Medical Society of New Jersey e-Newsletter
 
December 5, 2014

   
In This Issue
MEMBER BENEFITS
CME/EVENTS/TRAINING
CORPORATE PARTNERS
NEWS
-Repeal the Medicare SGR!
-Tax Policy Extension Bill
-Medicare Pay Cuts Coming in 2015
-Legislative Update
-Potential Circulation of Drifted Influenza A (H3N2) Viruses
-RWJUH Designated Ebola Treatment Centers
-Fatal Gastrointestinal Mucormycosis in Infant
-Data Breaches Article
-Quality Recognition Awards
-Call for Candidates
-DeGroot Award
-RTPBI Survey
PRACTICE MANAGEMENT
-Medicare Premiums and Deductibles for 2015
-CCI Quarterly Update
-Horizon Online Authorization Tool
-ICD-10
-ICD-10 Readiness Survey
-Coding Tip
 
Member Benefits
MSNJ is proud to announce a new benefit for MSNJ members:

SoFi refinances student loan debt from both federal and private sources into one loan with one monthly payment at lower rates. Physician borrowers save on average $20,800 on their student loans. Adjustable rates start at 2.66% APR, fixed rates at 4.99% APR. Access the discount.  

MSNJ, in conjunction with Medline and Cintas are proud to announce a joint effort to offer discounts to all of our members on personal protective equipment (PPE). Access the discount.

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.

This exciting and exclusive offer is available only to qualifying groups with at least 3 physician members. More information.
CME/Events /Training

Check out the MSNJ Calendar for upcoming meetings!

Board of Trustees Meeting (open to all members)

Sunday, December 7, 2014 at 10:30am

MSNJ Conference Room, Lawrenceville


MSNJ, in conjunction with the Essex, Morris, Sussex and Union County Medical Societies, is hosting a free dinner seminar on Insurance Fraud on December 10 at 6:00pm at The Madison Hotel. This activity has been approved for AMA PRA Category 1 Credits™. More information.

Rising to Challenges in End of Life Care/End-of-Life Communication Tools: POLST

Thursday, January 22, 2015 at 5:30pm
MSNJ Headquarters 
More information 
Registration

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 Federation of State Medical Boards is providing free CME activities on Opioids. Read more and register online.

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


The AMA will host a one-day seminar on CPT� Changes on December 8 from 8:30am to 4:00pm at the Hilton Newark Penn Station in Newark, NJ. This seminar will provide a comprehensive review of changes to the CPT� 2015 codebook. Register online.

PCSS-O Webinar: What is going on in the U.S. to Improve Pain Treatment & Deter Prescription Drug Abuse

Monday, December 8, 2014 at 1:00pm

Listen to updates on federal legislation and White House strategies and programs addressing the medical use of oxycodone and hydrocodone, palliative care and pain treatment education and prevention, and treatment of prescription drug abuse. Status of state laws and regulatory policies governing nursing practice and pain treatment will be reviewed. Additional state topics include: prescription drug monitoring programs, practitioner education and reducing non-medical use of prescription medications.

Register.

PCSS-MAT Webinar: Integrated Approach to Treatment Expansion

Tuesday, December 9, 2014 at 12:00pm

This webinar will review the benefits of using nurse care managers in Federally Qualified Health Centers (FQHCs) to implement and expand the accessibility of office-based treatment with buprenorphine.

Register.


ICD-10 and Clinical Documentation Improvement Webinar

CMS is collaborating with the American Health Information Management Association (AHIMA) to provide an ICD-10 and CDI webinar on Wednesday, December 10 at 12:00pm. Learn why detailed clinical documentation is important for the ICD-10 transition and obtain steps for training your staff. The webinar will be followed by a Q&A session. Register online.

The AMA is offering a free webinar on "HIPPA Standard Transaction Compliance: Physician Rights and Enforcement" on December 18 at 12:00pm. This webinar will discuss physician rights, health plan responsibilities, and enforcement options under the HIPAA standard electronic transaction regulations. Register online.

PCSS-MAT Online Module: Administrative, Medico-Legal, and Regulatory Aspects of Opioid Use Disorder Medication-Assisted Treatment

Access the module.

Seabrook House is offering a complimentary CME event with Atlantic and Cape County Medical Societies on "Identifying and Addressing Addiction in my Private Practice" on Wednesday, January 21, 2015 from 6:00pm to 9:00pm at Avalon Country Club. Click here for more information and registration.


The CDC will host a 2-day course on Epidemiology & Prevention of Vaccine-Preventable Diseases on March 17 and March 18, 2015 from 8:00am to 5:00pm at the Busch Campus Multi-Purpose Center, Rutgers, The State University in Piscataway. More information.

Corporate Partners

QualCare, Inc. - Platinum Level Partner   

 

  

Contact: Jenny Martinez
Address: 30 Knightsbridge Road, Piscataway, NJ 08854
Phone: 888.670.8135, option 6
E-mail: [email protected]
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.


 

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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NewsTOP

Time Running Out for Enacting Medicare Payment Reform-Call Congress Today!

Only days remain before Congress' "lame duck" session concludes, and few potential legislative vehicles remain for securing repeal of Medicare's sustainable growth rate (SGR) formula before the end of the year.

Expressions of support for acting on Medicare physician payment reform continue to be heard from members of Congress, including the congressional "doc" caucus, as well as private sector policy organizations. Earlier this year, Congress came close to passing the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, H.R. 4015/S. 2000, but stopped short of adopting this landmark bill. 

"If Congress does not seize the moment to act now during the lame duck session, all of the hard bipartisan, bicameral work that went into building that framework will be for naught, and the process of negotiating a solution will start all over again," AMA President Robert M. Wah, MD, wrote in a recent AMA Viewpoints post. "The current legislation is a remedy to improve care for patients through new health care delivery and payment systems that promise to create the stable environment that is needed for physicians to innovate."

As Rep. Kevin Brady, R-Texas, told physicians at the 2014 AMA Interim Meeting, "The clock is ticking." Please call
(800) 833-6354 or write to Congress today using AMA's grass roots portal.

Tax Policy Extension Bill-ABLE-Contains Medicare Pay Cut Acceleration on Misvalued Codes
A bill just passed by the House could have a negative impact on Medicare payments, accelerating cuts on misvalued codes.  If passed by the Senate the bill assures that physician services will be subject to across-the-board cuts for at least some portion of the 2016-2018 time period.

 

The "Achieving a Better Life Experience" (ABLE) Act would allow people with disabilities to create special savings accounts to pay for education, housing and other needs without jeopardizing government benefits under programs like Social Security or Medicaid.  The bill is broadly supported, but the version released this week included a provision that is objectionable. Section 202 of the bill would move up target dates for Medicare physician fee schedule redistributions that were included in the 17th physician payment patch, known as the Protecting Access to Medicare Act or PAMA, which was signed into law last March.  That bill would have required the Centers for Medicare and Medicaid Services (CMS) to meet annual targets for revising "misvalued" services amounting to 0.5 percent of total fee schedule spending through the years 2017-2020.  If payment redistribution were to fall short of the 0.5 percent target in any of these four years, CMS was instructed to implement across-the-board cuts equal to the shortfall amount.  The budget offset in the ABLE Act revises the PAMA policy timeframe and imposes a 1.0 percent redistribution target in 2016, followed by 0.5 percent targets in 2017 and 2018. Read more....

New Medicare pay cuts coming in 2015; participation selections due Dec. 31

Physicians have until Dec. 31 to decide whether they will be participating or nonparticipating physicians in the Medicare program next year. In addition to the annual threat of a steep payment cut as a result of the sustainable growth rate (SGR) formula, another factor for physicians to consider in making the decision this time around is that 2015 will be the first year that the Centers for Medicare & Medicaid Services (CMS) will impose penalties under the value-based modifier (VBM) program. 

According to CMS, 1,010 groups of 100 or more eligible professionals will see payment adjustments from the VBM in 2015. More than 300 of these groups will face Medicare payment cuts of 1 percent, while a few others will see cuts of 0.5 percent. Only 16 groups will receive bonuses of an amount yet unknown.

Other penalties that will be applied in 2015 based on 2013 performance-including those tied to quality reporting, meaningful use and ePrescribing-will decrease the limiting charge amounts that nonparticipating physicians can bill to patients for unassigned claims. The VBM penalties and bonuses, however, will not apply to unassigned claims. That means practices facing a VBM penalty next year could avoid the penalty by choosing the nonparticipating physician status option.

As described in the AMA guide to Medicare participation options, the Medicare payment schedule for nonparticipating physicians is set 5 percent below the participating physician payment schedule. At the same time, nonparticipating physicians can bill patients for 15 percent above that lower payment schedule amount. 

While participating physicians agree to accept assignment for all Medicare claims, nonparticipating physicians can decide whether to accept assignment on a claim-by-claim basis. This year, 96.6 percent of physicians are participating. Physicians who want to become nonparticipating in 2015 must send a letter to their Medicare contractor postmarked before Jan. 1 to terminate their participation agreement for the coming year.

Legislative Update

The Assembly Insurance Committee held its third and final hearing on the "out of network" issue. MSNJ previously submitted written testimony and provided oral testimony at this hearing. Find press coverage here. More press coverage can be found here.   

CDC Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses

RWJUH One of 35 Hospitals Designated as Ebola Treatment Centers

Robert Wood Johnson University Hospital in New Brunswick is one of 35 hospitals nationwide that has been designated by the US Department of Health & Human Services as an Ebola treatment center. Read the announcement that includes a full list of treatment centers.

Read a CDC factsheet on Why Ebola is not likely to become airborne and the NJDOH update on the virus.

Investigation of Contaminated Dietary Supplement - Fatal Gastrointestinal Mucormycosis in Connecticut Infant

The CDC, FDA and Connecticut Department of Public Health and Consumer Protection are investigating a fatal case of gastrointestinal (GI) mucormycosis in a premature infant in Connecticut who was given ABC Dophilus� Powder, a dietary supplement product containing viable microbial ingredients. The product was purchased from Solgar, Inc. in Leonia, New Jersey. It claimed to have "probiotic" properties and is marketed for infants and children. Later testing of the same lot of unopened Solgar ABC Dophilus� Powder revealed contamination with Rhizopus oryzae. Read an update for more information.  

Read NJBIZ's article titled "Doctors' offices must be wary of data breaches as use of electronic records grows." Check out our new benefit partner First Healthcare Compliance for a 10% discount on compliance solutions.


Quality Recognition Awards

The MSNJ Biennial Quality Recognition Award recognizes the outstanding physician members who demonstrate a commitment to quality, continuous improvement, leadership, and patient satisfaction.

The physician member needs to achieve 10 points every two years by meeting certain criteria. Awards will be distributed in January of each year.

 

Download the award application today! 

Please return to MSNJ via email at [email protected] by December 15, 2014.

Call for Candidates

MSNJ is accepting applications from candidates interested in positions on the Board of Trustees, AMA Delegation, Judicial Council and various positions. Please review the MSNJ Open Seats Chart and read a brief synopsis of the positions and expectations. Your involvement is key to the Success of MSNJ.

 

If you are interested in running for a position or have questions about specific vacancies, please feel free to contact your county executive or Sue Hoisington at 609-896-1766 x 207.

DeGroot Award Nominations

MSNJ is accepting nominations for the DeGroot Award which will be conferred at the MSNJ Inaugural Gala of the 223rd President, Steven Berkowitz, MD on May 9, 2015. The DeGroot Award was established by resolution to honor the selfless work of Dr. Robert DeGroot in service to the medical profession. The DeGroot Award will be given to the individual whose selfless and idealistic work benefits humankind and not himself or herself.

 

Nominations should be made by submitting a brief narrative to [email protected] by close of business on Friday, February 20, 2015.

Physician Input Needed for RTPBI Survey

The National Council for Prescription Drug Programs (NCPDP) is looking for physician input through a survey to help determine the scope of content for a future real-time prescription benefit inquiry(RTPBI) transaction. An RTPBI transaction is intended to provide patient-specific prescription benefit information at the point of care. The survey will close on Thursday, December 18, 2014 at 12:00pm EST. View a PDF copy of the survey questions. Please note: responses must be submitted online through the above survey link.

Practice Management

The Medicare Premiums and Deductibles for 2015 have been updated. Click here to view.

CCI Quarterly Update Now Available

The quarterly update to the Correct Coding Initiative (CCI) Edits, Version 21.1 is now available. Read the update.

New Horizon Online Authorization Tool Launched

Horizon requested that MSNJ advise members of the following new tool:

CareAffiliate, a utilization management tool, allows participating providers to submit authorization requests easily and securely online through NaviNet.  Providers will now be able to communicate electronically with Horizon and check the status of all requests in real time. 

 

CareAffiliate's main features include:

  • Submit treatment Authorization requests.
  • Submit treatment Pre-Determination requests.
  • Check status of already submitted Authorization or Pre-Determination Requests.

Providers can access CareAffiliate directly from NaviNet.net.  Please refer to the training document and the Frequently Asked Questions for more information.  Horizon encourages your office to use this new tool, which will eliminate the need to call or fax in your authorization requests.

ICD-10: 300 Days 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.

View December's Coding Tip of the Month for information on the use of F codes in ICD-10 for Mental, Behavioral and Neurodevelopmental disorders (F01 - F99)

 
Medical Society of New Jersey
2 Princess Road, Lawrenceville, NJ 08648
(o) 609-896-1766 e-mail:
 

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.

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