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Medical Society of New Jersey e-Newsletter
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Insurance Review for MSNJ Members
As a free service to our members, we provide a comprehensive insurance review helping to get the best terms available. More information. |
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New Jersey Prescription Savings Card
In New Jersey 15% of residents currently do not have any form of prescription drug coverage. With use of the New Jersey Drug Card, you can save on all of your out-of-pocket costs for prescription medications. Residents can also use the New Jersey Drug Card to save up to 75% if you have a high deductible plan, take a medication not covered by insurance or have no prescription coverage. Just log onto www.NewJerseyDrugCard.com to print your free card.
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MSNJ Webinar: Hospital & Group Relationships: Before, During and After
September 20, 2016 at 7:00pm
More information and registration. |
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MSNJ Webinar: The New Medicare Overpayment Regulations
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September free CME events in our area :
Cancer Care - Friday, September 9th:
Opioids - Saturday, September 17th: See details.
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Transformation Day: Hear the latest update directly from CME on MACRA and MIPS
September 28, 2016 from 9:00am to 3:00pm
Hilton Newark Penn Station
More information and registration.
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PCSS-MAT Module: Methadone: Its Role in Opioid Addiction Treatment vs. Pain Management
Access module.
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PCSS-MAT Online Module: Prescribing Naloxone to Patients for Overdose Reversal
Access the module.
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Renew your dues ONLINE by October 15, 2016 and receive a 5% discount on your STATE dues!
When prompted enter discount code msnj5, then click "update price." Discount is applied to state dues only.
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News
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Drug Abuse
Please read a letter from the US Surgeon General about the nation's opioid epidemic addressed to physicians. Then go to www.TurnTheTideRx.org/join to join with clinicians from across the country in a simple but powerful movement to end this epidemic. Take the pledge. And spread the word.
MSNJ has been sponsoring and promoting free CMEs on opioids across the state. The next one will be in Camden County on September 17th. See details.
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MSNJ to Discuss MACRA-MIPS Concerns with CMS Administrator
MSNJ will discuss our concerns about the impact of MACRA on physicians in the Garden State when our leaders meet with Andrew Slavitt, Acting Administrator of CMS, at his invitation, in September. We previously expressed concerns about the impact on small practices and the short time frame for all physicians to prepare for the seminal payment rule which is expected to be finalized in November. Read a Kaiser Health News article on the challenges that MACRA will present to small and rural practices.
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Exchange News-OSCAR Leaves New JerseyOscar announced this week that it would withdraw from the New Jersey marketplace. According to Bloomberg News, Oscar covered 26,000 individuals in New Jersey and based its decision on market conditions. The company suggested that its network of providers was not narrow enough to be competitive. New Jersey will have three insurers in the marketplace in 2017: Amerihealth, Horizon and Health Republic. Horizon has approximately 60% of the market. Health Republic is a co-op that recently left the New York marketplace and is one of a few remaining co-ops in the country. Read more.
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Insurance Mega Merger Update
Aetna and Humana have responded to the Department of Justice's challenge to their merger saying that the DOJ has "fundamental misconceptions about marketplace realities." Read Aetna's answer to the complaint. Aetna and Humana assert that Medicare Advantage and Medicare are competitive products, among other things. On the other side of the competition argument, Leemore Dafny, an economist from Harvard's Business School, says that '[she doesn't] find any evidence that reduction in provider payment leads to reduction in insurance premiums, and [she doesn't] know of any study that does." Read Fierce Healthcare's analysis and an article by NPR.
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New Overtime Rule Effective December 1, 2016
The Department of Labor (DOL) issued a Final Rule updating The Fair Labor Standards Act overtime provisions to double the salary threshold from $23,660 to $47,476. Employers should be prepared to pay overtime to affected employees once the rule goes into effect on December 1. This new rule could impact physician practices. Read First Healthcare Compliance's summary of the new rule.
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OCR to More Widely Investigate Breaches Affecting Fewer than 500 Individuals
The office of Civil Rights has begun an initiative to more widely investigate the root causes of breaches affecting fewer than 500 individuals. Among the factors Regional Offices will consider include:
- The size of the breach;
- Theft of or improper disposal of unencrypted PHI;
- Breaches that involve unwanted intrusions to IT systems (for example, by hacking); The amount, nature and sensitivity of the PHI involved; or
- Instances where numerous breach reports from a particular covered entity or business associate raise similar issues.
Regions may also consider the lack of breach reports affecting fewer than 500 individuals when comparing a specific covered entity or business associate to like-situated covered entities and business associates. More information.
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HIPAA Turns 20
Read a survey article by attorneys from Fox Rothschild on HIPAA's 20th birthday.
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MSNJ Board of Trustees meeting is on Thursday, September 15th in our 2nd floor Conference Room. Please register online or let Sue Hoisington know, if you plan to attend.
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Public Health
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ZIKA in the Garden State
There are approximately 100 cases of Zika in the Garden State, all of which are related to travel or sexual transmission. According to CDC there are 500 cases on the mainland and another 500 in the territories. Review information provided by the CDC this week on clinical laboratory testing and care of infants.
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National Suicide Prevention Week: September 5 - 11, 2016
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Practice Management
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CMS Updates Guidance on ICD-10 First Year Flexibilities- Unspecified Codes
Several members have asked whether the end of the of CMS' ICD-10 flexibilities on October 1, 2016 will also mean the end of unspecified codes. Below is CMS' response to this FAQ:
Question 27:
Will unspecified codes be allowed once ICD-10 flexibilities expire?
Answer 27: Yes. In ICD-10-CM, unspecified codes have acceptable, even necessary, uses. Information about unspecified codes, including an MLN Matters article and videos, can be found on the CMS website. While you should report specific diagnosis codes when they are supported by the available medical record documentation and clinical knowledge of the patient's health condition, in some instances signs/symptoms or unspecified codes are the best choice to accurately reflect the health care encounter. You should code each health care encounter to the level of certainty known for that encounter. When sufficient clinical information is not known or available about a particular health condition to assign a more specific code, it is acceptable to report the appropriate unspecified code (for example, a diagnosis of pneumonia has been determined but the specific type has not been determined). For ICD-10 coding resources, visit the Provider Resources section of the CMS ICD-10 website.
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Novitas No Longer Supporting Dial-Up Connectivity
Effective October 24, 2016, Novitas Solutions EDI will no longer support dial-up connectivity. Dial-up trading partners must use another connectivity method for claim submission and report retrieval such as: Secure File Transfer Protocol (SFTP), Direct Data Entry (DDE) (Part A), or their Novitasphere portal (Part B). Read more.
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Medically Unlikely Edits
CMS developed the Medically Unlikely Edits (MUE) program to reduce the paid claims error rate for certain services. Services billed to Medicare that exceed the MUE may be denied. Read Novitas' tips and resources.
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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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