MSNJ e-News - September 15, 2016

The Oncology Society of New Jersey and the Medical Oncology Society of New Jersey Dinner Symposium on the Economics of Reinventing American Health Care

Wednesday, October 19, 2016 from 5:00pm to 9:00pm

The Manor Restaurant, West Orange, NJ

More information and registration.

Corporate Partners

Legal Services:

Capehart & Scatchard, P.A. - Bronze Level Partner

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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ATTENTION PHYSICIANS:

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.

*Applies to physicians dues only.

Renew today!

Policy & Strategy Panel: Medical Marijuana Policy Discussion

Wednesday, October 19, 2016 at 5:30pm

More information
Registration

News

MACRA Relief Announced by CMS

Andrew Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), announced in a blog posting on September 8 that the agency would heed concerns expressed by the American Medical Association and other physician organizations about the proposed start date for performance reporting by physicians under the new payment systems created by the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. In its draft regulation, CMS proposed to require physicians to begin reporting under the Merit-based Incentive Payment System (MIPS) or through the advanced alternative payment model (APM) option on January 1, 2017, even though final regulations promulgating MACRA's sweeping payment system changes would not be issued until the fall. MSNJ was among those filing objections to the reporting and implementation time-line.

CMS announced that the final MACRA regulation will allow practices to "pick your pace" and will exempt physicians from any risk of penalties if they choose one of three different MIPS reporting options in 2017, in addition to the option of participating in an advanced APM:

Full-year reporting that begins on January 1;
Partial year reporting for a reduced number of days; and
A "test" option under which physicians can report minimal amounts of data.

Physicians who report in 2017 may be eligible for bonus payments in 2019, depending on which option they choose. Those who opt for full-year reporting will be eligible to receive a "modest positive payment adjustment;" those who choose partial year reporting will be eligible for a "small positive payment adjustment." Physicians who choose the "test" option will not be subject to any payment adjustments. Qualified participants in advanced APMs will be eligible for 5 percent incentive payments in 2019. Read AMA's statement. Read more.

Health Republic Insurance Placed in Rehabilitation

The Department of Banking & Insurance (DOBI) announced this week that Health Republic Insurance of New Jersey (HRINJ) has consented to being placed in rehabilitation because of its deteriorating financial condition. This was caused in large part by its $46.3 million liability under the Affordable Care Act's Risk Adjustment program. According to DOBI Commissioner Richard J. Badolato, "Our first priority in working with HRINJ under the anticipated order of rehabilitation will be to ensure that all HRINJ members and providers receive the service and payment promised them under the terms of their health insurance plans." Current policies will remain in place through the end of the year. HRINJ will exit the exchange market and offer no coverage in 2017. This affects 26,000 individual plan members and 9,000 small employer plan members. DOBI has advised that pre-authorizations obtained for patients with HRINJ coverage should be honored by their successor insurance. DOBI and MSNJ urge physicians to file claims for HRINJ members in a timely manner. Read DOBI's FAQs for providers. Read more. MSNJ will keep members informed about the rehabilitation proceedings.

Read MSNJ CEO Larry Downs' Op-Ed on how misleading health insurance plans must be fixed.

Home Health

New Jersey fines 36 home-health care agencies for alleged violations. The violations included improper record-keeping, failure to file plans of care and sending uncertified or unqualified caregivers into clients' homes. Read more.

Legislative Update

Telemedicine

MSNJ, along with several state and national physician associations, advocated to Congress against the allowance for physicians to practice across state lines without licensure. The National Defense Appropriations Act (NDAA) has a provision called the Enhancement of Use of Telehealth Services in Military Health System. We are concerned with the language in the Senate version of the NDAA that would alter the point of care from the location of the patient to the location of the provider. Read our letter.

Drug Pricing

Two legislative committees held hearings and passed bills attempting to address the recent spike in Epipen pricing. Read more.

Drug Abuse Resources:

Pharmacy Red Flags

Please see this video and this article for insight into pharmacy scrutiny of opioid prescriptions. Pharmacists are not only allowed to scrutinize prescriptions, but face penalties and fines for dispensing opioids indiscreetly. These resources aim to reduce prescriber frustrations and pharmacy denials. See our drug abuse resources.

Members in the News

MSNJ Board of Trustees member, Dr. John DiGioia, Jr. was featured in this NJTV piece: How Candidates' Health Matters to Voters.

Congratulations to Dr. Marilouise Venditti on being appointed to Carrier Clinic's Board of Trustees. Read more.

In Memory Of

MSNJ mourns the loss of long-time member, Dr. Victor Irmiere who passed away on Monday after 50 years in practice. Dr. Irmiere was the recipient of MSNJ's Golden Merit award in 2005. Read more about Dr. Irmiere's dedication to the practice of medicine.

Practice Management

CMS Updates Guidance on ICD-10 First Year Flexibilities-Audits

The first year ICD-10 flexibilities allowed by CMS will come to an end on October 1, 2016. Below is an updated CMS FAQ to assist with this transition.

Question 30: How does the end of the ICD-10 flexibilities affect audits that begin after October 1, 2016, but are for claims with dates of service before October 1, 2016?

Answer 30: Beginning October 1, 2016, all CMS review contractors are able to use coding specificity as the reason for an audit for a denial of a reviewed claim to the same extent that they did prior to October 1, 2015. Review contractors will notify providers of coding issues they identify during review and of steps needed to correct those issues to the same extent that they did prior to October 1, 2015. The provider community should code claims to the degree of specificity supported by the encounter and the medical documentation.

CMS Releases Guidance to Help Laboratories Determine Whether They Must Report Data

The Medicare Part B Clinical Laboratory Fee Schedule now requires that "applicable laboratories" must collect and report data to CMS for the Private Payor Rate-Based Payment System. Reporting begins January 1, 2017. Physician office laboratories may have to comply. Read more to determine if your laboratory must collect and report.

Read an article on Six Tips for a Small Business to Avoid HIPAA Security Breach Headaches.

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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.

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