Repeal the SGR Formula in 2014: Take Action NOW!

Exclusive New Medical Professional Liability Insurance Program for Physician Groups

MSNJ is pleased to announce that one of its platinum sponsors, Arthur J. Gallagher, has negotiated a program that will give qualifying physician groups that are insured on a claims-made policy, extended reporting ("tail") coverage AT NO ADDITIONAL COST.

At last, a program now exists that allows physicians to switch to an occurrence-type policy and eliminate the worry associated with expensive tail coverage - AT NO ADDITIONAL COST.

MSNJ has made arrangements with an on-line resource (Education in Palliative and End-of-life Care) to satisfy the 2 credit end-of-life training requirement via long distance learning - and at a 15% discount to members. MSNJ members, please click here to obtain the promo code.

The following modules are thought to meet the requirements. Each module is designated for 1 AMA PRA Category 1 Credit™ (cost to MSNJ members about $25.50 per credit)

• Gaps and Elements of Care
• Legal Issues
• Whole Patient Assessment
• Physician Assisted Suicide
• Last Hours of Living
• Withholding/Withdrawing Treatment
• Medical Futility

Choose two that meet your needs! See related News story. 

The Center for Italian & Italian-American Culture, Inc. is hosting their 2014 Annual Gala on November 21 at 7:00pm at the Villa at Mountain Lakes. This year's hon­orees are Ken Rosata, Chan­nel 7 News Anchor (Man of the Year) and MSNJ member, Dr. Josephine Vin­cenza Jasper, a board cer­ti­fied endocri­nol­o­gist (Woman of the Year). Call The Center office at 973-571-1995 for more details.

NJ Chapter, American College of Surgeons 63rd Annual Clinical Symposium

Saturday, December 6, 2014 from 7:30am to 5:30pm at the Renaissance Woodbridge Hotel & Conference Center

Clinical Sessions include:  

Bariatric Surgery; Cardio-Thoracic Surgery; Colon & Rectal Surgery; Neurosurgery; Trauma Surgery; Plastic Surgery; Otolaryngology; Urologic Surgery; Vascular Surgery; Trauma Surgery; Global Surgery.

Special Sessions include:  

End of Life Care - POLST; 2014 ACS Update; Sheen Award Lecture; Resident Jeopardy/Resident Manuscript Awards

More information and registration. 

Arthur J. Gallagher & Co. - Platinum Level Partner  

Contact: Brian S. Kern, Esq., Area Executive Vice President
Address: 101 JFK Parkway, Short Hills, NJ 07078-5000
Phone: 973.921.8497; Mobile: 908.642.4454
Fax: 973.921.2876
E-mail: Brian_Kern@ajg.com
Website  

Arthur J. Gallagher & Co is a recognized leader in the professional liability market, and is the largest broker for medical professional liability insurance in NJ as well as the US.  With a narrow focus on medical malpractice insurance, Gallagher's Healthcare Practice works with many of the largest groups in the region and maintains its high standards of excellence with each and every practice it represents.

Gallagher has unsurpassed access and is the largest broker with virtually every major medical malpractice company in the country, thus enabling it to help ensure that every physician secures the best possible terms for the lowest possible price. With its dedicated involvement in many areas of healthcare, Gallagher is the resource for physicians choosing among types of coverage, different policy terms and options, as well as the various companies. Gallagher offers the depth and insight to help practices navigate the new world of healthcare and build a foundation to assume risk.  In fact, Gallagher is a nationally-recognized leader in alternative risk, having helped clients build numerous risk-sharing programs, including captives and risk retention groups.  With its deep resources, Gallagher helps clients understand every facet of the liability process - from historical trends, to present claims handling, to managing risk for the future.

Gallagher works closely with organized medicine in virtually every capacity. The agency is a consistently strong supporter of state, specialty and county societies, and always at the forefront on important issues that can benefit the practice of medicine. The Gallagher healthcare team has been involved on many matters related to tort reform, including the fight for caps on non-economic damages, a better-defined statute of limitations, and an improved system based on fault, not based on deep pockets, and not one that encourages plaintiffs to name as many defendants as possible.

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.

MSNJ Advocates for Network Adequacy Standards
MSNJ has banded with the AMA and other state and specialty societies in a letter to chairs on the National Association of Insurance Commissioners (NAIC) urging them to adopt meaningful standards on network adequacy as they develop a managed care plan network model act. Among the issues that must be addressed:

• Networks must include a full range or primary, specialty and subspecialty physicians for children and adults;
• Regulators must actively review and monitor all networks using appropriate quantitative and other measure standards;
• Tiered provider networks and formularies must be regulated to assure access without additional cost and administrative burden;
• Insurers must be transparent on provider selection standards; and
• Directories must be accurate, up to date, and easily accessible.

Affordable Care Act Updates

There is considerable consternation over a loop-hole in the ACA that may allow employers to provide plans that do not include in-patient hospitalization. This occurs based on the calculation of the "minimum value" by employer plans under the implementing regulations. The federal government plans to close this loop hole as soon as possible by proposing an amendment to the regulations that "a plan will not provide minimum value if it excludes substantial coverage for in-patient hospitalization services or physician services (or both)." Read the CMS Fact Sheet.   

Congressional News

New Jersey's congressional delegation is shining in this new term. Veteran Congressman Frank Pallone (District 6) won an intraparty election to serve as the ranking member of the Energy & Commerce Committee. Though he is the senior member, new rules allow for challenges and an election for ranking member.  The Health Committee is a subcommittee of the House Energy Committee, making Pallone a key member for health policy issues.  See press coverage here.  

Medisoft EMR Users: Tell Us about Your Experience

An MSNJ member recently reported issues with Medisoft's EMR product, especially with the eRx component. We are trying to ascertain the scope of this issue and are looking for member input. If you are currently using Medisoft/McKesson EMR products in your office, please let us know about your experience (good or bad) by emailing details to  info@msnj.org with "Medisoft EMR" in the subject line.

MSNJ's Mishael Azam named in political women power list for second year in a row. Read more. 

Surgical Practice Registration
The New Jersey Department of Health has published a final notice at 46 N.J.R. 2286(a) advising of a final registration period for surgical practices that are currently operating. Any surgical practice that did not previously register has 60 days from November 17 to do so. We have advised that the Department is concerned about procedures being performed in rooms of facilities where anesthesia is being used. The notice demonstrates this concern by indicating that the application should be documented with records that show the administration of conscious sedation or general anesthesia. Physicians who are administering conscious sedation or general anesthesia to perform procedures in their offices, and who do not know whether they fall within an exemption, should review the notice and consult with an attorney if they have questions. 

Brain Injury

The Assembly has passed A3453, which establishes a brain injury screening and education program in the Department of Children and Families (DCF). MSNJ is concerned about the cost of this bill, but will work with DCF if the bill is signed.

Protecting Patient Information

The Assembly has passed S562, which requires health insurance carriers to encrypt certain information. As previously reported, MSNJ supports this bill, which now heads to the Governor's desk.

Assisted Suicide

The Assembly passed, by one vote, a bill that would allow physician-assisted suicide in New Jersey. Under the bill, suicide, assisted suicide and euthanasia are still illegal. Please find our opposition letter here and a video of the opposition press conference here.   MSNJ will continue to oppose this legislation. Please find press coverage here. Join this petition! Gov. Chris Christie: Stop Assisted Suicide!  

This month is National Hospice and Palliative Care Month! There are 76 licensed hospice providers serving all 21 counties in New Jersey. MSNJ supports increased funding and availability of these options. Read the NJ DOH press release. 

Caregivers

The Governor has signed a bill that requires hospitals to provide patients and their legal guardians with opportunities to designate a caregiver to provide after-care assistance. The bill provides procedures for the caregiver designations and also allows a caregiver to be designated on an advanced directive, clarifying that caregivers are distinct from legally designated proxies for care instructions. Prior to a patient's discharge from a hospital, the hospital would be required to consult with the designated caregiver and issue a discharge plan that describes a patient's after-care assistance needs. This is an AARP initiative, but is also supported by the pharmaceutical industry. The NJ Hospital Association was involved in negotiating the bill with AARP.

Drug Abuse

This week Mishael Azam, COO & Senior Manager of Legislative Affairs, and Dr. Bruce Bonanno, a MSNJ member from Monmouth County, participated in a drug abuse roundtable discussion hosted by the Kean University Center for History, Politics and Policy.  As previously reported, MSNJ is working with legislators on bills to reduce drug addiction and diversion.  See more at www.msnj.org/drugabuse. See press coverage here. Video coverage can be found here.   

Health Insurance Marketplace and Medicare Open Enrollment

Open enrollment for 2015 health insurance coverage under the Affordable Care Act (ACA) began November 15 and runs through February 15, 2015. Some health plans purchased through the Marketplace will automatically renew, while others will not. Each insured will receive notice from the insurance company that states whether the plan will automatically renew for 2015 or the coverage will end effective December 31. 2014. Individuals with automatically renewing plans do not need to stay with their current plan and may choose a new one. Those with plans that do not automatically enroll must enroll in a plan by December 15, 2014 to obtain coverage beginning January 1, 2015. All individuals, including those whose plans are automatically renewed, must update their applications annually with any important changes.

2015 Medicare Participation

The 2015 open enrollment period for physicians runs November 14 through December 31, 2014. More information about the open enrollment period can be found on Novitas Solutions' webpage. View the Medicare Physician Fee Schedule fees for service rendered in calendar year 2015 here. View AMA's Medicare Participation Toolkit. Please note: AMA has not yet updated their Participation Toolkit, however the information still applies.

Medicaid Re-Enrollment Starting July 2015

The New Jersey Division of Medical Assistance and Health Services (DMAHS) reported that physicians will be asked to re-enroll in New Jersey Medicaid. Starting July 2015 through March 2016, DMAHS will begin the process of re-enrolling NJ Medicaid providers who were enrolled prior to January 1, 2013. Any provider that enrolled on or after January 1, 2013 or submitted a completed enrollment packet for re-activation of their provider number on or after January 1, 2013 will not be required to re-enroll. Read more. Visit the NJMMIS website for more information. 

ICD-10: Less than One-Year Away

October 1, 2015 is the deadline to transition to the ICD-10 code set. MSNJ encourages all physicians to begin preparing for implementation by working with software vendors and testing their systems. View resources on MSNJ's website.  

NJ DOBI Standard ICD-10 Readiness Survey - Respond by December 12 

The New Jersey Department of Banking and Insurance (DOBI) ICD-10 Implementation Task Force, which MSNJ participates in with NJHA and many New Jersey payors and hospitals, is conducting their second standardized ICD-10 Readiness Survey to collect your practice's ICD-10 implementation project coordinator's contact information, as well as information regarding your ICD-10 readiness. The goal is to have all healthcare trading partners respond to one standard survey. Your survey responses will be shared. Everyone who participates in the survey will receive the results in Excel format. Trading partners, including participating payors, may use this information to follow your progress and schedule a time to begin end-to-end testing with you. This survey will be reissued periodically so you can continue to update information as you continue to make progress. Only one person should register and submit a response on behalf of your organization. Once you have done so, you will have access to all other trading partners that have submitted survey responses. Please keep in mind that registered users will also have access to your information. We urge members to participate in this survey and begin communicating with payors about transitioning to ICD-10. Submit your survey response by December 12, 2014.

Toolkit for Physicians Facing Medical Audits

View November's Coding Tip of the Month for information on the use of G codes in ICD-10 for diseases of the Nervous System (G00 to G99)