Webinar: Horizon Patient-Centered Advantage EPO Plans

Wednesday, July 16, 2014 from 12:00pm-1:00pm

Speaker: Kevin Jennings, Network Specialist, Horizon BCBSNJ 

This webinar will review Horizon's new product offerings for July 1, 2014. Horizon will review the key features, benefits, network, and reimbursement for the Horizon Patient-Centered Advantage EPO plans.  

This event is free for MSNJ members, $25 for PAHCOM & NJMGMA members, and $75 for non-members

Register 

More information  

• Both high-level and detailed information about key aspects of the Medicare program
• A half-day basic track for those who are new to Medicare or who want a refresher
• A "Current Topics" session to raise awareness of program changes
• An update on the new Health Insurance Marketplace
• Casework exercises
• Medicare training modules and workbooks
• Networking opportunities with CMS staff and other partners who share your commitment

Join the Surgery Center Coalition on September 16 for "A Day of Compliance", for ASCs.

Listen to presentations on:

• Infection Control Update;
• OSHA;
• NJ State/NHSN Reporting;
• HIPAA, Security and Privacy;
• And more! 

View the agenda.

Register.

Free PCSS-MAT Online Module - Patient-Centered Urine Drug Testing: Facts you should know!

New PCSS-O Archived Webinar: Non-Opioid Pharmacologic Management of Chronic Pain: A Primer.

This webinar will examine and compare non-opioid medications for pain management that may be used alone, as adjuncts to opioids, and/or in conjunction with non-pharmacologic modalities, to improve the life and function of the chronic pain patient. Watch now! View the presentation slides.

View July's Coding Tip of the Month for information on the use of L codes for diseases of the skin and subcutaneous tissue in ICD-10.  

MSNJ and New Jersey Dental Association (NJDA) proudly announce a joint effort to offer discounts to all of our members on prescription blanks. Participating vendors include:

POS® is a full-service print and electronic communication company that helps healthcare practices create and improve patient communication tools. POS® is your patient communication partner for everything from branded practice and patient education printed materials to patient statement processing and automated messaging services. Take advantage of our special offer available to members-

SPECIAL MSNJ/DSNJ RATE:

• 5 PADS/500 sheets= $66.60
• 10 PADS/1000 sheets= $78.00
• 20 PADS/2000 sheets= $117.45
• 40 PADS/4000 sheets=$172.80

For higher quantities please contact POS®.

Laser RX Sheets for printers also Available!

• 1000 laser RX sheets= $156.75
• 2000 laser RX sheets= $255.00
• 4000 laser RX sheets= $453.00

Nelson Press has been a manufacturer of quality printed materials for New Jersey Business since 1900. They were recently approved to print and sell the revised New Jersey Prescription Blanks for physicians. Special member pricing includes:

• 400 - Single Prescriptions - $60.00
  (Including Tax & Shipping)
• 800 - Single Prescriptions - $80.00
  (Including Tax & Shipping)
• 1200 - Single Prescriptions - $100.00
  (Including Tax & Shipping)

 
American Express Global Corporate Payments, in collaboration with Essesna/Innovatix Purchasing Group, is introducing a new offering on their Purchasing Card program.

For qualifying members, benefits Include:

• Cash back on all spending starting from dollar one.  
• 100% company liability. No personal guaranties.
• No Card fees. No annual fees.
• No Fee Access to the Essesna buying group, offering deep discounts with over 2,000 vendors.
• A suite of payment solutions that can help automate vendor payment and AP reconciliation processes.

View the flyer. Click here to access the discount.

Now available to MSNJ Members: A Workers' Compensation "Health Services" Safety Group. This unique Workers' Compensation program guarantees up to a 20% up-front discount, the maximum allowable by law in New Jersey, and a back-end dividend of up to 40%.

For more information, view the flyer.

The Prudential Center is proud to offer MSNJ members a discount for their upcoming events. The following discounts are now available.

Member Discount! 

Take advantage of your in-store, Macy*s Business Smart Pass from June 15 through July 14, 2014. As an MSNJ Member, save 15% all day, as many times as you want. See Pass for further details. Save on designer brands, such as Calvin Klein, Lauren Ralph Lauren, Jones New York, DKNY, Michael Kors, Ann Klein, Polo Ralph Lauren, Tommy Hilfiger, etc. Download your pass today. 

Policy & Strategy Panel

Thursday, July 24, 2014 5:30 pm

At MSNJ Headquarters 

Topics Include:

• Learn how to protect your online reputation, with a presentation from a leading national website provider
• Share experiences of access to care issues for insured patients, including those with new exchange products as we join a new project to educate policy makers 

Be sure to check out MSNJ's new Prescription Drug Abuse webpage for current information and resources! 

Update on CME Requirement on End-of-Life Care

On July 9 the New Jersey Board of Medical Examiners (BME) released information on the end-of-life continuing medical education (CME) requirements that were enacted into law as part of the POLST (physicians orders for life-sustaining treatment) legislation. For the biennial renewal period which began on July 1, 2013, physicians are required to complete two credits in Category 1 courses on topics related to end-of-life care. Physicians, who believe that the statutory mandate has little applicability to their practice, may apply for a waiver from the requirement or for an extension of time. The applications for a waiver or extension must be filed by April 30, 2015 and, if granted, will apply to the current license cycle. Physicians may apply for a waiver in the following license cycle if the reasons for the waiver still exist. Read the BME's announcement for details on the waiver.  MSNJ will assist members to identify appropriate training or apply for waivers if appropriate. MSNJ will continue to discuss the CME requirement with BME and will comment on the implementing regulations once proposed. Please check with your hospitals, which are already offering courses to meet this requirement. MSNJ will begin offering courses soon.

MSNJ Urges Federal Appellate Court to Honor Assignment of Benefits in ERISA Plans

On July 7 MSNJ joined with the AMA to file a "friends of the court" brief with the 3d Circuit Court of Appeals in North Jersey Brain & Spine Center v. Aetna. At issue is whether the medical practice has standing to sue Aetna for payments that were assigned by patients with self-insured ERISA health plans.  Also at issue is whether any particular "magic words" must be part of the assignment language. While most federal district trial courts in New Jersey have found that physicians have derivative standing to pursue an ERISA claim for payment benefits, the lower court in this case did not. A ruling from the 3d Circuit Court of Appeals would settle the split of opinions and establish the rule in New Jersey.  All of the physicians in the North Jersey Brain & Spine Center are members of MSNJ. We appreciate the support of the AMA Litigation Center on this issue that is important to physicians in New Jersey and nationwide. 

CMS Issues Proposed 2015 Medicare Physician Payment Rule

On July 3 CMS issued its proposed rule to update Medicare payment rates and policies for services beginning on January 1, 2015. The proposal will be published in the Federal Register on July 11 and comments will be accepted until September 2. Adoption of the final rule is expected by November 1 with implementation on January 1, 2015.  Congress previously provided for a zero percent update for the period between January 1 and March 31, 2015 in an effort to allow time for a repeal of the SGR and comprehensive payment reform. 

Key provisions in the proposed rule include:

• Application of the Value-Based Modifier (VM) to all physicians beginning in 2017 based on 2015 quality and cost performance data, including up to a 4% penalty in 2017 for poor performance
• Increases in the number of PQRS measures to report in 2015 or be penalized in 2017
• Increases the number of quality measures for Medicare Shared Savings Program ACOs
• Removal of the CME exclusion from reporting under the Sunshine Act
• Addition of more physician quality information on the Physician Compare website in 2015
• Includes a separate payment for chronic care management if certain requirements are met
• Changes to the process and timelines for revising relative values

MSNJ staff is reviewing the proposal and will file comments. For details on the proposal read CMS fact sheets.

IHCAP Notice Requirement for Physician Offices

The New Jersey Department of Banking and Insurance (DOBI) recently adopted regulations requiring physician offices to post notice regarding patient rights under the Independent Health Care Appeals Program (IHCAP). MSNJ provided comments to DOBI on the proposed regulations requesting that the notice include language that clarifies that IHCAP may not apply to all patient plans. We thank DOBI for honoring our request. Note that IHCAP does not apply to most government-sponsored coverage, such as Medicare, the Federal Employee Health Benefits Program, the New Jersey State Health Benefits Program and self-funded plans according to DOBI.  The notice language may be downloaded from DOBI's website. The notice must be posted by August 3, 2014, include the specific content from DOBI's website, and be printed on at least 8 ½" by 11" paper with 12-point type or larger. Physicians may choose to print it on larger paper, in order to incorporate all the information on one sheet; in this case the text must also be at least 12-point type. MSNJ created a one page sample notice, for member use. Please feel free to download, print, and post this legal sized (8 ½" by 14") poster in your office.

Health Care Reform Update

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. One way to report is though clinical registries, for which CMS recently released the approved lists. Read more at AMA Wire™. Read more on how to avoid the penalty.

Attention Physicians: Please Help MSNJ Medical Student Member by Taking 5 Minute Obesity Survey

A rising second year medical student at the Rowan School of Osteopathic Medicine and MSNJ medical student member has asked for MSNJ's help in getting physicians to participate in a survey that is part of her  summer project for Rowan-SOM's Research Fellowship Program. The project will assess the topic of obesity management. Physicians of all specialties are encouraged to participate in the 5 minute survey.

Project Medicine Drop

Project Medicine Drop is intended to raise awareness of the prescription painkiller abuse problem in New Jersey and the proper disposal of these medications. Please post the appropriate county flyer in your office:

End-of-Life: "Consider the Conversation" to be Released on September 27

After twenty-one months in the making, award-winning independent filmmakers Michael Bernhagen and Terry Kaldhusdal have announced the release of their second film,

Consider the Conversation 2: Stories about Cure, Relief, and Comfort that will be made available to PBS stations nationwide on Saturday, September 27, 2014. Consider the Conversation 2 sheds light on the importance of the patient/doctor relationship and patient/doctor communication when living with severe chronic disease. The documentary also explores some of the unintended consequences of American medicine's success. Kaldhusdal talks about the goals for this film: "First, we want to demonstrate that communication is a skill on par with diagnosis, treatment, and prognosis-something that medical professionals can teach and learn. Second, we want to help patients, families and doctors understand that talking about end-of-life wishes well in advance can help prevent unnecessary suffering at end-of-life. And third, we hope to inspire end-of-life care that is more person-centered and less system-centered."

Attention Addiction Specialists: Please fill out the Survey Below to help us Improve Care

Help New Jersey Psychiatric Association's efforts to streamline prior authorizations, specifically Buprenorphine prescribing, by completing a survey for the next 10 or 15 patients for whom prior authorizations are needed. Submit to NJPA by July 15 via fax to 908-719-4747 or send to: NJPA, PO Box 428, Bedminster NJ 07921. Read NJPA's letter.

New AMA ICD-10 Practice Training Program

The AMA has developed a new on-site consultation program, "Train with AMA" to get your practice up to speed on the latest coding guidelines and information. Physicians and office staff can choose from one of the following three training programs:

• AMA Guides® Sixth Training
• CPT® Changes Workshop
• ICD-10-CM Workshop

Medicare Signature Requirements

MUEs and Bilateral Procedures

Fraud Prevention System Report

In June 2014, CMS released a report to Congress on the Fraud Prevention System.

This year's report introduces the new concept of adjusted savings. Read the report.

QualCare, Inc. - Platinum Level Partner   

Contact: Jenny Martinez
Address: 30 Knightsbridge Road, Piscataway, NJ 08854
Phone: 888.670.8135, option 6
E-mail:  mewasales@qualcareinc.com
Website 

QualCare, Inc., administers the MSNJ Affiliated Physicians and Employers - MEWA Health Plan, a multiple employer welfare arrangement (MEWA) which provides members with access to healthcare coverage options that might otherwise be too costly. Through this program, physicians may buy self-insured health plans at the equivalent of large-group rates.

 

QualCare, Inc. is New Jersey's largest, provider-sponsored Managed Care Organization that offers self-funded PPO, HMO network, point of service (POS) network, and open access health plans; third party administration (TPA) services, provider network access, wellness programs, care management services, and a workers' compensation product. QualCare also provides ACO consultative services and infrastructure.

 

Headquartered in Piscataway, New Jersey, QualCare services over 800,000 members and is owned by 16 non-profit hospitals and physician-hospital organizations, with a clientele that spans health systems, unions, local governments, school boards, and other commercial employers. QualCare's network covers over 100 acute, specialty and rehabilitation hospitals, as well as over 31,000 physicians and other ancillary providers across NJ, PA & NY.

Carroll McNulty & Kull LLC - Gold Level Partner 

 

Contact: Michael Moroney, Esq.; Catherine J. Flynn, Esq.
Address: 120 Mountain View Boulevard, Post Office Box 650, Basking Ridge, NJ 07920
Phone: 908.848.6300
Fax: 908.848.6310
E-mail:  mmoroney@cmk.com; cflynn@cmk.com
Website 

Health care is one of the most complex, fastest growing and heavily regulated industries, requiring specialized legal counseling and representation. At CMK, our health care attorneys dedicate their time to understanding our clients' business issues, while staying informed of the rapidly changing compliance and regulatory landscape. We provide state and federal regulatory advice, compliance counseling and health care litigation services to both institutional and individual clients. Our clients include academic and community hospitals, for-profit and not-for-profit health care systems, private practice physicians and physician organizations, nursing staffs, ambulatory care providers, nursing homes, home health care providers, professional medical societies and trade associations, medical staff organizations and allied health care providers.

 

CMK's health care attorneys have specialized health law litigation experience with specific concentrations enabling them to provide client focused legal services in professional liability defense, credentialing & licensure matters and fraud investigations. We develop and implement regulatory compliance programs required to keep our clients in line with federal and state mandates. CMK's health law attorneys are members of the American Health Lawyers Association (AHLA), a professional organization dedicated to serving the health care industry and its practitioners; they routinely present on various hot topics within the health care industry to clients, physician groups and medical societies.

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.