This week, Larry Downs, MSNJ’s CEO and General Counsel, met with Congressman Frank Pallone to discuss a repeal of Medicare’s sustainable growth rate (SGR) which results in annual Medicare fee decreases to physicians. Congressman Pallone is a member of the Energy & Commerce Committee, and Ranking Member of the Health Subcommittee which shares jurisdiction over Medicare with the Ways & Means Committee. We are pleased to report that Congressman Pallone supports our efforts to repeal the SGR. Read MSNJ’s letter to Congressman Pallone.
MSNJ, the AMA, and organized medicine are urging Congress to seize upon this historic opportunity to use funds in the Overseas Contingency Operations (OCO) to pay for the elimination of the SGR. OCO is the discretionary fund for Afghanistan, Iraq and similar conflicts. Using OCO funding as an offset is appropriate because these conflicts are winding down significantly, but the Congressional Budget Office cannot downwardly adjust the OCO spending estimate over the next ten years until the next (FY2012) Defense Appropriations bill is passed. Read more about the rationale to use OCO funds to offset the SGR elimination which would pay for the accumulated cost of repeal. The current cost is approximately $300 billion. Congressman Pallone agrees that using OCO funds is an appropriate solution and will advocate for this. On behalf of physicians at large and our members who treat our senior population, we express sincere thanks for this support.
MSNJ also signed a letter authored by the AMA to members of the conference committee on payroll taxes, unemployment insurance and physician payments, urging it to repeal the SGR. The AMA reports that during the first public meeting on January 24 virtually all statements addressed the payment crisis and several members called for the permanent repeal as part of the final conference committee package. MSNJ will continue to meet with our delegation. Meetings with Congressmen Leonard Lance (R-NJ, 7th district) and Jon Runyan (R-NJ, 3rd district) have already been scheduled.
Tax, Education, Corrections Reform Highlight Governor’s Second Address
Governor Chris Christie delivered his second State of the State address after a one week delay due to the tragic death of Assembly Republican Leader Alex DeCroce. In it, Christie focused on what he dubbed the “The New Jersey Comeback” and credited bipartisan achievements such as property tax caps and public employee benefits reforms.
Moving forward, the Governor focused on Tax, Education, and Corrections reforms the Administration will be pushing in 2012. Perhaps the most ambitious, and surprising, of the three is his call for an across-the-board 10% cut in New Jersey’s income tax and restoration of the Earned Income Tax Credit for New Jersey’s poorest. Christie couched the proposal as drawing a stark contrast between New Jersey and states like New York, Connecticut, Illinois and California, who have recently increased their rates. Since this initiative will obviously have an impact on the FY2013 budget, it is likely to dominate the political discourse during the first six months of 2012.
Christie’s six point education plan came as no surprise as it’s elements have been pushed by reform advocates for years. They include: tenure reform, ending the “last in-first out” structure for layoffs, increasing pay for teaching difficult subjects or coming to failing schools, prohibiting forced placement for teachers, increasing the numbers of charter schools, and offering tax credits for families in underperforming districts.
Finally, and most important to healthcare advocates, Christies proposed sweeping changes to our penal system. While his concept of denying bail to violent offenders should be expected of a former crime fighter, his transformational plan for how New Jersey should punish non-violent drug offenders represents real, 21st Century reform that should raise more than a few eyebrows in the medical community. Under the plan, funding for addiction treatment would increase and non-violent offenders would be diverted away from prisons and into alternative treatment centers. This closely mirrors plans previously endorsed by the Medical Society and New Jersey Psychiatric Association. Like tax reform, this will impact the State’s FY2013 budget, so legislation is likely to be debated early in the session. Read the full address.
Chicago – The American Medical Association (AMA) today named James L. Madara, M.D., as its new Executive Vice President and Chief Executive Officer. Dr. Madara will assume leadership of the nation’s oldest and largest physician group on July 1.
Dr. Madara, 60, is an accomplished academic medical center physician, medical scientist and administrator who served as Timmie Professor and Chair of Pathology and Laboratory Medicine at the Emory University School of Medicine before assuming the Thompson Distinguished Service Professorship and deanship at the University of Chicago Pritzker School of Medicine, where he was the longest serving Pritzker dean in the last 35 years. Subsequently, he added the responsibility of CEO of the University of Chicago Medical Center, bringing together the university’s biomedical research, teaching and clinical activities. As CEO, he engineered significant new affiliations with community hospitals, teaching hospital systems, community Federally Qualified Health Centers on Chicago’s South Side, as well as with national research organizations including the Janelia Campus of the Howard Hughes Medical Institute in Bethesda and the Ludwig Foundation of New York.
“The AMA is a venerable institution, and I am honored to lead it during this challenging and exciting time,” Dr. Madara said. “The AMA has been at the forefront working to improve public health, physician practice, patient care and our American health care system for the past 164 years. Today more than ever, America’s patients and physicians need a strong and vibrant AMA to tackle the many challenges facing them. I look forward to leveraging my skills and experience to help the AMA succeed and fulfill its core mission to promote the art and science of medicine and the betterment of public health.”
While at the University of Chicago from 2002-2009, Dr. Madara oversaw a significant renewal of the institution’s biomedical campus, including the Comer Children’s Hospital, the Gordon Center for Integrative Science, a new adult hospital pavilion, and the Knapp Center for Biomedical Discovery. His deanship also extended to the University’s renowned Biological Sciences Division.
“The American Medical Association is thrilled to have a proven medical leader like Dr. Madara serve as our next EVP/CEO,” said Ardis D. Hoven, M.D., chair, AMA Board of Trustees. “Dr. Madara is a strong strategic thinker and planner who has a track record of bringing people together to accomplish significant, ambitious, health-related goals and projects. Having overseen a $1.6 billion integrated academic medical center, Dr. Madara understands many of the complex clinical, academic and business-related issues confronting medicine and health care today. His insight and perspective will be invaluable in helping the AMA tackle its agenda.”
Dr. Madara is a noted academic pathologist and an authority on epithelial cell biology and on gastrointestinal disease. He has published more than 200 original papers and chapters, making important contributions to understanding the biology of the cells that line the digestive tract. His work has garnered both national and international awards.
Dr. Madara has served as President of the American Board of Pathology, as Editor-in-Chief of the American Journal of Pathology, has received a prestigious MERIT Award from the NIH, has been elected to membership in the Association of American Physicians, and recently received the Davenport Award for lifetime achievement in gastrointestinal disease from the American Physiological Society.
Most recently, Dr. Madara served as senior advisor with Leavitt Partners, a highly innovative health care consulting firm started by former Secretary of Health and Human Services Mike Leavitt.
Dr. Madara earned his medical degree from Hahnemann Medical College in Philadelphia. He completed his internship and residency at New England Deaconess Hospital in Boston. He subsequently completed a fellowship in anatomy and cell biology at Peter Bent Brigham Hospital in Boston (now Brigham and Women’s Hospital). Following his fellowship, Dr. Madara joined the faculty of Harvard Medical School where he rose to a full tenured professor and served as director of the Harvard Digestive Diseases Center.
Dr. Madara is married to Vicki M. Madara. They have two children: Alexis and Max.
LAWRENCEVILLE, NJ – Employment in medical practices in New Jersey grew steadily through much of the past decade despite two recessions and contributes significantly to the state’s economy, according to an Edward J. Bloustein School of Planning and Public Policy study.
The report estimates there are approximately 9,100 private practice physicians’ offices employing nearly 70,000 medical professionals and other staff in NJ as of 2009. In addition to providing vital health care services, the ongoing annual expenditures associated with operating private practices result in significant annual economic and fiscal benefits to the state’s economy. This occurs directly through the employment of staff and the purchase of materials, equipment and services, and indirectly, through the multiplier, or ripple effects, of these expenditures throughout the general economy.
The study finds the industry directly employs more people than comparable professional and other industries including offices of lawyers, the accounting and engineering sectors, and the amusement and recreation sector.
Estimates of the direct and indirect contributions of physicians’ practices in New Jersey to the state economy include:
- Nearly 113,000 jobs
- $7.3 billion in annual income
- $10.7 billion in annual gross domestic product for the state
- $334 million in annual state tax revenue
- $353 million in annual local tax revenue
The sector’s economic growth has been significantly stronger than that of the state as a whole, and the industry was not strongly affected by the deep job losses of the 2007-2009 recession. To the contrary, while total state employment declined by almost 3% from 2001 to 2009, employment by physicians’ offices grew by over 20% (about 12,000 jobs) and total annual wages in the industry grew by almost 50%.
This strong performance is consistent with the private healthcare sector as a whole, which saw employment growth of approximately 23% at state and national levels over the same period. As of 2009, physicians’ offices in New Jersey directly employed nearly 70,000 people with a total payroll of $5.5 billion.
“The annual economic contributions of medical practices to the New Jersey economy are significant,” said Dr. Joseph J. Seneca of Rutgers’ Edward J. Bloustein School of Planning and Public Policy, a co-author of the study. “In addition, the broader benefits resulting from effective health care and treatment by physicians and their offices, such as reduced morbidity and mortality, improved quality of life, and decreased pain and suffering are undoubtedly enormous and should be properly added to our estimates of economic and fiscal impacts,” he added.
The complete study can be found here: http://www.policy.rutgers.edu/reports/other/MSNJ_FINAL_REPORT_10May2011.pdf.
A special session to present these findings will be held at the MSNJ Annual Meeting on Friday, May 13 at 4:00 pm at the Hyatt Regency New Brunswick.
A1982, a bill addressing comprehensive medical liability reform passed the Assembly Health Committee today with the support of five Democrats and three Republicans. There were two abstentions, Asw. Nancy Munoz (R – Union) and Asm. Jerry Green (D – Union).
The move marks the most progress on comprehensive tort reform in over six years. The measure is now pending on the Assembly floor for a vote by the full House. MSNJ thanks sponsor Asm. Herb Conaway, MD (D – Burlington) and will work with him to see that this momentum continues.
The Assembly Health and Senior Services Committee has scheduled a vote on comprehensive medical liability reform legislation this Monday, March 7 at 10:00 am. The committee will be voting on A-1982, which includes new requirements for expert witnesses, modifications to the statute of limitations, requirements for affidavits, and a prohibition on premium increases for claims that do not succeed or arise out of charitable or emergency care.
A favorable vote by the Committee on Monday will mark the most progress made on tort reform in over 6 years. MSNJ members are encouraged to call or write their legislators, or come to the proceedings and show your support for this important legislation. For a complete listing of committee members, click here.
FRAUD & ABUSE: Federal Government Increases Prosecutions
The United States Department of Health & Human Services (HHS) and the Department of Justice joined forces to recover a record $4 billion for fraudulent activity in 2010. In addition to the federal government’s enhanced enforcement activity the Affordable Care Act contains new compliance requirements and enforcement tools that will trickle down to the states.
Last week, HHS, the Centers for Medicare & Medicaid Services (CMS) and the Office of the Inspector General filed final rules under the new law that will govern Medicare, Medicaid, and SCHIP programs. Read the press release announcing the rules and the fraud and abuse program report.
TORT REFORM: MSNJ Supports Federal Legislation
Last week, MSNJ joined the AMA, other state medical societies, and specialty organizations in a letter to Congressman Phil Gingrey, MD, supporting H.R. 5, the “Help Efficient, Accessible, Low-Cost, Timely Health (HEALTH) Act of 2011.” The bill promotes speedier resolutions to medical malpractice suits and limits non-economic damages. It would not supercede more effective state medical liability tort reform laws. MSNJ will continue tort reform initiatives in New Jersey.
PHYSICIAN OUTREACH RECRUITMENT
Four MSNJ physicians received an award from the AMA’s Physician Outreach Recruiting Program for their outstanding efforts in recruiting new AMA members for 2010:
Peter Carmel, MD
Michael Goldrich, MD
Charles Moss, MD
Niranjan Rao, MD
Read more about the Program on the AMA website.
In early January, the US Secretary of Health & Senior Services offered her Department’s assistance to the state of California concerning Blue Shield’s significant premium increases. In a news release, she stated that:
The practice of insurers imposing these kinds of rate increases without public scrutiny would be the wave of the future without the Affordable Care Act. If the law were repealed, we would be left with few tools to protect consumers against these kinds of rate increases. Insurers would be able to spend more on profits, marketing, and CEO bonuses, instead of care. Families and small businesses would lose their ability to negotiate more competitive rates in the Exchanges, and insurers would again be able to deny coverage to children based on their pre-existing health conditions. [News Release, U.S. Department of Health & Human Services (January 6, 2011)].
Independent Payment Advisory Board
The Congressional Research Service (CRS), a non-partisan entity, has issued a report raising questions about the legal authority of the Independent Payment Advisory Board (IPAB) established under the Affordable Care Act. The IPAB was created to “reduce the per capita rate of growth in Medicare spending.” Board members are appointed by the President. The report takes the position that the IPAB is open to legal challenge because it shifts “the balance of power to the executive branch and away from Congress.” MSNJ objected to the IPAB for the same reason. Read the report in its entirety.
Physician Compare Website
The Physician Compare website is now live. The website was required by the healthcare reform law and is being implemented by CMS. While the physician directory is only for those who treat Medicare patients, the website is available to the public at large. Currently, the website includes information on physicians such as contact and address information, medical specialty, degree credentials, gender and languages spoken.
A second phase, schedule for later this year, will indicate whether physicians are prescribing electronically. In 2013 the website will include data on quality of care. MSNJ has expressed concern to CMS about how the quality of care information will be presented. MSNJ urges members to access the website to confirm the accuracy of the information provided.
Today, the House of Representatives passed H.R. 4994, the “Medicare and Medicaid Extenders Act of 2010,” on a bipartisan vote of 409-2. This legislation, which passed the Senate yesterday by unanimous consent, would stabilize Medicare physician payments at current rates for 12 months, through the end of 2011. It will now be sent to President Obama to sign into law.
In addition to providing an additional 12-month reprieve from the 25 percent Medicare physician payment cut scheduled to take effect on January 1, the bill extends a number of payment policies that were set to expire at the end of this year. It also includes funds to enable Medicare contractors to reprocess claims for physician services affected by provisions of the Patient Protection and Affordable Care Act passed last spring with a retroactive effective date of January 1, 2010. A detailed summary of the bill’s provisions, prepared by the AMA, will be available tomorrow.
Medicine was supported in its advocacy efforts by aggressive grassroots pressure from AARP, which included over 100,000 contacts by seniors to Congressional offices as well as paid radio and print advertising, direct mail, tele-townhall meetings, and educational efforts conducted jointly with medical societies in several key states. Also key to successful and timely passage of the bill was the bipartisan cooperation among leaders in the Senate and the House. MSNJ appreciate the support of our Senators and House of Representatives. We also appreciate the efforts of our members who participated at the grassroots level by contacting members of Congress.
All parties agree with medicine that the time for recurring stop-gap measures to end the disruption caused by the sustainable growth rate formula is long past. As noted in a statement issued yesterday by President Obama: “It’s time for a permanent solution that seniors and their doctors can depend on and I look forward to working with Congress to address this matter once and for all in the coming year.”
Organized medicine must now turn its attention to a repeal of the broken payment formula and a permanent Medicare payment solution.
The President Signs the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010
2.2 Percent Medicare Physician Fee Schedule Update for June 1, 2010 Through November 30, 2010
On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.” This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. The Centers for Medicare & Medicaid Services (CMS) has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered June 1, 2010, and later, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. We expect to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.
Claims containing June 2010 dates of service which have been paid at the negative update rates will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician/provider. Physicians/providers should not resubmit claims already submitted to their Medicare contractor.
–Centers for Medicare and Medicaid Services