News from Trenton
AMA National Advocacy Conference (NAC)
This week, Mary F. Campagnolo, MD, MBA and John Poole, MD, along with MSNJ CEO Larry Downs and COO and Senior Manager, Legislation, Mishael Azam, attended the AMA’s National Advocacy Conference. They heard from national leaders, including Secretary Sebelius, on federal budget issues, SGR reform and GME changes. They also met with staff for key members of the New Jersey Congressional delegation to discuss SGR and other reforms. A House Energy and Commerce held a hearing on Thursday entitled, ‘SGR: Data, Measures and Models; Building a Future Medicare Physician Payment System.’ MSNJ will keep members apprised of these issues. Read more.
Tanning for Minors
On Thursday, the Assembly took a final vote on a bill that would (1) permit a tanning facility operator to allow minors who are at least 14 years of age to use a tanning facility for spray tanning and (2) permit a minor who is at least 17 years of age to use a tanning bed in a tanning facility, provided that the minor’s parent or guardian is present at the tanning facility for the initial consultation. Tanning facility operators must also post notice of the law in conspicuous view near the reception area. The bill now heads to the Governor’s desk.
Gun Control Measures
The Assembly Law and Public Safety Committee on Wednesday heard over 20 bills on gun control. MSNJ weighed in on a mental health bill and successfully sought amendments to protect physicians. The amended bill requires licensed medical professionals in this State to report to the Attorney General when, in their reasonable professional judgment, a patient they are treating is likely to engage in conduct that would result in serious harm to that patient or others. As amended, the bill clarifies that the licensed practitioner who discloses such a privileged communication in is immune from civil liability in regard to that disclosure. The goal of the bill is for the AG to seize weapons from such patients, if appropriate. The bill leaves in place current immunity for physicians from civil liability for a patient’s violent act against another person or against himself. The bill also leaves in place duty to warn requirements and immunity if the duty is upheld. The bill heads to the floor for a full vote but has not yet been considered by the Senate.
In the Assembly Education Committee, MSNJ supported protections of child privacy. Current law states that, a school district must receive prior written informed parental consent before it administers to students any academic or nonacademic survey, assessment, analysis or evaluation which reveals information concerning:
- political affiliations;
- mental and psychological problems potentially embarrassing to the student or the student’s family;
- sexual behavior and attitudes;
- illegal, anti-social, self-incriminating and demeaning behavior;
- critical appraisals of other individuals with whom a respondent has a close family relationship;
- legally recognized privileged or analogous relationships, such as those of lawyers, physicians, and ministers;
- income, other than that required by law to determine eligibility for participation in a program or for receiving financial assistance under a program; or
- social security number.
The bill would loosen parental control requirements by only requiring consent if participation in such surveys is required by the school. If the survey is voluntary, only written notice is required. But, voluntary surveys may not request the student’s political affiliation, sexual behavior and attitudes or social security number.
MSNJ supported medical liability reform in the Assembly Health Committee this week. A1831, sponsored by Chairman Conaway, would prohibit the addition of defendants using fictitious names at least 120 days prior to the date on which the action is set for trial. This bill also clarifies the existing legal immunity for health care professional who volunteers to respond in good faith to an emergency at a hospital or health care, removing the requirement that the service be provided without payment.
The bill provides that an insurer cannot increase the premium of any medical malpractice liability insurance policy based on a claim of medical negligence or malpractice against an insured unless the claim results in a medical malpractice claim settlement, judgment or arbitration award against the insured. Finally, the bill also prohibits an insurer from increasing medical malpractice insurance premiums, if the alleged malpractice occurred in certain charitable or emergency situations. The trial lawyers oppose the bill. Read the New Jersey Lawsuit Reform Alliance’s support letter and flier on the benefit of reform on women’s health.
MSNJ has advocated for changes to the regulatory proposals which would allow collaborative practice agreements between physicians and pharmacists over the last two years. On February 4 the State Board of Medical Examiners and State Board of Pharmacy adopted regulations that addressed many of our concerns. The boards clarified in the preamble to the adopted regulations that “pharmacists do not have prescriptive authority” and may not engage in therapeutic interchange without the express consent of the physician and patient. [44 N.J.R. 213(b), Response to Comment 6]. Specific provisions for which MSNJ advocated include:
- Pharmacists may modify, continue or discontinue drug therapy, but may not initiate;
- Collaborative practice arrangements are limited to individual pharmacists (and may not be with a pharmacy or a chain);
- There must be a bona fide relationship for a physician and pharmacists to enter into a collaborative practice arrangement;
- The pathways for pharmacists to participate in collaborative agreements has been better defined; a voucher of 2,000 hours of training is not sufficient;
- Covering physicians and pharmacists must meet the same standards as the individuals entering into the arrangements;
- Specific conditions/diseases must be specified in the collaborative agreement; and
- Pharmacists must complete ten hours of continuing education on the specific disease states or conditions covered by the collaborative agreement which may require more than the minimum 30 hours, biennial, of continuing education depending on the number of conditions/disease states covered; physicians may customize the disease specific training required for the treatment of his/her patients.
MSNJ appreciates the careful consideration given to our concerns and the responsiveness of the Boards of Medical Examiners and Pharmacy to our comments.