Doctor’s Day: N.J. Doctors Work to Keep Care Accessible – Urge New Jersey Senators to Vote in Favor of Legislation
By: Lawrence Downs, Esq.
Doctors want to help people. That’s what drives them; that’s what gives them satisfaction and purpose. And that’s what they spend their lives doing.
For more than a decade, however, physicians have faced rising barriers to caring for older patients. Due to flaws in the Medicare system – the federal health insurance program for seniors – growing numbers of physicians simply cannot afford to treat Medicare patients, and seniors are increasingly struggling to access medical care.
But across New Jersey and nationwide, caring doctors are stepping forward to help. They’re strongly supporting legislation that would ensure seniors access to physicians in their communities.
The problem is not new: Congress has enacted 17 temporary patches over the past 12 years to address Medicare’s faulty “Sustainable Growth Rate” (SGR) formula – which determines physician payment rates each year. (Ironically, the $170 billion price tag on these patches has already exceeded the cost of simply freezing payment rates for the next 10 years, estimated at $137 billion by the American Medical Association.)
But now, there’s a real chance for a permanent – and less costly – repair: Congress has introduced, and the House has already voted on groundbreaking legislation that would eliminate the SGR and provide real solutions to ensure seniors’ access to good care.
After many years with little consensus, we finally have a bipartisan, bicameral bill, and the vital support of key stakeholders including patient organizations, policy think tanks, and advocacy groups across the political spectrum.
The Medical Society of New Jersey is one of more than 600 national and state physician associations that vigorously support the legislation, known as the “SGR Repeal and Medicare Provider Payment Modernization Act of 2014” (H.R. 1470 / S. 810).
Since the House has already taken historic action, we encourage New Jersey Senators Menendez and Booker to vote in favor of this legislation when the Senate returns on April 13, so it can be sent to the president’s desk for signature.
If nothing is done, the problem will only worsen. Today, with the baby boomers hitting retirement age, 10,000 Americans are enrolling in Medicare each day. In New Jersey, 1.4 million people currently rely on Medicare; nationally, the total is about 50 million.[i] The flawed SGR also affects the care of 10 million veterans and active-duty military personnel enrolled in Tricare, the health care program for armed-services members and their families.
Physician members of MSNJ urge everyone’s strong support of the SGR Repeal Act, to help ensure care for some of our most vulnerable citizens. For more information, including links to contact Congress, please visit www.msnj.org, scroll to “News” and click on “SGR Repeal.”
Time is running out; please act now.
[i] Kaiser Family Foundation, Total Number of Medicare Beneficiaries (2012). Accessed March 24, 2015 http://kff.org/medicare/state-indicator/total-medicare-beneficiaries/
Yesterday Horizon Blue Cross released the results of a study it paid for that concludes that insurers are paying too much to physicians and hospitals that don’t participate in its network. Horizon also suggested it could lower premiums if NJ’s important consumer protections were repealed.
Horizon is a financial juggernaut. The company made $214 million net of expenses in 2013 according to its published financial statements, that’s $10 million better than they did in 2012. The company (a non-profit) has reserves over $2.5 billion. It seems they have some room to lower premiums now.
What Horizon failed to say is that they have the ability to contract with all physicians and hospitals in the state, but they choose not to. New narrow network plans exclude physicians that want to treat patients. So in effect Horizon is contributing to the problem they seem so desperate to fix.
Dialog on the financing of healthcare in NJ is sorely needed. But the laser focus on out of network payments is unfounded.
On February 2 at 7:00pm, MSNJ’s Revolving Reference Committee (RRC) will hear two resolutions via webinar.
- Physician/Patient Relationship – Right to Continuity of Care, Admitting and Consultation Privileges for Family Physician and internist for their Hospitalized Patients – Camden County
- Recreational Use and Abuse of Prescription Drugs – Hudson County
Information on these resolutions may be found on MSNJ’s website and by taking the following steps:
- Log into the website;
- Click on “Communities” located in the main menu across the top of the screen;
- Then click on “Committees and Councils” from the menu on the left;
- Next click on “Revolving Reference Committee,” which is the 2nd option from the top
The web page will include information on the RRC as well as information on each resolution and submitted comments.
- Webinar: Audio Login Call 866.740.1260 Enter access code: 8961259
- Web Login www.readytalk.com Enter access code: 8961259
In a meeting on December 7, the Board of Trustees of MSNJ considered the recommendation of the Revolving Reference Committee that it adopt a resolution that would require MSNJ to seek legislation to limit the end-of -life continuing medical educational requirement to a one-time two credit event. The law currently requires two credits of CME on end-of-life at each biennial license renewal. The Board voted to adopt the resolution which was brought forward by Union County and joined by 6 other counties.
In comments to the Board of Medical Examiners on December 5, MSNJ urged the BME to exercise its authority to allow the credits to be in either Category 1 or 2. MSNJ further urged the BME to convene the medical education advisory committee, on which MSNJ has a member, to consider the comments filed and how to best implement the statutory requirements. Finally, MSNJ encouraged the BME to carefully consider applications for waivers from the CME requirement since there are many licensed physicians in New Jersey who do not have patient contact or would not be in a position to either treat at end-of-life or counsel on end-of-life choices.
Wilmington, DE and Lawrenceville, NJ—December 17, 2014—First Healthcare Compliance (http://www.1sthcc.com), a national provider of a comprehensive compliance solution to help healthcare providers save time and money by efficiently implementing an effective compliance program, announces the official launch of their affinity partnership with Medical Society of New Jersey (http://www.msnj.org).
The First Healthcare Compliance Affinity Partners program provides partners with an opportunity to refer members to First Healthcare Compliance, and for their members to receive a ‘members-only’ lifetime discount as a new subscriber. First Healthcare Compliance helps their members save time and money, mitigate risk and maintain focus on patient care by providing them with a comprehensive solution to implement and manage a compliance program that addresses HIPAA/HITECH, OSHA, the False Claims Act, the Anti-Kickback Statute and Stark in a simple, efficient and effective manner, in one place.
“As First Healthcare Compliance continues to grow nationally, we are committed to developing relationships with qualified Affinity Partners. It is a winning proposition for organizations interested in offering an innovative new service benefit to their members,” said Julie Sheppard, Founder and President of First Healthcare Compliance. “We are thrilled that such a well-respected organization as the Medical Society of New Jersey is also committed to providing the resources and tools for healthcare practitioners and professionals to better manage their practice. We are confident that this new partnership will help us better reach physicians and other healthcare providers in private practice, and healthcare networks or health systems in New Jersey.
“Like us, the Medical Society of New Jersey understands the pressing needs of this market for a comprehensive compliance program management solution,” continues Julie Sheppard. “They recognize the incredibly limited resources available and the void that the First Healthcare Compliance solution fills.”
For further information, please visit http://1sthcc.com/partners/ or contact First Healthcare Compliance at 888.54.FIRST.
About First Healthcare Compliance
First Healthcare Compliance provides solutions to address the needs of the physicians and healthcare providers and their staff in private practice, or those in hospital networks and health systems, to implement and maintain a high quality compliance program in a simple, effective and efficient manner. The new business model created by First Healthcare Compliance enables them to offer a comprehensive, single-source compliance solution.
A privately-owned women business enterprise founded in 2012 in Wilmington, DE by Julie Sheppard, First Healthcare Compliance was created from the rising concern Julie had in witnessing the increasing demands being placed on physicians and other healthcare providers in private practice and in hospital networks and health systems, to comply with the rules and regulations of the Affordable Care Act. As a nurse, an attorney, and a physician’s spouse, Julie identified a widening gap between the expectations of government and the reality of compliance for healthcare professionals. She recognized the opportunity available to fill the void of practical compliance resources and options to solve these needs; this became the impetus for the formation of First Healthcare Compliance.
MSNJ would like to congratulate Anthony Tarasenko, MD, and Concentra Urgent Care for being awarded the 2014 Best of South Plainfield Award in the Doctors & Clinics category by the South Plainfield Award Program.
Each year, the South Plainfield Award program identifies companies that they believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small businesses through service to their customers and the community. These companies help make South Plainfield area a great place to live, work and play. Dr. Tarasenko is the Medical Director of Concentra Urgent Care. He has been an active member of MSNJ since 1990 and serves as a Board of Trustees member. Dr. Tarasenko is also Past President of Union County Medical Society.
Lawrenceville, NJ – The Medical Society of New Jersey (MSNJ) is pleased to welcome ENT and Allergy Associates (ENTA) as a new member. ENTA was originally formed in 1998 when three practices merged with 12 partners and 8 locations. Today, the group has grown to over 160 physicians practicing in 40+ office locations throughout New York and New Jersey. Additionally, ENTA offers patients the services of over 80 licensed audiologists.
“With 10 clinical locations in seven New Jersey counties, we at ENTA are very proud of our significant presence in New Jersey and our service to the deserving patients who call the Garden State home,” noted Robert Glazer, CEO of ENTA. “We stand with the Medical Society of New Jersey and applaud their dedication to both the patients and physicians of New Jersey. Helping to promote the betterment of public health throughout the state is exactly what our practice is all about.”
Added Lee Eisenberg, MD, partner at ENTA’s Englewood office, “Through a comprehensive program of legislative, legal, regulatory, economic and social advocacy, MSNJ superbly represents the interests of health professionals in numerous practices and specialties. That translates into enormous benefits for patients all over New Jersey. We are delighted to be a part of their organization.”
Founded in 1766, MSNJ is the oldest professional society in the United States. It represents the interests of group and individual physician practices and 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.
“We are pleased to welcome ENT and Allergy Associates as a new MSNJ member,” said Larry Downs, CEO of MSNJ. “We are committed to improving the healthcare environment for physicians and patients. Our advocacy with insurers, the government and private sector partners helps to extend the overall impact of physician practices. Partnerships with practices such as ENTA give us much better market perspective in our services to members.”
Information on group membership is available by visiting http://www.msnj.org.
Founded in 1766, the Medical Society of New Jersey is the oldest professional society in the United States. The organization and its dues-paying 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. This allows response to the patients’ individual, varied needs, in an ethical and compassionate environment, in order to create a healthy Garden State and healthy citizens. For more information, visit http://www.MSNJ.org.
About ENT & Allergy Associates, LLP:
ENT and Allergy has over 160 physicians in 40+ office locations in Westchester, Putnam, Orange, Dutchess, Rockland, Nassau and Suffolk counties, New York City, Long Island and northern/central New Jersey. Each ENT and Allergy Associates clinical location provides access to a full complement of services, including General Adult and Pediatric ENT, Voice and Swallowing, Facial Plastics and Reconstructive Surgery, Disorders of the Inner Ear and Dizziness, Asthma, Clinical Immunology, Diagnostic Audiology, Hearing Aid dispensing, Sleep and CT Services. ENTA has a clinical alliance with The Mount Sinai Hospital for the treatment of diseases of the head and neck and esophageal cancer, a clinical alliance with the Montefiore Medical Center for the tertiary treatment of pediatric patients and a partnership with the American Cancer Society to educate and treat patients with smoking disorders and cancer. The Practice has also expanded its clinical capabilities to include advanced Immunodeficiency trials. Visit http://www.entandallergy.com for more information.