The Medical Society of New Jersey is devoted to advocating for the
issues that matter most to physicians. Be it taking on the managed care
companies through legislation or the courts, lobbying Congress to increase
Medicare payments, or preventing taxes on physicians, we are your full time
advocate and resource for information. We hope that this site will help
empower you to learn about the major issues facing physicians, help you
advocate, and allow you an easy way to participate in the process.
MSNJ Letter Sent to Highmark Medicare Services
MSNJ's
letter to Highmark Medicare Services- 'Request to post new Medicare Fee Schedule' and the
response received
CDS: Writing Prescriptions for 90-Day Supply of Schedule II Substances
MSNJ is pleased to announce that physicians may now write multiple prescriptions authorizing a patient to receive a total of up to a 90-day supply of a Schedule II controlled dangerous substance (CDS) under recent amendments to the law. MSNJ advocated actively for the recently passed amendments. While rulemaking is necessary from both the Board of Medical Examiners and the Division of Consumer Affairs, the Christie Administration has issued a letter that will allow patients, physicians, and pharmacists to benefit from the new law before the rulemaking is complete. MSNJ applauds the administration’s leadership, streamlining and cutting through the red tape, to improve healthcare delivery on this issue.
Physicians must comply with each of four conditions set forth in a
letter dated June 2010 from the New Jersey Attorney General. Physicians may write three thirty-day prescriptions so long as:
1. Each separate prescription is issued for a legitimate medical purpose by the physician acting in the usual course of professional practice; and
2. The physicians provides written instructions on each prescription, other than the first prescription if it is to be filled immediately, indicating the earliest date on which a pharmacy may fill each prescription; and
3. The physician determines that providing the patient with multiple prescriptions in this manner does not create an undue risk of diversion or abuse; and,
4. The physician complies with all other applicable state and federal laws.
Read the June 2010 letter from the Acting Director of the New Jersey Office of the Attorney General, Division of Consumer Affairs for details.
The amendments to the Board of Medical Examiners and Division of Consumer Affairs rules will be available online. MSNJ will comment on the proposed rules when they become available.
Assignment of Benefits Bill Passes the Legislature
Legislation requiring health insurers to remit a patient’s reimbursement directly to an out-of-network provider has passed the Senate on January 11, 2010, just days after passing the Assembly and a week after clearing its biggest hurdle before the Assembly Financial Institutions and Insurance Committee. MSNJ encourages the Governor to sign A-132.
HEALTHCARE REFORM
MSNJ leadership has taken a position on the federal legislative initiatives to reform healthcare. The position is based on a number of existing policies including the
“Principles of Coverage of the Uninsured” (adopted in March of 2008). Read the July 21, 2009
letter to Congress expressing our concerns about the legislation and the
statement of MSNJ’s President Joseph Reichman to members explaining our position.
Side-by-Side Comparison of Pending Bills (Kaiser Family Foundation October 15, 2009)
AMA Resources:
- AMA’s Press Release concerning Support of H.R. 3200 (July 16, 2009)
- AMA’s Letter concerning Support of H.R. 3200 (July 16, 2009)
- AMA’s Letter concerning reform of Medicare as part of Healthcare Reform (July 18, 2009)
- AMA’s FAQs on H.R. 3200
Commentary:
Three Former AMA Presidents Weigh-In (
Washington Post Op-Ed July 23, 2009)
Health Affairs Resources:
Public Plan Option
One controversial question in the current health reform debate is: Should Americans be able to enroll in a newly created, publicly administered health insurance option as the nation works to expand health coverage? This
Health Affairs policy brief explains public health insurance plan proposals and concerns of supporters and opponents.
Taxing Employer-Sponsored Health Plans
A key question in the healthcare reform debate is whether employer-sponsored health insurance should be taxed. This is the subject of a
Health Affairs policy brief. It outlines the proposals to limit the tax exclusion on employer-sponsored health plans and explores the concerns of supporters and opponents.
Doing More with Less?
Kerry Weems served as acting administrator of the Centers for Medicare & Medicaid Services (CMS) from June 2007 through January 2009. In a candid interview with
Health Affairs he discusses healthcare reform and the strain that will occur when additional responsibilities are placed on CMS. According to Weems, CMS is already straining to perform its current duties, because Congress and the executive branch, regardless of party, have chronically deprived the agency of needed managerial resources. “On the operational side, there is not enough money to be able to even pay the [Medicare] bills in a reasonable way," states Weems.
The
interview can be read on the
Health Affairs web site.
MEDICARE ADVANTAGE
In this policy brief,
Health Affairs explores the issue of funding to Medicare Advantage plans. The
policy brief on Medicare Advantage funding explains how payments to these private plans are calculated, delineates the arguments on whether to cut plan payments, and provides research to support the competing arguments.
Insurance Plan Interaction Costs Physicians $31 Billion Annually
Health Affairs has published two studies that quantify the cost and time spent by physicians annually to interact with insurance plans. The studies are timely given that policy makers are in the midst of evaluating ways to cut healthcare costs as part of national healthcare reform. The
national study finds that physicians spend, on average, the equivalent of three work weeks, annually, to perform administrative tasks required by health plans. The cost is $31 billion annually and represents 6.9% of all national expenditures for physicians and clinical services. A second study takes an in-depth look at the billing and insurance-related activities performed at a large group multi-site practice in California. The
study found that the clinicians spent more than 35 minutes per day performing this work. This administrative work also required the equivalent of 0.67 non-clinical full-time staff per full-time physician at an annual cost of $85,276 per physician and amounted to 10 percent of operating revenue.
MEDICAID: Medicaid & Medicare Reimbursement Gap is Narrowing
Medicaid physician fees rose 15.1% between 2003 and 2008 according to a study by researchers from the Urban Institute. This increase narrows the gap between Medicaid and Medicare reimbursement rates, but it still lags behind general inflation. The
paper can be accessed through the
Health Affairs web site.
MEDICAID: Coverage for Low Income People
Congress is considering legislation to increase enrollment in Medicaid, the government health insurance program for low-income families, as well as in the Children's Health Insurance Program (CHIP). Read
Health Affairs Health Policy Brief to learn how the health reform bills making their way through Congress would expand Medicaid and make more children eligible for CHIP.
MENTAL HEALTH: Thematic Issue Addressing Parity
The May/June 2009 issue of
Health Affairs is dedicated to mental healthcare coverage issues.
Health Affairs notes that while Congress passed legislation last year prohibiting group health plans that provide mental health coverage from imposing stricter limits on this treatment than for other medical care there is still work to ensure parity in care. Visit the
Health Affairs web site for details.
ELECTRONIC MEDICAL RECORDS
The Obama Adminstration has focused on health information technology as a way to reduce the costs of healthcare in this country. Health Affairs has dedicated its entire March/April 2009 issue to “Stimulating Health IT.” Articles cover topics such as “Lessons Learned,” “Patients & Privacy,” and “E-Prescribing.
Obesity: The Rising Cost of Care
As Congress struggles to determine how it will pay for healthcare reform researchers from RTI International, the Centers for Disease Control & Prevention (CDC), and the Agency for Healthcare Research & Quality have found that national medical spending on obesity could reach $147 billion a year. The study, reported in
an article in Health Affairs, finds that medical spending on obesity conditions doubled between 1998 and 2006. This rise accounted for 89 percent of the increase in obesity spending. It now accounts for 9.1 percent of medical spending, a jump from 6.5 in 1998. Medical spending linked with obesity accounts for 8.5 percent of Medicare expenditures and 11.8 percent of Medicaid expenditures.
Kaiser Resources:
Kaiser Health Tracking Poll on Healthcare Reform (July 2009)
Web Resources: