage of Items and Services Furnished to Beneficiaries in Custody under a Penal Authority." This fact sheet provides information on Medicare's policy to generally not pay for medical items and services furnished to beneficiaries who are incarcerated or in custody at the time the items and services are furnished. Read the fact sheet. 

Medicare Will Not Accept Claims with ICD-9 Codes After October 1

Medicare will no longer accept ICD-9 codes on claims with dates of service on or after October 1, 2014. Institutional claims, and professional and supplier claims containing ICD-9 codes for services on or after October 1, 2014, will be Returned to Provider (RTP) as unprocessable. You will be required to re-submit these claims with the appropriate ICD-10 code. ICD-10 diagnosis codes have different rules regarding specificity and providers/suppliers are required to submit the most specific diagnosis codes based upon the information that is available at the time. Read more.  

HIPAA Guidance on Sharing Information on Mental Health

The Department of Health and Human Services (HHS) has developed a new guidance document on how the HIPAA Privacy Rule works to protect privacy rights with respect to mental health information. This guidance document covers some of the more frequently asked questions about when it is appropriate under the Privacy Rule for a health care provider to share the protected health information of a patient who is being treated for a mental health condition.  The HHS Office for Civil Rights clarifies when HIPAA permits health care providers to: communicate with a patient's family members, friends, or others involved in the patient's care, depending on whether the patient is an adult or a minor; and considers the patient's capacity to agree or object to the sharing of their information.  The document also clarifies how providers may communicate with family members, law enforcement, or others when the patient presents a serious and imminent threat of harm to themselves or others. View the guidance document and HIPAA FAQs.

Novitas to Launch Novitashere Portal

Novitas will be launching the Novitasphere Portal that will offer the ability for providers to perform eligibility and claim inquiries, retrieve Remittance Advices, perform claim submissions and initiate clerical error reopenings. Claims can be submitted through the Novitasphere portal as an alternative to using dial-up or Secure File transfer Protocol (SFTP). Novitas asks for your participation by taking a survey to allow them to understand the features you would be interested in using. Take the survey!

Four Part Series: E&M Score Sheet

Beginning on March 6, Novitas Solutions will host a four part series on Evaluation and Management Score Sheet. This four part series was developed to increase your understanding of evaluation and management services. The series will consist of the following:

• March 6 at 11:00 A.M.-Part 1: "Understanding the Key Components of E&M Services" Register.
• March 13 at 11:00 A.M.-Part 2: "Introduction to the Score Sheet" Register.
• March 20 at 11:00 A.M.-Part 3: "Using the Score Sheet" Register. 
• March 27 at 11:00 A.M.-Part 4: "Scoring Medical Records Using the Score Sheet" Register. 

New Standards Can Help Physicians Streamline Payment

eHealth Interactive Timeline Tool

There are many important milestones approaching in 2014. CMS has released a new eHealth Interactive Timeline Tool to help prepare for program deadlines by providing resources and key program dates for 2014-2017 including the Medicare and Medicaid EHR Incentive Program, Quality Measurement, Administrative Simplification Operating Rules, and Patient Outcomes and Payment Reform. View the tool.

2013 Open Payments Program Year Registration and Data Submission

On February 18, Open Payments registration and data submission for applicable manufacturers and applicable GPOs will open with a two-phased approach for this first reporting year of this new program. Phase 1 will begin February 18 through March 31 and includes user registration in CMS' Enterprise Portal and submission of corporate profile information and aggregate 2013 payment data. Phase 2 will begin in May 2014 and extends for no fewer than 30 days. This phase includes industry registration in the Open Payments system, submission of detailed 2013 payment data, and legal attestation to the accuracy of the data. Both phases of data submission will be complete by August 1, and at that time healthcare providers and manufacturers will have an opportunity to review and correct inaccuracies. No action is needed from covered recipients at this time. Click for Phase 1 instructions.

Medicare EHR Attestation Deadline Extended to March 31

CMS has extended the deadline for eligible professionals (EPs) to attest to meaningful use for the 2013 reporting year for the Medicare EHR Incentive Program from February 28, 2014 to March 31, 2014. This delay will allow more time for EPs to submit their data and receive an incentive payment for the 2013 program year. Please note: This does not impact the deadlines for the Medicaid EHR Incentive Program or any other CMS program including the electronic submission for the PQRS EHR Incentive Program Pilot .

The following are helpful tips that will help to make the process easier:

• Ensure that your payment assignment and other relevant information is up to date in the Medicare payment system PECOS;
• Make sure to include a valid email address in your EHR program registration;
• Consider logging on to use the attestation system during non-peak hours such as evenings and weekends;
• Log on to the registration and attestation system now and ensure that your information is up to date and begin entering your 2013 data;
• If you experience attestation problems, call the EHR Incentive Program Help Desk and report the problem;
• If your organization has more than 1,000 providers assigned to a proxy user, use the PECOS system to designate additional proxies to facilitate attestation.

Register: CMS ICD-10 Testing Week

To help you prepare for the ICD-10 transition, CMS announced a national testing week for providers and clearinghouses from March 3 through March 7, 2014. The testing week will give trading partners access to the MACs and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. This event will be conducted virtually. Registration is required. Complete the registration form. More information. Read the FAQ. 

2014 PQRS Participation and Program Changes

CMS has released a new fact sheet for eligible professionals (EP) and group practices participating in the 2014 PQRS reporting year that highlights program changes. Some 2014 program and reporting changes include:

• An EP or group practice participating in the GPRO must successfully report 2014 PQRS quality measures to avoid a 2 percent penalty in 2016.
• CMS added 37 new individual quality measures for the 2014 program year and voided 45 measures from 2013.
• EPs must report on 9 measures across 3 National Quality Strategy (NQS) domains via claims, qualified registry, and EHR-based reporting methods.
• Group practices of 25 or more eligible professionals now have the option to report PQRS data through the certified survey vendor reporting method.
• EPs and group practices can no longer use the administrative claims-based reporting method to avoid a 2016 payment adjustment.

ONC & OCR Digital Privacy Notice Challenge

The Office of the National Coordinator (ONC) and the Office for Civil Rights (OCR) are launching the Digital Privacy Notice Challenge which is a call for designers, developers, and patient privacy experts to create and submit a user-friendly online/digital notice of privacy practices.  This submission must be based off the model paper notices for content and format, and must be legible by patients and easily integrated into websites. The submission period is open from now until April 7, 2014. A review panel will determine the winning entries in May. The first place winner will receive a $15,000 award. View more details.  

Winning entries must demonstrate:

• Accurate use of content from paper Notices of Privacy Practices (NPP);
• Use of best practices in presenting Web content for public consumption;
• Visual appeal; and
• Capacity for entity to customize content and link to other relevant content.

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