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Medical Society of New Jersey e-Newsletter
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Final Audit Series Webinar
Webinar: Cyber and Regulatory Insurance: Are you Covered?
Wednesday, April 9, 2014 from 12:00 P.M. to 1:00 P.M.
Join MSNJ for a webinar on "Cyber and Regulatory Insurance: Are you Covered?" Bollinger Gallagher will explain what these coverages are; who needs to be covered; when the policy is triggered; which carriers have these coverages built into their policies; the limits of these coverages; when the policyholder should buy higher limits from the carrier; and steps to follow when an insured believes they are going to be audited or named in a suit.
This event is $25 for MSNJ members, $50 for PAHCOM & NJMGMA members, and $100 for non-members
Register
More information
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Webinar: MSNJ's MPMS Presents: Common Modifier Q&A
Wednesday, April 30, 2014 from 12:00 P.M. to 1:00 P.M.
Our speaker will go over common modifiers, how they are used, and answer questions. Please submit your questions to info@msnj.org with "Modifier Webinar" in the subject line and we will do our best to address them during the webinar.
This event is $25 for MSNJ members, $50 for PAHCOM & NJMGMA members, and $100 for non-members
Register
More information
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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.
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Diversity & Equity in Mental Health: A Special Cooper Psychiatry Grand Rounds Program
April 26, 2014 from 8:00 A.M to 12:30 P.M. at Cooper Medical School of Rowan University
Register
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The MDSuccess Spring Event: Building the Patient Driven Practice
May 1, 2014 at 8:00 A.M. at the Wyndham, Mount Laurel, NJ. More information.
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8th ANNUAL AMERICAN CONFERENCE
FOR THE TREATMENT OF HIV (ACTHIV)
May 8 - 10, 2014
Sheraton Downtown Hotel
Denver, Colorado
Registration Now Open!
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Symposium on Tick-Borne Diseases
Saturday, May 17, 2014
Hyatt Regency Chesapeake Bay, Cambridge, Maryland
Join the Lyme Disease Association of Eastern Shore Maryland for a one-day medical conference designed to provide the most current information about the research, diagnosis, treatment and management of Lyme and other tick-borne diseases. More information.
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View April's Coding Tip of the Month for more information on the Use of O 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.
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Registration now open
May 2, 2014
East Brunswick Hilton Registration now available!Don't miss the keynote presentation by  The Honorable Chris Christie,
Governor of the State of New Jersey!
May 10, 2014
Inaugural Gala honoring Paul Carniol, MD, FACS, MSNJ's 222nd President
Parsippany Hilton
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News
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2014 Reference Committee Hearing Webinar
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Congress Fails to Repeal SGR; Postpones 24% Payment Cut for a Year
This week, the House and the Senate voted in favor of the "Protecting Access to Medicare Act of 2014." The legislation stops the payment cut of 24% that would have occurred on April 1. The House passed the legislation by a voice vote on March 27. The Senate passed its identical version of the House bill on March 31 by a vote of 64 to 35. MSNJ, AMA, and virtually all of organized medicine opposed this bill because it failed to repeal the flawed SGR payment formula that will continue to result in annual payment cuts. Over the past year, bipartisan, bicameral policy was developed that would have eliminated the SGR and replaced it with a Medicare payment reform. Congress failed to seize this historic opportunity. Key terms of the legislation follow:
- Extends the 0.5% payment update through the end of 2014.
- Provides a freeze between January 1, 2015 and March 2015
- Delays implementation of ICD-10 for at least one year through October 1, 2015.
Read a summary of the bill.
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CMS to Provide Unprecedented Access to Physicians' Data
On Wednesday, April 2, CMS announced its plan to provide unprecedented access to individual physician's Medicare Part B data for services delivered in 2012. The information would include the number and type of healthcare services, the average submitted charges and the average amount Medicare paid for the services, and the site of the service. The information will be released no sooner than April 9. This announcement follows on the heels of a January announcement of CMS's new policy that would allow CMS to release physician data that is the subject of a FOIA request on a case-by-case basis. According to CMS physicians' privacy interests are outweighed by the public interest in the information that may assist the public's understanding of Medicare fraud, waste, and abuse. AMA's immediate response to the announcement charges that the broad release of physician payment data could be misleading to the public, result in harmful treatment decisions, and bias against physicians that could destroy careers. In addition, it points out that there will be no opportunity for physicians to review and correct any inaccurate data prior to the release. AMA is seeking safeguards to ensure that the data is accurate and reliable and that there is an understanding of the limitations of the analysis and methodology used to compile the data.
MSNJ is concerned about the scope of the planned data release as well as the underlying rationale. We will work with the AMA to obtain safeguards against the release of inaccurate or misleading information that could result in harm to physician patient relationships, patient treatment decisions, as well as harm to physicians' careers.
Read the letter to the AMA from CMS announcing this new policy.
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Click here to read the Summary of the Board of Trustees Meeting from March 16, 2014.
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Doctor's Day 2014
Governor Christie has filed a resolution passed by both houses of the Legislature institutionalizing an annual commemoration of Doctors Day in New Jersey. We are thrilled and thankful that the Administration and Legislature recognize the important contributions that physicians make. The Governor has also signed a proclamation commemorating Doctors' Day 2014.
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Patient Information
The Senate has passed a bill that requires health insurance carriers, when compiling or maintaining computerized records that include personal information, to secure the information by encryption or by any other method or technology rendering it unreadable, undecipherable, or otherwise unusable by an unauthorized person. As defined in the bill, "personal information" means an individual's first name or first initial and last name linked with any one or more of the following data elements: (1) Social Security number; (2) driver's license number or State identification card number; (3) address; or (4) identifiable health information. MSNJ strongly supports this bill. Recently, patient information was compromised by Horizon.
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Physician Identity Theft Tax Return Scam
The Indiana State Medical Association (ISMA) has warned its state medical society colleagues about an IRS tax scam that has been directed at physicians. The scam involves individuals filing fraudulent federal income tax returns using physician names, addresses and Social Security numbers. The majority of affected physicians are first becoming aware of this when they receive a 5071C letter from the IRS alerting them of possible fraud. Other physicians are receiving a rejection notification, indicating a return has already been filed, when they attempt to electronically file their taxes. If you believe you are a victim of tax fraud, it is important to act quickly. Read ISMA's Special Alert for more information.
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Security Risk Assessment Tool
The Office of the National Coordinator (ONC) has released a tool that can help you understand the HIPAA Security Rule and can help make your security risk assessment easier. This tool shows each HIPAA standard that must be addressed and provides space for you to document how you meet or plan to meet the current standard.
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Revisions were made to the New Jersey Practitioner Orders for Life-Sustaining Treatment (POLST) form. The POLST form now includes revised language in Section E to improve clarity. A line has also been added in Section F to allow for the practitioner's license number. Facilities should be using the new form, however both forms will be honored. View the POLST FAQs.
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Hold on Medicare Claims until April 14
CMS asked that Medicare Administrative Contractors (MACs) hold claims from April 1, 2014 through April 14, 2014, while waiting for Congress to prevent the fee cut. This only affects claims with dates of service of April 1, 2014 and later. All claims for services delivered on or before March 31, 2014 will be processed and paid under normal procedures. Read more.
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Practices Must Start Using the New CMS 1500 Claim Form by April 1
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. Medicare will only accept the revised version of the form starting April 1, 2014, as will many other payors. Use the free AMA resource to walk you through the form changes. Read more.
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Penalty Information for Medicare Eligible Professionals
Eligible Professionals (EPs) participating in the Medicare EHR Incentive Program may be subject to penalties beginning on January 1, 2015. The penalty is based on meaningful use data submitted prior to the 2015 calendar year. EPs must demonstrate meaningful use prior to 2015 to avoid the penalties.
The following will determine how your participation start year will affect the 2015 penalties:
- 2011 or 2012: If you first demonstrated meaningful use in 2011 or 2012, you must demonstrate meaningful use for a full year in 2013 to avoid the payment adjustment in 2015.
- 2013: If you first demonstrated meaningful use last year, you needed to demonstrate meaningful use for a 90-day reporting period to avoid the payment adjustment in 2015.
- Plan to begin in 2014: If you first demonstrate meaningful use in 2014, you must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid the payment adjustment in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and eligible professionals must attest to meaningful use no later than October 1, 2014, to avoid the payment adjustment.
To avoid penalties in the future you must continue to demonstrate meaningful use every year. If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you must demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid. If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these penalties.
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Meaningful Use Hardship Exception Available
CMS announced that there will be an additional hardship exception available to physicians to avoid the penalty under the EHR Meaningful Use Incentive Program. This additional exception applies to those who have not received or were unable to implement updated 2014 certified software. Some physicians, such as those new to Medicare or those in certain specialties, are exempt from the penalty and do not need to apply for a hardship in 2014. Below is a list of the hardship exemptions that are now available.
- Infrastructure: Eligible professionals must demonstrate that they are in an area without sufficient internet access or face insurmountable barriers to obtaining infrastructure (e.g., lack of broadband).
- New eligible professionals: Newly practicing eligible professionals who would not have had time to become meaningful users can apply for a 2-year limited exception to payment adjustments. Thus eligible professionals who begin practice in calendar year 2015 would receive an exception to the penalties in 2015 and 2016, but would have to begin demonstrating meaningful use in calendar year 2016 to avoid payment adjustments in 2017.
- Unforeseen circumstances: Examples may include a natural disaster or other unforeseeable barrier.
- Patient interaction:
- Lack of face-to-face or telemedicine interaction with patient
- Lack of follow-up need with patients
- Practice at multiple locations: Lack of control over availability of CEHRT for more than 50 percent of patient encounters
- 2014 EHR vendor issues: The eligible professional's EHR vendor was unable to obtain 2014 certification or the eligible professional was unable to implement meaningful use due to 2014 EHR certification delays.
The hardship application and information on the exceptions are available.
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CMS Open Payments Webinar
CMS will host an Open Payments Webinar on Tuesday, April 15, 2014 from 1:00 P.M. to 2:00 P.M. This webinar will provide an overview of the final rule, information on your role in the program, resources available to you as a health care provider, and key program dates.
Webinar link: https://webinar.cms.hhs.gov/openpaymentsro1-4/
Telephone dial-in number: (877) 267-1577
Meeting ID number: 997 848 185
This meeting does not require a password.
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Improper Medicare Payments Identified for Psychiatry and Psychotherapy Services
Many improper payments have been identified by the CERT program's review of claims for Part B Psychiatry and Psychotherapy Services. This is likely the result of the big changes to psychiatry billing in 2013. The main error found is the failure to document the time spent on the E&M service separately from the time spent on the add-on psychotherapy service. When a beneficiary receives an E&M service with a psychotherapeutic service on the same day, by the same provider, both services are payable if they are significantly and separately identifiable and billed using the correct codes. New add-on codes designate psychotherapeutic services performed with E&M codes. Read more.
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Avoid the 2016 PQRS Penalty
Eligible professionals and group practices that fail to successfully report data on quality measures during 2014 will be subject to a two percent reduction on Medicare Fee Schedule amounts for services furnished by the eligible professional or group practice between January 1, 2016 and December 31, 2016.
To avoid the 2016 penalty, eligible professionals must meet one of the following criteria during the 2014 reporting period:
Individual Eligible Professional:
- Meets the criteria for satisfactory reporting adopted for the 2014 PQRS incentive, which are identified in the 2014 Medicare PFS Final Rule and in PQRS educational materials available on the PQRS website. Meeting the criteria will also ensure a PQRS incentive payment equal to 0.5 percent of estimated Medicare Part B allowed charges for covered professional services in 2014.
Or
- Participates in PQRS via qualified clinical data registry, qualified registry, or claims reporting and reports at least three measures covering one National Quality Strategy domain for at least 50 percent of the eligible professional's Medicare Part B FFS patients.
Group Practice:
- Meets the Group Practice Reporting Option (GPRO) requirements for satisfactory reporting (which are similar to the criteria for satisfactory reporting for the 2014 PQRS incentive), as identified in the 2014 Medicare PFS Final Rule and in PQRS educational materials available on the PQRS website.
Or
- Participates in PQRS via qualified registry reporting and reports at least three measures covering one NQS domain for at least 50 percent of the group practice's Medicare Part B FFS patients.
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ICD-10 Delayed
Legislation was recently passed that prevents the DHS from implementing the new ICD-10 code set before October 1, 2015. Read AMA's article. See below for some helpful ICD-10 resources and toolkits to help you prepare.
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CMS ICD-10 Resource for Small Practices: Road to 10
CMS released the Road to 10, a free online resource that is intended to help small medical practices jumpstart their ICD-10 transition. The Road to 10 allows providers to build ICD-10 action plans tailored for their practice needs. The customized action plans are broken down into the following steps:
- Plan your Journey - Look at the codes you use, prepare a budget, and build a team
- Train your Team - Find options and resources to help your team get ready for the transition
- Update your Processes - Check your clinical documentation and update policies, procedures, systems, and forms
- Engage your Partners - Talk to your software vendors, clearinghouses and billing services
- Test your Systems and Processes - Test within your practice and with your partners.
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CMS' eHealth University ICD-10 Resources
CMS launched eHealth University as a resource to the healthcare community to successfully participate in CMS eHealth programs. Use the following educational modules to help you prepare for the 2015 ICD-10 compliance deadline:
Intermediate and advanced resources are also available on the eHealth University website.
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Corporate Partners
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MD On-line Inc. - Bronze Level Partner
Contact: Nick Dannenbaum
Address: MD On-Line, Inc., 6 Century Drive, Parsippany, NJ 07054
Phone: 888-499-5465
Fax: 973-734-9910
E-mail: nick@mdon-line.com
Website
 MD On-Line, Inc. (MDOL) is a proven industry-leading provider of electronic healthcare solutions that leverage data to improve provider workflow and industry connectivity. Co-branded and endorsed by more than 40 major insurance companies and increasing its presence in providers' offices of all sizes, MDOL is working to make the healthcare system significantly more cost-effective by eradicating inefficiencies. Its "all-payer" core EDI solutions encompass a network of over 2,200 payer organizations and are used by tens of thousands of healthcare providers nationwide. Additional MDOL offerings include fully integrated PMS and EMR systems, clinical data feeds, patient reminders, and gaps-in-care identification.
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Shiriak and Timins - Bronze Level Partner
Contact: Arthur J. Timins, Esq Address: 101 Gibraltar Drive, Suite 1E1, Morris Plains, NJ 07950
Phone: 973.740.1771
E-mail: atimins@timinsesq.com Website
Shiriak and Timins routinely handles business-related litigation, arbitration, and administrative hearings, with a focus on health-care law and employment law, as well as matters before the State Board of Medical Examiners.
Arthur J. Timins, Esq. is a member of the American Society of Medical Association Counsel and has represented many practitioners as well as multiple medical staffs at area hospitals. Arthur J. Timins, Esq. is also a member of the End of Life Task Force of the New Jersey State Bar Association. And, he is a member of the Board of Directors of the Institute of Medicine and Public Health (IOMPH).
With over 65 years of combined legal experience, Shiriak and Timins have had the opportunity to represent professionals in a variety of settings. Assignments are handled personally by the partners and not delegated, and approached aggressively and responsively, while we remain sensitive to the billing concerns of our clients.
In 1997 Arthur J. Timins, Esq. was selected as a charter member of MSNJ's Legal Consultant Network. In 1999 MSNJ had recognized Arthur J. Timins, Esq. to exclusively administer an Employment Law Program, providing a cost-effective benefit for its members.
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As an Affiliated QualCare Network Provider, your practice may be eligible for our "Health Services Safety Group" Read more.
MSNJ Magazine Subscription Service
Subscription Services, Inc., does their very best to get you the lowest rates. As a member, you are eligible for the very lowest prices on magazine subscriptions as well as personalized hands-on customer service. Click "Shop for Magazines" to place new subscriptions, renewals, as well as gift order subscriptions. You can also inquire about titles you may be interested in. If you ever have a question regarding your order or your account, please call 1-800-603-5602, or use the contact page to communicate with a customer service
representative. And if you ever find a lower authorized price, they will match it!
Don't Overpay for Payroll
Easy Online SurePayroll gives you incredible value on a small practice budget, so you can increase your bottom line and avoid overspending on payroll. And as a Featured Benefit for MSNJ members, you will save up to 50% compared to traditional payroll providers. Get a Free Quote today.
Member Resource Guide
Check out the current MSNJ Member Resource Guide! Inside, you will find a complete listing of partners by service/product category, along with contact information. Also, be sure to check out the individual Corporate Partner pages on our website as some offer additional discounts to members!
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.
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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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2014 � 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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