Archive | May 2013

Gun Violence Reduction Initiatives

The Governor, through Executive Order Number 130 has created of a Mental Health and Community Safety Working Group to serve as an inter-agency, multidisciplinary

working group focused on decreasing violence, promoting safer and healthier communities, and highlighting the importance of de-stigmatizing mental illness, while encouraging early intervention.  The Governor had created the New Jersey SAFE Task Force on Gun Protection, Addiction, Mental Health and Families, and Education Safety (“NJ SAFE Task Force”) in January to conduct a comprehensive, balanced, and well-informed review of the root causes of mass violence.  In its April 10, 2013 report, the NJ SAFE Task Force recommended the creation of a standing interagency working group to consider the many long-term issues raised by their study.  The Working Group will consist of the following cabinet members: the Commissioners of the Department of Children and Families, the Department of Corrections, the Department of Education, the Department of Health, the Department of Human Services; the Attorney General; and the following non-cabinet members: the Executive Director of the Juvenile Justice Commission and the Chairman of the State Parole Board. Among other things, the working group will 1) develop strategies with respect to prevention and intervention, including, but not limited to, educating youth, parents, and teachers about the warning signs of violence and the negative consequences felt by teens and young people who are ostracized, isolated, and experience despair; 2) develop a public information campaign utilizing all forms of media, communications, and technology to better inform New Jersey residents about the broad range of programs and services available in the community as well as encourage individuals to seek help and no longer suffer under the shadow of the stigma of mental health illness; and 3) focus on strategies to facilitate workforce expansion in, among other professions, licensed clinical social workers, nursing, and psychiatry, while also encouraging such professionals in those and similar disciplines to work in the public or community health systems.

License Renewal-MSNJ Asks that Physicians Complete the Workforce Survey

Last week, the NJ Board of Medical Examiners mailed and posted notices for license renewal. The notices were delayed at least in part because of pending legislation which would have required physicians to complete the accompanying  physician workforce survey. Governor Christie vetoed the legislation. Participation in the workforce survey is voluntary. MSNJ is urging our members and all physicians in the state to participate in the voluntary workforce survey which is included in the license renewal. The information will assist the state in its evaluation of physician demographics and access to care.

Applications are due on or before July 15, 2013. Please see the MSNJ FAQ and BME Guide for more information.

Ruth Schulze, M.D. Installed as 221st President of the Medical Society of New Jersey

Lawrenceville, NJ – Ruth Schulze, M.D. was installed as the 221st president of the Medical Society of New Jersey (MSNJ) at its annual meeting held in May. She is the fourth woman to hold the title of MSNJ president since the organization was established in 1766.  She joined the MSNJ Board of Trustees in 2004 and has served six years as secretary followed by vice-president and president-elect positions.  She is a past officer and president of the Bergen County Medical Society.

Dr. Schulze practices at Women’s Total Health of Woodcliff Lake with Dr. Gail Sobel. Her gynecology practice focuses on adolescent, perimenopausal and senior women’s health and surgical needs. In addition, Dr. Schulze serves as the director of the Obstetrics and Gynecology department for Valley Hospital in Ridgewood. She was the first female president of the medical staff at Valley Hospital from 2010-2012.

During her inaugural speech, Dr. Schulze presented a number of initiatives for her term, focusing on expanding membership to include physicians from all types of practice and employment settings, as well as representation from all subspecialty organizations. Dr. Schulze is particularly interested in partnering with physicians in training along with community groups and business organizations to encourage healthcare forums or town hall type discussions to focus needed healthcare changes on quality medicine and patient safety.

“Ralph Waldo Emerson said it best, ‘Nothing worthwhile in life is accomplished without passion,’” said Schulze. “I am passionate about medicine and I am passionate about the Medical Society of New Jersey. With all of us working together, I firmly believe we are ready to create a new revitalized MSNJ speaking as the united voice of medicine.”

Dr. Schulze, a Phi Beta Kappa scholar, graduated from Union College in Schenectady, NY summa cum laude with a BS in Biology. She earned her medical school degree at SUNY Stony Brook and completed her residency at Baystate Medical Center in Springfield, MA. She has been married for 30 years to her college sweetheart and they are the proud parents of three daughters.

“Ruth’s passion and commitment to organized medicine and her vision for her term as president of MSNJ will result in new initiatives and an energized and diverse membership base,” said Larry Downs, CEO of MSNJ. “We welcome her as president and look forward to putting into action MSNJ’s aggressive agenda to improve healthcare in New Jersey.”

**June 30th Deadline to Avoid the 2014 eRx Penalty

CMS has re-opened the Quality Reporting Communications Support Page from March 1, 2013 to June 30, 2013, allowing physicians to request a hardship exemption for 2014. In order to avoid the 2 percent penalty in 2014, physicians must meet the requirements of the Medicare e-prescribing (eRx) program; meet one of the limited exemption categories, or obtain approval for a hardship exemption. Individual physicians who do not meet one of the exemption or hardship categories must report the eRx measure 10 times via claims between January 1, 2013 and June 30, 2013.

Groups using the group reporting option must report at least 75 times (2-24 Eligible Professionals), at least 625 times (25-99 EPs), and at least 2,500 times for groups of 100 plus. Physicians can also avoid the penalty by registering for the EHR Incentive Program by June 30, 2013, or achieving meaningful use under the EHR Incentive Program during the January 1, 2013 to June 30, 2013 reporting period. For a complete list of hardship exemptions and more information, view CMS’ Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.

MSNJ Legislative Update: May 10, 2013

Pediatric Respite Care Facilities

The Assembly Regulated Professions Committee unanimously approved A. 3558 which will provide a license for pediatric respite care facilities.  A pediatric long-term care facility is not required to seek a dual license under this bill.  MSNJ took no position on this bill, but recognizes its potential to help families deal with pediatric illnesses.

Mental Health Coverage for Alcoholism & Substance Abuse Disorders

The Assembly Health Committee passed A. 1665/S. 1253, which would revise statutory mental health coverage requirements and require all health insurers and SHBP to cover treatment for alcoholism and other substance-use disorders under the same terms and conditions as for other diseases or illnesses. MSNJ has supported mental health parity measures, including this one, for years. The bill is particularly important in light of the focus on mental health issues related to gun violence.

Influenza Vaccinations for Healthcare Workers

The Assembly Health Committee passed A. 2172, which would require that a healthcare facility annually offer on-site or off-site influenza vaccinations to its health care workers, and they would be required to receive an influenza vaccination, but would be permitted to present acceptable proof, including an attestation by the health care worker, of a current influenza vaccination from another vaccination source, or sign a written declination statement. The bill is poised for full votes in both houses; the Governor vetoed the bill last year. MSNJ supports the bill.

Prescription Drug Donation Repository Program

The Assembly Health Committee passed A. 2188/A. 3964, which would establish a prescription drug donation repository program in the Department of Health (DOH).  This program will provide for the donation of unused prescription drugs and supplies by persons, health care facilities, and pharmacies to a central repository for redistribution to authorized medical facilities and pharmacies in order to re-dispense these medications, which would otherwise be destroyed, for use by individuals who meet eligibility criteria specified by the Commissioner of Health. MSNJ supports the bill, as it is in line with our goal to reduce abuse and diversion of drugs, particularly opioids.

Limitation of Settings for Certain Surgeries

The Senate Health Committee approved S. 2079, sponsored by Senator Richard Codey, which would limit settings where certain surgeries may be performed.  Under the bill, a physician may only perform any of the following procedures in an office or facility that is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, the Accreditation Association for Ambulatory Health Care, or The Joint Commission: a liposuction procedure that involves more than 750 cubic centimeters of aspirate; a procedure that utilizes a breast implant; or an aesthetic truncal contouring procedure that involves the excision of skin. This bill is supported by plastic surgeons, but opposed by dermatologists. MSNJ opposes the bill on the principle that clinical matters of such specificity should not be legislated.

Medicaid Expansion

The Senate Health Committee also passed S. 2644, sponsored by Senators Joseph Vitale, Nia Gill and Loretta Weinberg, which would expand Medicaid eligibility pursuant to the federal Affordable Care Act.  The bill essentially is the legislative version of the Governor’s decision to expand Medicaid eligibility under the ACA.  MSNJ’s position on expansion can be found here.

Value Based Benefit Design for Chronic Health Conditions

The Assembly Appropriations committee passed A. 1214, which establishes a pilot program to utilize value-based benefit design in the State Health Benefits Plan to increase health benefits coverage for certain employees concerning chronic health conditions.  The coverage design will utilize explicit financial incentives to increase the employee’s interaction with appropriate health care providers, and encourage use of those health benefits that specifically relate to the employee’s chronic health condition.  MSNJ is monitoring this bill, which mirrors the goals of ACOs and other new payment models that focus on outcomes.

Health Benefit Mandate for Breast Imaging Services

The Assembly Appropriations committee also passed A. 2022/S. 792, which contains an insurance mandate for certain tests following mammograms and requires certain notice about risk factors. 

The bill requires health insurers to provide health benefits coverage for additional testing deemed medically necessary by a patient’s health care provider, of an entire breast or breasts, after a baseline mammogram examination, if the mammogram demonstrates extremely dense breast tissue, if the mammogram is abnormal within any degree of breast density including not dense, moderately dense, heterogeneously dense, or extremely dense breast tissue, or if the patient has additional risk factors for breast cancer.  Additional risk factors include, but are not limited to, family history of breast cancer, prior personal history of breast cancer, positive genetic testing, extremely dense breast tissue based on the Breast Imaging Reporting and Data System, or other indications as determined by the patient’s health care provider. The bill also requires providers of mammography services to include information on breast density in mammography reports sent to patients and physicians, if a patient’s mammogram demonstrates extremely dense breast tissue based on the Breast Imaging Reporting and Data System.  The bill provides that the information on breast density must include the following statement:  “Your mammogram shows that your breast tissue is extremely dense as determined by the Breast Imaging Reporting and Data System established by the American College of Radiology.  Dense breast tissue is very common and is not abnormal.  However, extremely dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with a risk factor for cancer.  This information about the result of your mammogram is given to you to raise your awareness.  Use this information to talk to your health care provider about this and other risks for breast cancer that pertain to your personal medical history.  A report of your results was sent to your physician.”

MSNJ was engaged in improving the bill along with radiology and ob/gyn specialty societies, so that it reflects clinical realities and current practices.  Insurance providers and business groups oppose the bill.