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Medical Society of New Jersey e-Newsletter
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MSNJ Risk Advisors
MSNJ Risk Advisors is able to offer MSNJ partners and members what we feel is the best workers compensation protection plan on the market. While maintaining premiums that are most likely commensurate with, or lower than, your current rate - it offers several advantages over competing products in the insurance marketplace. Over the last two years this product has paid out 35% in dividends. Additionally, participation in this plan will help to bolster MSNJ, and our position in assisting our member doctors. More information.
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Webinar: HIPAA - Texting and Emailing
Tuesday, January 26
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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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Corporate Partners
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Health Insurance:
QualCare, Inc. - Platinum Level Partner
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Legal Services:
DeCotiis, FitzPatrick & Cole, LLP - Gold Level Partner
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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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Out of Network Legislation - Stalled
The Assembly Financial Institutions and Insurance Committee had passed A-4444, the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act." But, the bill stalled in the Senate Commerce Committee and will not be reconsidered in lame duck. MSNJ continues to oppose this legislation. See press coverage.
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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. Three lawsuits have now been filed by Tier 2 hospitals. Read more.
If you have been assigned to Tier 2, please take this survey to help us assess the impact.
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Hospital Property Taxation
Legislation has been introduced to require hospitals to make contributions to their host municipalities. Many hospitals support the bill, as it provides predictability and keeps the issue out of the courts. Physician use of hospital space is exempted for the purpose of determining the contribution amount. MSNJ supports this exemption. Read more.
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Congress Proposes Omnibus Appropriations Package
Just before midnight on December 15, House leaders revealed the details of two legislative packages for passage before Congress adjourns for the holidays. The FY2016 omnibus appropriations package will fund federal agencies and programs through September 30, 2016. Many of the earlier debated policy riders, such as the proposal to "defund" Planned Parenthood, were omitted from the bill. However, the $1.1 trillion spending package does include a two-year delay of the so-called "Cadillac tax" on benefit-rich health insurance plans (for 2018 and 2019) as well as a one-year delay of the health insurance tax (for 2017). Read more.
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Bills Signed
The Governor has signed a bill that requires certain health care facilities to be generator ready, but allows them to qualify for NJEDA loans for cost of generators. MSNJ was neutral on this bill.
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News
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NJ Supreme Court Will Consider Standard to Prove Insurance Fraud by Physicians
The New Jersey Supreme Court has granted the appeal of Allstate Insurance Company in Allstate Insurance Company v. Northfield Medical Center to consider the standard of proof of fraud that an insurer must meet under the Insurance Fraud Protection Act. This case involves Allstate's position that medical practices formed in the 1990s violated the regulatory prohibition on the corporate practice of medicine and, consequently, bills submitted for medical services were fraudulent. At issue is whether the defendant MDs, DOs, chiropractors and consultants knowingly violated the prohibition.
MSNJ has consistently taken the position that fraud is a specific intent crime and that actual knowledge of a violation must be proven. We will seek permission from the court to file an amicus brief.
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Sale of Medical Practice Ordered in Hospital Demerger Case
A federal court judge has ordered that Saltzer Medical Group, part of the St. Luke's hospital system merger that was found to violate anti-trust laws, be sold within a year. This highly publicized case brought by the Federal Trade Commission required the demerger of a large medical practice when the hospital and practice failed to convince the court that the merger resulted in efficiencies. Read more.
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Medicare Spending Not a Surrogate for Private Insurance Spending
A new study has found that Medicare spending is of limited use in understanding health spending on the privately insured. Unfortunately, policy-makers have relied heavily on the assumption that Medicare spending and private insurance spending are similar bringing into question the direction of healthcare reform. The study recommends more research on spending and prices for privately insured, hospital price transparency and more rigorous antitrust enforcement. Read more.
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| Medical Publishing, LLC published the 2015-16 New Jersey Healthcare Guide. Read the guide.
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The University of Washington Medicine Charged With $750,000 in HIPAA Settlement
The University of Washington Medicine (UWM) has agreed to settle for $750,000 for potentially violating the HIPAA Security Rule by failing to implement policies and procedures to prevent, detect, contain, and correct security violations. UWM is an affiliated covered entity, which means they must have in place appropriate policies and processes to assure HIPAA compliance with respect to each of the entities that are part of the affiliated group. A breach was reported on November 27, 2013, which indicated that the electronic protected health information of about 90,000 people was accessed after an employee downloaded an email attachment that contained malicious malware. Read the Resolution Agreement and Corrective Action Plan, the HHS press release, and guidance on how your organization can conduct a HIPAA Risk Analysis.
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MSNJ Board Meeting Summary
MSNJ held a Board of Trustees meeting on December 3, 2015, please read the summary of the meeting.
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Practice Management
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2016 HIPAA Audits
Phase 2 HIPAA audits are scheduled to begin in early 2016. The most frequent targets are currently private practices and outpatient facilities. These audits will be desk reviews of policies as well as onsite reviews. Excellentia Advisory Group will host training sessions for $139.00 per session for the two levels of responsibility/accountability:
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Stage 2 Meaningful Use Survey
The Office of the National Coordinator (ONC) is gathering information to improve the summary of care document that is produced to meet the Transfer of Care objective in Stage 2 of Meaningful Use. Please take a quick survey that will help ONC create a new standard that will reduce the number of pages in the summary of care, making it easier to find relevant information. The survey deadline is December 23.
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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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