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Medical Society of New Jersey
SEND TO A FRIEND February 16, 2012

MSNJ e-News


Conferees Reach Agreement on Short-Term SGR Patch; AMA & MSNJ Express Deep Disappointment
A Message from the AMA

While some details are still being finalized, it is being reported from Capitol Hill that conferees have reached agreement on extending the payroll tax holiday, unemployment insurance benefits, and current Medicare physician payment rates for the next 10 months, through the end of 2012. The agreement does not repeal the SGR. We are deeply disappointed that Congress did not seize upon the historic opportunity to repeal the flawed payment formula. Read more on our blog.

MSNJ Meets with Congressional Delegation on Repeal of SGR
Before the Conferees' announcement, MSNJ CEO and General Counsel Larry Downs and MSNJ President Niranjan Rao, MD, met with Rep. Rush Holt (D-12) regarding the need for a repeal of the SGR. Rep. Holt offered his support and indicated that he ha signed onto a letter written by Rep. Joseph Crowley (D-NY) supporting the repeal. This meeting follows earlier outreach to Congressmen Leonard Lance (R-7), Frank Pallone (D-6) and Scott Garrett (R-5). A meeting with Rep. Jon Runyan (R-3) has also been scheduled. MSNJ will continue to support all efforts to repeal the SGR and will keep members apprised of developments.

Update on UnitedHealth Group UCR Settlement Disbursements
A federal court recently cleared the way for settlement fund distributions to physicians who filed claims against UnitedHealth over its calculation of usual, customary, and reasonable (UCR) fees. (Read AMA’s press release for details.) Many MSNJ members filed such claims and should watch for the checks.  Members who filed claims with the Claims Administrator should receive checks by April 15. The checks will be from Berdon Claims, LLC. Members who filed claims with MCAG should also receive claims by April 15, but the checks will be from MCAG. For details, read AMA’s announcement.

U.S. Department of Health & Human Services (HHS) May Delay ICD-10 Compliance
HHS announced today that HHS will initiate a process to delay the compliance date for ICD-10 from October 1, 2013 to a new compliance date moving forward. HHS Secretary Kathleen Sebelius commented:

“We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead.  We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.” Read more.

NJ Supreme Court Rules to Limit Scope of Practice for PAs 
In their January 19 opinion, the Supreme Court of New Jersey ruled that physician assistants cannot perform needle electromyography, as the procedure is not in their scope of practice. In an American Medical News article published on Monday, MSNJ CEO and General Counsel, Larry Downs said, "The Supreme Court upheld the appellate decision, basically narrowing the [trial] court's broad opinion. If the court had reversed, "physician assistants would have had an equal scope of practice without the similar background and training" of licensed physicians”

MSNJ thanks the AMA and the AMA Litigation Center for their support on this issue.

5010 Transitions in Physician Practices May Cause Cash Shortages 
As physicians make the transition to 5010, there is a growing concern of impending cash flow issues with delays in payment processing.

MSNJ Sapphire Level Corporate Partner Sun National Bank offers physicians a professional line of credit that helps doctors meet cash flow obligations and automatically covers overdrafts as it links to your checking account. Additionally, Sun National bank will reimburse any practice up to $1,000 towards its 2012 annual MSNJ dues when they open a Professional relationship account and take advantage of Sun’s credit solutions. Interested members should contact Brandon Kaletkowski, Healthcare Private Banker at Sun National Bank either by e-mail or cell phone, 609-389-2175.

Medical Audits: What Physicians Need to Know
Government and private payers have increasing pressure to lower healthcare costs. This inevitably drives them to audit practices for alleged overpayments and to attempt to recoup. It is imperative that physicians understand the risk of these audits, how to prepare and how to respond. Physicians need to prepare for and manage external payer audits just as they manage any other part of the business side of their practices to minimize the risk of being audited and to ensure that any audit findings are fair and accurate. Read a comprehensive white paper prepared by the Physicians Advocacy Institute (PAI) and share it with your staff. Read more about PAI and this new practice product.

Cosmetic Surgery Tax Repeal’s Phase-Out Schedule 
MSNJ recently achieved one of its legislative priorities with the repeal of the cosmetic surgery tax. There have been some questions about the scheduled phase-out, of 2% per year until July 2014 when the full repeal is effective. View the phase-out schedule. MSNJ objects to all taxes on medical treatment and facilities and will continue to advocate against these taxes.  

Weigh What Matters Update 
In the fall of 2011, MSNJ recruited 9 physicians to participate in the Weigh What Matters pilot program in cooperation with the America Medical Association. Since the pilot, the AMA released a free “Weigh What Matters” application to help people achieve a healthier lifestyle. The Weigh What Matters application is free and encourages users to consult with their physicians to establish health goals. For more information about the application, visit the AMA website.

Nominating Committee Election Results 
Richard Scott, MD, and the Nominating Committee would like to announce the results of the Nominating Committee Election held on January 18 at the MSNJ headquarters. Congratulations to all.

Top Doctors 2011: Make Your Voice Heard in New Jersey Monthly 
New Jersey Monthly’s annual survey of physicians is underway. This is the only survey that is mailed to all doctors in active practice in New Jersey rather than relying on the opinions of a smaller group of doctors or a national poll. MSNJ encourages all members to participate. Vote online by Friday, February 24. You will be asked to enter your medical license number before entering the site to vote. The list is "locked down" before any solicitation of advertising, and a variety of methods are employed by the polling company to prevent ballot-box stuffing. The results will be published in a fall edition of New Jersey Monthly.

Reminders & Notes

"ABC’s of ACO’s – and Alternative Forms of Integrated Care" 
March 19 - 6:00 P.M. 9:00 P.M.

Stony Hill Inn, Hackensack (Bergen County)
March 28 - 6:00 P.M. 9:00 P.M. 
Harbor Pine Country Club, Egg Harbor (Atlantic County)

MSNJ is taking our well received "ABC’s of ACO – and Alternative Forms of Integrated Care" seminar on the road. There will be a panel of esteemed physicians from the state sharing their insights. Alfred Tallia, MD, will speak about governance of managing an ACO, Thomas Kloos, MD, will discuss IPA development of ACOs and Mark Van Kooy, MD, will discuss the IT needs of integration. An attorney will address the legal aspects of ACOs. This seminar targets physicians, practice managers, physician assistants, nurses and other healthcare professionals. Check MSNJ e-News for additional information on both seminars.

The next meeting of MSNJ's Policy & Strategy Panel will take place on Thursday, March 15 at 4:30 P.M. The meeting will feature a mock court hearing on the constitutionality of the Affordable Care Act. Lawyers from McElroy, Deutsch, Mulvaney & Carpenter, a distinguished New Jersey law firm, will present a mock appellate oral argument on the constitutionality of the Affordable Care Act as a prelude to the Supreme Court oral arguments currently scheduled for the end of March. Two lawyers will take opposing sides and argue to "the court" - a panel of senior healthcare lawyers acting as judges.  The mock argument will be followed by a question and answer session. It will conclude with predictions from the panel of likely outcomes and what that might mean for physicians.

EMR Users Group: Wednesday, March 21, 2012 
MSNJ and NJ-HITEC will be hosting an “EMR Users Group” on Tuesday, March 20, 2012 from 2:00 P.M. to 7:00 P.M. at The Conference Center at Mercer County Community College. Here current users can present their experiences, helpful tips and tools, and network with other users. Our vendors have the opportunity to provide training in a group setting to their end users. Physicians and practice managers can mingle and see how everyone is using their system. Physicians who do not have an EMR system can take a look at the vendors and listen to presentations, including a CME presentation from NJ-HITEC on how to get started and the processes that follow. Register online.

MSNJ's 2012 Annual Meeting will take place on May 4-5, 2012 at the Westin Mount Laurel in Mount Laurel, NJ. Online registration coming soon! Browse the preliminary program, reserve exhibit space, submit an ad or sponsor the Inaugural Gala for Mary Campagnolo, MD, MSNJ's 220th President. More information is available on our Annual Meeting event page.

2012 Webinar Series

NJ-HITEC Meaningful Use 2-Part Webinar Series 
Join MSNJ and NJ-HITEC for a two-part series on becoming a Meaningful User. Archived versions of both parts will be available on the MSNJ website.

Part 2: On Thursday, February 23, 2012, NJ-HITEC will cover “How the Meaningful Use Reporting System Works.” Learn about different nuances of reporting the Meaningful Use data to CMS. This presentation will focus on both Medicare and Medicaid attestation process. This event is $49 for MSNJ members and $129 for non-members. For PAHCOM and NJMGMA members, the fee is $99. Register online by Wednesday, February 22.

Privacy & Security in an Era of Telemedicine, Social Media and the Internet” 
Thursday, April 19 from 12:00 P.M. to 1:00 P.M.

This webinar will discuss issues such as:  When are telemedicine services reimbursable? Can a physician provide telemedicine to patients in another state in which such doctor does not hold a license? Are devices such as Skype, iPads and BlackBerry’s secure means to transmit patient information? Register online.

Practice Management

Practice Management Study on Health Insurance ID Cards 
MSNJ is urging practices to send examples of health insurance ID cards on which it is difficult to determine if the plan is self-funded or commercially, fully funded. A photo or scanned copy of the front and back of the card is requested from the first quarter of 2012 (newest cards on file). The name, birth date, and ID # should be blocked out. Please keep the group number visible. We would like 1 card per plan for each payer and the date it was copied. Submit examples to The sample cards will help support our continuing dialogue with the Department of Banking & Insurance on the importance of the clarity of this information.

Medicaid Providers Receive Nearly $40 Million in EHR Incentive Funds 
On February 10, 2012, the Departments of Health and Senior Services (DHSS) and Human Services (DHS) announced that nearly $40 million in federal money will be disbursed to about seventy hospitals and high volume Medicaid providers for implementing Electronic Health Record (EHR) technology. The funding comes from the American Recovery and Reinvestment Act (ARRA) HI-TECH law through New Jersey’s Office of Health Information Technology (HIT). Medicaid physicians are eligible for up to $63,750 over six years and hospitals can receive up to $6 million over three years. The EHR technology must be acquired, implemented and used in a meaningful way for providers to receive the incentive payments. About $500 million is expected to be given to New Jersey Medicaid providers for EHR. Medicaid providers should take advantage of the EHR incentive program and can register online. More information can be found on the HIT website, and CMS’ website. View a related article.

New CQM page on CMS’ Website 
CMS created a new page for clinical quality measures (CQMs) on the EHR website. The page intends to help providers better understand the purpose of CQMs and how to report on the measures. Included on this new page are general program definitions, and eligible professional, eligible hospital and critical access hospital CQM reporting requirements.

PQRS & eRx Incentive Program National Provider Call 
CMS will host a national provider call on the 2012 PQRS & eRx Incentive Program on Tuesday, February 21, 2012 from 1:30 P.M. to 3:00 P.M. This call will focus on an overview of claims-based reporting for PQRS and eRx Incentive Program, followed by a Q&A. Register online. Presentation materials will be available soon.

New Timely Charge Submissions Tool for MSNJ Members 
MSNJ, with Laura S. Tarlow, MBA, CMPE, developed a new practice management tool for our members. With continued pressure on practice expenses and income, the speed with which you can obtain full payment becomes increasingly important. Speed of payment translates to positive cash flow

Using this tool, you will have faster submissions, which leads to addressing the appeal quicker and resolving issues faster to obtain payment. This tool is free for members and is available for purchase by non-members for $125.00. Members may enter a contest to win a free consultation to set up the tool for your office. Enter by emailing the Member Resource Center at with subject line "MPMS Tool Contest." Contest ends March 9, 2012. Read more: [Members]  [Non-members]. 

5010 Conversion Problems
A Message from Highmark Medicare Services:

On 01/25/2012, 01/26/2012 and 01/27/2012, Highmark Medicare Services experienced technical problems with the 5010 translator.  Some Electronic Data Interchange (EDI) claim files submitted on these days never produced the 999 or 277CA acknowledgement transactions as would have been expected.  

Currently we are handling these issues on a case by case basis. If you have experienced this issue and have not resubmitted the file, please contact us and we will reprocess your file for you. We are working on identifying all files affected.  We apologize for any inconvenience this has caused.

Highmark Medicare Services EDI

MSNJ has been assisting members with 5010 conversion problems with a number of different payers including United Healthcare. Members may direct questions to the United Healthcare dedicated 5010 mailbox at for answers to technical questions.


The Princeton Center for Dermatology is hosting a "Safe from the Sun" Melanoma Walk at Mercer Park in Princeton on March 24. The Center is looking for vendors who would like to donate items such as water, food, etc. or set up a stand for advertising for sun safe products. All proceeds will benefit the Melanoma International Foundation. Register a team and learn more online.

Save the Date: NJPA will present, "Challenges to Cure and Care," on March 31, 2012. This all day conference will take place at the Renaissance Woodbridge Hotel in Iselin. The keynote speaker will be Peter Carmel, MD, MSNJ Member, AMA President, Professor & Chair of the Department of Neurological Surgery at New Jersey Medical School and Co-Medical Director of the Neurological Institute of New Jersey. Come visit MSNJ’s exhibit table at this event. Registration coming soon.

In This Issue
-Reminders & Notes
-2012 Webinar Series
-Practice Management
-AMA SGR Fix Videos
-Check it out!
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MSNJ Event Calendar

Check out the AMA's new videos calling for a permanent SGR fix!

"A Permanent Fix for Medicare"

"Know the Facts"

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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.
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