In the News ...In the News ...
Return on Investment for Health Information Exchange Participation
Blog: In the News ... | Posted By: GUEST | Released: July 6, 2018, 7:02 am
By: Laura McCrary, Ed.D, Executive Director, Kansas Health Information Network and Senior Vice President, KAMMCO
What is the return on investment (ROI) for participating in a health information exchange (HIE)? As the Executive Director of one of the most successful HIEs in the nation, I am often a
What’s New with Novitasphere Part B
Blog: In the News ... | Posted By: GUEST | Released: May 16, 2018, 9:41 am
Novitas, the Medicare Administrative Contractor (MAC) for Jurisdictions L (and Jurisdiction H), is always looking for ways to improve our customers’ Medicare experience. Novitasphere, a FREE, secure internet portal for providers, billing services, and clearinghouses...
CMS Changes Name of EHR Incentive Program & Advancing Care Information Performance Category
Blog: In the News ... | Posted By: Marlene Mathew Kalayilparampil | Released: May 4, 2018, 5:33 am
In late April, the Centers for Medicare and Medicaid Services (CMS) announced proposed rule changes directly aimed at empowering patients and reducing administrative burden for physicians.
Diane B. Allen Equal Pay Act
Blog: In the News ... | Posted By: Mishael Azam, Esq. | Released: May 3, 2018, 6:25 am
The "Diane B. Allen Equal Pay Act," (S104) which takes effect July 1, modifies the Law Against Discrimination, (LAD), to strengthen protections against employment discrimination and promote equal pay for all groups protected from discrimination.
Effective July 2: CMS Reinstating QMB Identifier on RAs
Blog: In the News ... | Posted By: Amanda Shiber | Released: May 2, 2018, 10:33 am
Medicare will include Qualified Medicare Beneficiary (QMB) identification on remittance advice (RAs) again beginning 7/2/18. Read more. Due to a system issue, CMS had to suspend publication of this information. The issue has been resolved and Medicare Contractors have been advised to start including
Out of Network
Blog: In the News ... | Posted By: Mishael Azam, Esq. | Released: April 26, 2018, 12:59 pm
The "out-of-network" bill was passed by both houses. Please find a summary of the bill, which will likely be signed soon.
National Healthcare Decisions Week
Blog: In the News ... | Posted By: Marlene Mathew Kalayilparampil | Released: April 26, 2018, 12:58 pm
Last week was National Healthcare Decisions Week (April 16-22). The New Jersey Department of Health encourages residents to contemplate their healthcare preferences and plan ahead for end-of-life care decisions. The national theme for 2018 is "It Always Seems Too Early, Until It's Too Late."
NJ DOBI Independent Health Care Appeals Program for Prior Authorization Denials
Blog: In the News ... | Posted By: Amanda Shiber | Released: April 26, 2018, 6:44 am
The NJ Department of Banking & Insurance administers an external review program for prior authorization denials for procedures and prescriptions. Since 2014, physicians are required to post notice regarding the Independent Health Care Appeals Program (IHCAP) in their office.
IHCAP is available to
UHC, Oxford, Americhoice Fined $2.5 Million for Regulatory Violations
Blog: In the News ... | Posted By: Melinda Martinson, Esq. | Released: April 5, 2018, 11:26 am
The Department of Banking & Insurance (DOBI) fined UnitedHealthcare (UHC), Oxford and Americhoice $2.5 million for regulatory violations, some of which MSNJ brought to DOBI’s attention based on our members’ complaints. In particular, we asserted that UHC could not require physicians to provide patie
Blog: In the News ... | Posted By: Mishael Azam, Esq. | Released: March 1, 2018, 7:50 am
Continue to encourage your patients to get vaccinated! The flu vaccine is 36% effective this season and has been most effective for young children, according to interim estimates the Centers for Disease Control and Prevention (CDC) released [February 15th]. “These early VE (vaccine effectiveness) es
2017 MIPS Claims Data Performance Scores Now Available on QPP Website
Blog: In the News ... | Posted By: Amanda Shiber | Released: February 15, 2018, 9:41 am
If you submitted quality data via claims for the 2017 reporting year, you may now view your performance scores at: https://qpp.cms.gov/login by using the data submission feature.
Submitting Quality Performance Data via Claims
If you’ve already submitted quality data via claims, you don’t have to t
New United Opioid Coverage Policy
Blog: In the News ... | Posted By: Mishael Azam, Esq. | Released: February 8, 2018, 12:35 pm
New to Therapy Short-Acting Opioid Supply and Daily Dose Limits for UnitedHealthcare Community Plan and UnitedHealthcare Commercial Plans – Effective March 1, 2018.
Beginning March 1, 2018, UnitedHealthcare Community Plan in some states and UnitedHealthcare commercial plans will implement a short-
State Adopts Rules on Health Claims Processing & Payment Act
Blog: In the News ... | Posted By: Melinda Martinson, Esq. | Released: February 8, 2018, 11:55 am
The Department of Banking & Insurance adopted regulations implementing the Health Claims Authorization Processing & Payment Act (HCAPPA) which was passed in 2006. MSNJ filed comments joined by the NJ Association of Osteopathic Physicians & Surgeons, NJ Society of Interventional Pain Physicians, New
DOJ Seeks More Information on Proposed CVS-Aetna Merger
Blog: In the News ... | Posted By: Melinda Martinson, Esq. | Released: February 8, 2018, 11:36 am
On February 1, the Department of Justice made a second request for information concerning CVS’s attempt to merge with Aetna to create an integrated health system. Those who attended MSNJ’s last Policy & Strategy Panel meeting heard potential anti-trust concerns from the AMA which is carefully analyz
Medicare Mammography Payment Issue
Blog: In the News ... | Posted By: Amanda Shiber | Released: February 1, 2018, 7:46 am
Practices that perform mammography are urged to review their Medicare claims dating back to October 1, 2017 to ensure proper payment. There was a system edit, causing the rejection of mammography claims using new, more specific ICD-10 codes. The edit has now been deactivated and these claims may be
Prior Authorization Progress
Blog: In the News ... | Posted By: Amanda Shiber | Released: January 26, 2018, 11:58 am
MSNJ supported the AMA in its Prior Authorization and Utilization Management Reform Principles in early 2017. As a result of publication of these principles, a workgroup comprised of the AMA, the American Hospital Association, America's Health Insurance Plans, American Pharmacists Associati
Tiered Network Surveys
Blog: In the News ... | Posted By: Melissa Zarzycki | Released: January 26, 2018, 11:48 am
In anticipation of a Senate hearing on OMNIA, MSNJ has published new Tier 1 and Tier 2 surveys to collect information from our members to help inform our testimony before the Legislature. Members are encouraged to complete the appropriate survey for their OMNIA tier designation.
Rules Limiting Compensation from the Pharmaceutical Industry Adopted
Blog: In the News ... | Posted By: Melinda Martinson, Esq. | Released: January 23, 2018, 7:50 am
Rules governing prescribers' acceptance of compensation from pharmaceutical manufacturers became effective on January 16, 2018, Governor Christie's last day of office. Even with improvements urged by MSNJ and adopted, the rules are the most restrictive in the nation. Together with other stakeholders
New Jersey Physicians Boost the State’s Economy, Generating 281,923 Jobs
Blog: In the News ... | Posted By: Melissa Zarzycki | Released: January 11, 2018, 8:16 am
New Jersey Physicians Boost the State’s Economy, Generating 281,923 Jobs
New study demonstrates that physicians drive $55.4 billion in economic activity
Lawrenceville, NJ – Physicians add opportunity, growth and prosperity to the New Jersey economy by creating 281,923 jobs and generating $55.4 bil
Connecting for Better Care with New Statewide Health Information Exchange
Blog: In the News ... | Posted By: Melissa Zarzycki | Released: December 4, 2017, 10:14 am
The Medical Society of New Jersey (MSNJ) announces the launch of OneHealth New Jersey, a statewide health information exchange (HIE) that is now live. OneHealth New Jersey encompasses an interoperable health information exchange, as well as a patient health portal, extensive data analytics tools, an
NEW BENEFIT: MIPSwizard
Blog: In the News ... | Posted By: Melissa Zarzycki | Released: November 15, 2017, 8:41 am
Up to 4% of your Medicare Payments are At Risk—Are You Ready?
Satisfy your MIPS Requirements with MIPSwizard
The #1 Registry for Quality Measures reporting to CMS
MIPSwizard is an easy to use online tool to help eligible clinicians quickly and easily participate in the Merit-based Incentive Payme
Call for Nominations
Blog: In the News ... | Posted By: Sue Hoisington | Released: November 9, 2017, 2:10 pm
We are accepting applications from interested candidates for positions on the Board of Trustees, AMA Delegation, Judicial Council and various committees. Please review the MSNJ Open Positions for 2018 and read a brief synopsis of the committees and expectations. Your involvement is key to the Succes
Due December 31: MIPS Annual Security Risk Analysis
Blog: In the News ... | Posted By: Amanda Shiber | Released: November 9, 2017, 2:10 pm
Security Risk Analysis is a required measure under the Advancing Care Information Category for 2017 MIPS reporting. If you plan to report data for this category, you must complete your analysis by December 31. For more information, please see Quality Insights' webinar slides; recording; or transcrip
MSNJ Weighs-in on PIP, EOBs, In-plan Exceptions & IURO Rules
Blog: In the News ... | Posted By: Melinda Martinson, Esq. | Released: November 9, 2017, 2:08 pm
PIP: MSNJ filed comments on a pre-proposed rule that would link certain PIP fees to Medicare. We have long advocated against the use of Medicare to set fees. This is particularly true for PIP since the statute sets the standard at 75% of reasonable and prevailing fees in the region.
EOBs: MSNJ has
New Narrow Network Horizon Medicare Advantage Product
Blog: In the News ... | Posted By: Melinda Martinson, Esq. | Released: November 2, 2017, 9:58 am
Horizon announced this week that it will offer a new Medicare Advantage product during open enrollment for the 2018 plan year. Horizon has chosen select providers from its Managed Care Network to participate in the Medicare Blue Advantage HMO plan. Letters were mailed last week to participating and
Horizon BCBS News & Legal Notices
Blog: In the News ... | Posted By: Amanda Shiber | Released: November 2, 2017, 9:48 am
Horizon BCBS requires providers to visit its website or NaviNet in order to review communications regarding material adverse policy changes. We have asked Horizon to provide MSNJ notice of these changes, so that we can inform our members. As a service to MSNJ members, we will post these changes, as
Sign-Up for Payer Notices to Stay up to date on Policy Changes
Blog: In the News ... | Posted By: Amanda Shiber | Released: November 2, 2017, 9:40 am
Members are urged to sign up for payer notices, in order to stay up to date on policy changes that could impact your practice. While MSNJ reviews payer policies and works with the state and national specialty societies on potential issues, it is important that practices also stay informed and tell u
Write To Your Legislators To Repeal the Flawed IPAB!
Blog: In the News ... | Posted By: Melissa Zarzycki | Released: October 30, 2017, 12:12 pm
Legislation to repeal the Independent Payment Advisory Board (IPAB) is moving on Capitol Hill, but Congress needs to hear from America's physicians in order to push it over the finish line. Please urge your legislators to support H.R. 849 to repeal the arbitrary and flawed IPAB by calling AMA’s toll
PreCheck MyScript: New Online Drug Prescribing Solution for UnitedHealthcare Commercial, Medicare and Medicaid Benefit Plans
Blog: In the News ... | Posted By: Melissa Zarzycki | Released: October 12, 2017, 7:22 am
By Dr. Marilyn Gordon, Medical Director, UnitedHealthcare of New Jersey
As physicians, we know you spend several hours each week on prior authorization requests, especially
UPDATE: UHC Delays Consult Code Policy
Blog: In the News ... | Posted By: Amanda Shiber | Released: September 22, 2017, 12:24 pm
In July, MSNJ was joined by 36 medical and specialty societies in a letter to United Healthcare (UHC) opposing its proposed policy change to no longer pay for consultation CPT codes 99241-99245 and 99251-99255 for dates of service on and after October 1. This week, UHC advised MSNJ that it will dela