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Medical Society of New Jersey e-Newsletter
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Medical Society of New Jersey Welcomes New Members from University Orthopedic Associates
Read more.
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Save the Date! MSNJ's 2016 Advocacy Conference and House of Delegates Meeting
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Save the Date! MSNJ's 250th Anniversary Celebration and Inaugural Gala honoring Dr. Joseph Costabile
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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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Legislative Update
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Call to Action: Out of Network Legislation
The Assembly Financial Institutions and Insurance Committee released A.4444, the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act." MSNJ continues to oppose this legislation. Read our testimony on the bill. See press coverage and our recent statement.
WE NEED YOUR HELP IN DEFEATING THIS BILL! PLEASE WRITE TO YOUR LEGISLATOR. PLEASE USE THE TEMPLATE AND PORTAL ON OUR WEBSITE.
If you are not a member, please use this template. See a list of legislators by district.
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OMNIA
A package of bills has been introduced to address tiered networks. Read a summary. MSNJ supports network adequacy and fair contracting, as well as transparency in physician ranking. We are analyzing these bills.
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News
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Member Alert on Rights of Hearing Impaired Individuals
The Office of Civil Rights has settled an enforcement action against a hospital in Connecticut with an agreement that requires improved access to communication services for deaf and hard of hearing individuals or to deaf companions. At issue was whether the hospital had implemented adequate policies and procedures to ensure effective communication with hearing impaired patients and hearing impaired companions, whether or not the patient is hearing impaired.
Members are urged to read the settlement agreement for guidance on how to assess the need and when to provide a sign language interpreter for hearing impaired patients or hearing impaired companions. Read more.
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Insurer May Rescind Medical Malpractice Policy for False Statements in Application
The New Jersey Supreme Court has ruled in a split decision that an insurer may rescind a medical malpractice policy where the insured made false statements in the insurance application. This absolves the insurance company of any duty to defend or to indemnify.
DeMarco v. Stoddard involved a podiatrist who made false statements about the volume of his business in another state. The high court reversed the appellate division which had fashioned a remedy requiring the insurer to pay the judgment up to the statutory minimum requirement. The Supreme Court rejected the public policy consideration that injured patients rely upon medical professionals to have insurance in the statutory minimum amount.
Members are urged to provide accurate and complete information in both applications for insurance and renewals. Ask the insurer to clarify questions that are not clear and document the agreed interpretation.
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Oxford v. Sutter Class Arbitration Settled After Thirteen Year Epic Battle
The billing dispute brought by Dr. John Sutter against Oxford thirteen years ago has finally come to a close. The long and circuitous route of the case included consideration by the United States Supreme Court. There, MSNJ supported the right of the physicians to arbitrate as a class in an amicus brief. The Supreme Court agreed that the in-network New Jersey physicians were entitled to arbitrate their claims as a class under their participation agreements. The arbitration covers claims filed between 1996 and 2004. The settlement includes a fund of $1.38 million to be distributed to physicians. Physician class members will receive between $170 and $1,700 early next year. Read the press release and settlement agreement for details on this epic battle.
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Medicare Alternative Payment Models
Read the AMA and Center for Healthcare Quality and Payment Reform's "Guide to Physician Focused Payment Models" that describes seven different APMs that can help physicians in every specialty redesign the way they deliver care in order to control spending, improve quality for patients and qualify for APM annual bonus payments. Harold Miller, the co-author, addressed a group of MSNJ members last month on this topic.
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Call for Nominations
We are accepting applications for interested candidates for positions on the Board of Trustees, AMA Delegation, Judicial Councilor and various positions. Please review the MSNJ Open Positions for 2016 and read a brief synopsis of the committees and expectation. 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.
The Deadline to submit a request is January 25, 2016. Watch e-News for weekly updates on Declared Candidates. The Nominating Committee meeting is on Sunday, February 7, 2016 at 9:30am at MSNJ.
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Practice Management
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PQRS Informal Review Period Deadline December 16
Individual eligible professionals, Comprehensive Primary Care practice sites, PQRS group practices, and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed for the 2016 PQRS negative payment adjustment have until December 16 to submit an information review request. All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page. The following are steps to submit and informal review request. - Go to the Quality Reporting Communication Support Page (CSP)
- In the upper left-hand corner of the page, under "Related Links," select "Communication Support Page"
- Select "Informal Review Request"
- Select "PQRS Informal Review"
- A new page will open
- Enter Billing/Primary Taxpayer Identification Number (TIN), Individual Rendering National Provider Identifier (NPI), OR Practice Site ID # and select "submit"
- Complete the mandatory fields in the online form, including the appropriate justification for the request to be deemed valid. Failure to complete the form in full will result in the inability to have the informal review request analyzed. CMS or the QualityNet Help Desk may contact the requestor for additional information if necessary.
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EHR Incentive Program Materials for Eligible Professionals
CMS published the following materials to help eligible professionals successfully participatein the Medicare and Medicaid EHR Incentive Programs in 2015.
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Medicare Deductible, Coinsurance and Premium Rates for 2016
Read CMS' updated article on "Medicare Deductible, Coinsurance and Premium Rates for 2016."
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New Educational Tool: Advance Beneficiary Notice of Noncoverage Interactive Tutorial
CMS launched a new Advance Beneficiary Notice of Noncoverage Interactive Tutorial educational tool. Learn how to properly complete a Fee-For-Service Advance Beneficiary Notice of Noncoverage (ABN).
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Updated CMS Guidance on Meaningful Use Public Health Reporting Measure
Eligible Professionals (EPs) in Stage 1 must attest to 1 public health measure.
- EPs may claim an alternate exclusion for up to 2 measures, if they were not planning to attest to the public health measure prior to the final rule being published.
- For the remaining measure, EPs must attest OR meet the exclusion requirement.
Eligible Professionals (EPs) in Stage 2 must attest to 2 public health measures.
- EPs may claim an alternate exclusion for the Syndromic Surveillance OR the Specialized Registry reporting measure, OR both, if they were not planning to attest to the public health measure prior to the final rule being published.
- For the remaining measure, EPs must attest OR meet the exclusion requirements.
CMS has clarified that EPs in Stage 2 may claim an alternate exclusion for BOTH Syndromic Surveillance and the Specialized Registry reporting measures; whereas previous guidance indicated that only one could be claimed as an alternate exclusion. Read more in the CMS FAQ.
The New Jersey Department of Health website includes information on immunization and syndromic surveillance reporting options through the state.
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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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2015 © 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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