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Medical Society of New Jersey e-Newsletter
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MSNJ serves as the voice of physicians and is the only society representing all specialties and practice models in the state. We offer unparalleled advocacy and practice support.
Numbers matter...each member adds to our influence! Help us spread the word...joining is simple! Visit www.msnj.org/membership for more information.
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Bergen, Essex, Hudson and Passaic County Medical Societies Joint Membership Meeting and Dinner Seminar
Wednesday, January 20, 2016 at 6:30pm
Valley Regency, Clifton, NJ
More information.
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Symposium - Fear of Tiers: Finding the Right Balance of Government Oversight, Transparency and the Free Market for Narrow Health Insurance Networks
January 21, 2016 from 1:00pm to 4:30pm at Princeton University
Come see MSNJ CEO, Larry Downs speak on this issue.
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Brach Eichler's 1st Annual Fraud & Compliance Forum for Doctors
Thursday, January 21, 2016 from 6:30pm to 9:30pm
W Hoboken, Hoboken, NJ
More information.
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Webinar: HIPAA - Texting and Emailing
Tuesday, January 26
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HMA and CohnReznick Webinar: Value-Based Payment Readiness: A Self-Assessment Tool for Primary Care Providers, FQHCs, and Behavioral Health Providers
Wednesday, January 27, 2016 from 1:00pm to 2:00pm
More information.
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Health Management Associates Webinar: Provider Vitality Workshop: Strategies for Ensuring an Energized and Effective Healthcare Workforce
Thursday, January 28, 2016 from 1:00pm to 2:00pm
More information.
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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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IT Solutions:
Priority One Group - Silver 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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Policy & Strategy Panel Meeting
Thursday, January 21, 2016 at 5:30pm
MSNJ Conference Center
Two Hot Topics for 2016:
- Presentation by the Federation of State Medical Boards on the Interstate Compact to Expedite Medical Licensure and Facilitate Multi-State Practice
- Discussion of telemedicine policy and legislation - balancing convenience and good medicine
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Attention Tier 2 Physicians:
If you have been assigned to Tier 2 by Horizon, please take this survey to help us assess the impact.
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Call for Nominations
We are accepting applications of interested parties for positions on the Board of Trustees, AMA Delegation, Judicial Council and various positions. Please review the MSNJ Open Positions for 2016 and read a brief synopsis of the committees 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, first contact your county executive, then contact MSNJ 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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Legislative Update
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2016 State of the State
Governor Christie delivered the State of the State address this week. Read the full transcript. Of note, he announced an increase in funding for mental health treatment. See the proposal.
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Notice Mandates
The Governor has signed a bill that requires the Department of Health to prepare information on Down Syndrome for parents of newly diagnosed children. The physician mandate was added at the end of the legislative process and reads as follows: "Any physician, health care provider, nurse midwife, or genetic counselor who renders prenatal care, postnatal care, or genetic counseling shall, upon receipt of a positive test result from a test for Down syndrome, provide the expectant or new parent with the information that is provided by the Department of Health under section 1 of this act."
In addition, as previously reported, a narrow notice mandate took effect last month. Any physician dispensing a controlled substance must provide information on medication disposal. Read more.
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Physicians Testifying in Workers Comp Cases
The Governor has signed a law that raises from $400 to $600, the maximum fee paid to an evaluating physician for a written opinion regarding the need for medical treatment or providing an estimation of permanent disability. MSNJ was neutral on this legislation that aimed to even out payments between petitioner's physicians and respondent's physicians.
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Drug Abuse
MSNJ, AMA and others have filed comments on proposed CDC guidelines on opioid prescribing. Read our comments. See AMA's comments.
In addition, MSNJ has filed comments with the New Jersey Division of Consumer Affairs regarding regulations proposed to implement the 2015 Prescription Monitoring Program law. |
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Epinephrine Administration
The Governor has signed the "Epinephrine Access and Emergency Treatment Act," which facilitates access to epinephrine auto-injector devices, which may be used to treat symptoms of life-threatening allergic reactions, known as anaphylaxis, by persons who have completed and received a certificate of completion from an educational program approved by the Commissioner of Health. Health care professionals would be authorized to prescribe and dispense an epinephrine auto-injector device, either directly or through a standing order, to a person authorized to administer, maintain, and dispose of the device under the bill. |
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Behavioral Health Treatment for Minors
The Legislature has accepted the Governor's conditional veto of the "Boys & Girls Clubs Keystone Law," a bill to allow minors over 16 access to outpatient mental health treatment (excluding medication) without parental consent. MSNJ supported NJPA in negotiating improvements to the bill. The new law takes effect immediately. |
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Regulation of Pharmacy Benefits Managers
The Governor has signed a bill that requires pharmacy benefits managers (PBMs) to disclose the methodology and sources utilized to determine multiple source generic drug pricing. That pricing information is required to be updated daily and the PBM must have a process for the prompt notification of those pricing updates to network pharmacies. The bill also requires PBMs to maintain a procedure to eliminate products from the list of drugs subject to multiple source generic drug pricing or modify maximum allowable cost rates in a timely fashion. MSNJ and the pharmacy community support this new law. |
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Insurance Coverage of Medications
The Governor has signed a bill requiring health benefits coverage for synchronization of prescribed medications under certain circumstances. Read more. |
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Health Data
The Governor has signed a bill that establishes a secure, Statewide, integrated Population Health Data (iPHD) Project ("Project") containing certain data collected by New Jersey administrative departments and agencies, that includes data related to health and publicly supported programs that will facilitate approved, project-by-project analysis and research and the development of the most effective means for improving the health, safety, security, and well-being of New Jersey residents and the overall cost-efficiency of government programs. Under the bill, the Rutgers Center for State Health Policy will be required to organize a consortium of researchers from New Jersey academic institutions and affiliated medical schools to facilitate actionable population health research to help improve health outcomes and promote New Jersey's research institutions. MSNJ supports this new law.
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EMS Providers
As previously reported, EMS providers negatively affected by a new law that shifts services sued to stop the law. The NJ Supreme Court has upheld the law. Read more.
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Medicaid Coverage for Advanced Care Planning - Vetoed
The Governor has vetoed a bill that would have required Medicaid coverage for advanced planning. MSNJ was neutral on this bill. |
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Report on Medicaid Utilization
Rutgers University's Center for State Health Biomedical and Health Sciences Working Group on Medicaid High Utilizers has released a report commissioned by Governor Christie to help the State devise a program to innovate and improve health care. MSNJ provided input for the report and we are analyzing the recommendations. Read the report.
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Legal Update
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MSNJ Weighs in on Insurance Fraud Enforcement by Private Carriers
In a troubling trend Allstate has gained traction in its cases against medical practices for alleged violations of regulations under the Insurance Fraud Protection Act (IFPA). The law permits treble damages. Most recently Allstate was successful at the trial level against a radiologist who was ordered to disgorge almost $200,000 on the theory that he had not independently determined the medical necessity of a diagnostic test ordered by a lesser licensee. The partial summary judgment is being appealed and MSNJ joined with the Radiological Society of New Jersey in an amicus brief objecting to the judge's interpretation of the regulation and the proposition that this would constitute a violation of the IFPA. MSNJ will also file an amicus brief with the New Jersey Supreme Court on the issue of the standard of proof required under the IFPA which is pending before it.
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News
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Hospitalists Unionize in Oregon
While the United State Supreme Court considers whether to rule on a case that would undermine the strength of unions in the public sector a group of hospitalists in Oregon has unionized. This was in response to Sacred Heart hospital's announcement that it would seek to outsource its hospitalists to a management company that would become their employer. Read more.
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California Holds Hearings on Insurance MegaMergers
California has begun hearings on whether the proposed mergers of Aetna and Humana and Anthem and Cigna are anticompetitive and violate antitrust laws. If the Cigna deal is approved Anthem will become California's largest health insurer surpassing Kaiser Permanente. Read more.
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Aetna to Leave American Health Insurance Plan
Aetna has announced that it will leave AHIP. This announcement follows the recent departure of UHC from this national insurance trade association. Read more.
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Meaningful Use Outlook for 2016
Read Healthcare IT's article "Meaningful use will likely end in 2016, CMS chief Andy Slavitt says."
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ERISA: Appealing Payment Denials
Most patients are now covered through employer sponsored self-insured plans. These plans are governed by ERISA. If you have never pursued a denied claim in an ERISA plan, or if you have not been successful, read this article by Leslie Howard, Esq. for tips.
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Brach Eichler's Health Law Year in Review
The 2015 Year in Review highlights key issues and developments at the state and federal level concerning health care providers over the past twelve months. Read the report.
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MSNJ Member in the News
Congratulations to MSNJ members, Dr. Paul Carniol and Dr. Nazar Haidri on being appointed to the New Jersey State Board of Medical Examiners. Read more.
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Practice Management
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2016 Medicare Physician Fee Schedule Now Available
Medicare contractors held claims for 2016 services from January 1, 2016 through January 14, 2016 to implement corrections to technical errors discovered after publication of the final rule. The 2016 fee schedule is now available for download on the Novitas website and the 2016 claims hold is now lifted. It is important to note that if you bill Medicare an amount less than the Medicare fee schedule, you will be paid the lesser amount.
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Individuals' Right under HIPAA to Access their Health Information
As the health care system evolves and transforms into one supported by rapid, secure exchange of electronic health information and more targeted treatments discovered through the new precision medicine model of patient-powered research, it is more important than ever for individuals to have access to their health information. Unfortunately, individuals face obstacles in accessing their health information, even from entities required to comply with the HIPAA Privacy Rule. The Office of Civil Rights released a fact sheet and a first set of FAQs to further clarify individuals' core right under HIPAA to access and obtain a copy of their health information. The first set of materials can be found on their website.
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CMS Announces 121 New ACO Participants
This week, Centers for Medicare & Medicaid Services (CMS) announced that 121 new participants will be added to the Medicare Accountable Care Organization (ACO) initiative, which now covers 49 states and the District of Columbia.
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Medicare Overpayments
Read CMS' Medicare Overpayments Guide.
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PQRS Web-Based Measure Search Tool
CMS announced a new PQRS Web-Based Measure Search Tool. This tool will assist in easily identifying claims and registry measures that may be applicable, and help find measures that meet satisfactory reporting requirements for the 2016 PQRS program year.
Through a partnership with PQRSwizard®, MSNJ has made it easy for your practice to participate. PQRSwizard, like Turbo-Tax™ for PQRS reporting, will help guide you step-by-step to simplify the CMS PQRS reporting process. Visit www.msnj.org/benefits to access the preferred MSNJ price of $225 per provider (Regular Fee is $299). The deadline for 2015 reporting through PQRSwizard, using the MSNJ discount, is February 26, 2016.
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| Read First Healthcare Compliance's blog "Jumpstart you Compliance Program" and view their archived webinar "Maintaining Effective Compliance Under the ACA's Evolving Reimbursement Rules."
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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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2016 © 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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