By: Lawrence Downs, CEO, MSNJ
August 31 marks International Overdose Awareness Day, a global event designed to raise awareness of drug addiction as a disease and to help bring attention to the need to reduce the stigma, disgrace and shame that often surrounds treatment, overdose and drug-related deaths.
The members of the Medical Society of New Jersey (MSNJ), especially our addiction specialists, join their colleagues nationwide in commemorating Overdose Awareness Day. They are leading the fight against stigma and are committed to offering patients the best, and most effective course of action in treating their addictions. It is in this vein that MSNJ calls upon New Jersey state policy makers to partner with physicians in the fight, by offering patients obtain better access to addiction treatment options.
Unfortunately, there are barriers to successful treatment. MSNJ strongly supports legislation that would improve insurance coverage of the treatment of mental and behavioral health conditions, including addiction. Senate Bill 324 establishes a Behavioral Health Insurance Claims Advocacy Program, recognizing the difficulty patients face in obtaining coverage for treatment. Senate Bill 2180 requires health benefits plans to provide coverage for behavioral health care services. Both bills recognize patients’ struggles for access to care when insurers either deny their coverage or cover so little that the proposed treatment cannot be effective. For example, carriers regularly first seek to place patients in a lower level of care, like an outpatient program just, “to see if it works,” when in reality, the patient needs a comprehensive inpatient or residential program of care for at least 30 days. Length of treatment is often limited to an amount less than what is needed for meaningful treatment.
In addition to general coverage for mental health and addiction treatment, MSNJ is fighting for insurance coverage of specific, proven treatment models, like medication assisted treatment (MAT). MAT is a widely accepted successful form of treatment which is often rejected by insurance carriers. Assembly Bill 3830 would require insurance coverage for MAT, thus changing the lives of many patients for the better.
While the New Jersey Legislature has taken the lead in moving a package of bills on addiction issues, it has not yet passed these bills, despite the vast number of patients who cannot obtain treatment due to insurance barriers.
We praise Governor Christie for signing several bills in the package, including Assembly Bill 3723, which permits successful completion of drug court for those who are utilizing MAT for substance use disorders. This new law gives hope to those struggling to recover. We hope the Legislature sends the insurance coverage bills to his desk as well.
The stigma that mental and behavioral health patients face is institutional. We ask New Jersey policy makers to break these barriers to access to allow true and desperately needed insurance coverage, so mental health conditions are recognized and covered, just like physical conditions. Our physicians need the support of the carriers and the government to provide their patients with the treatment options they need to recover.
New Jersey’s Physicians at the Forefront of Addiction Prevention and Treatment Efforts, MSNJ Spearheading Reform
Physicians throughout the state of New Jersey continue to be at the forefront of addiction prevention and treatment efforts – and MSNJ is spearheading real reform in this area. Here is a breakdown of what we are doing:
- Understanding that opioids may fall into the wrong hands and must be prescribed only when needed, New Jersey physicians already prescribe fewer opioids than physicians in other states, so that the potential for misuse is already low. MSNJ asks that all physicians use the state Prescription Monitoring Program (PMP), and have long advocated for it to be a more reliable, accurate and accessible healthcare tool. We applaud Governor Christie for signing S1998 this week, as it requires these improvements.
- We are also encouraging patients to store medications securely and dispose of any unused or unneeded medicine so that it is not stolen or misused. MSNJ supports A-709, also recently signed by Governor Christie, which requires patients to receive information about proper disposal, since most prescription drug abuse occurs when a patient’s medicine is taken by someone else. According to statistics from the New Jersey State Board of Medical Examiners, only about 20 percent of medication that is abused comes directly through patient prescriptions. As such, we must focus on reducing diversion.
- Addiction specialist physicians are on the front lines in treating addiction. We strongly support legislation that would improve insurance coverage of addiction treatment (S324, S2180 and A3830). While the New Jersey Senate has taken the lead in moving a 21-bill package on addiction issues, it has not yet passed these bills, despite the vast number of patients who cannot obtain treatment due to insurance barriers.
- MSNJ has also held numerous educational events for physicians to learn new tools. We hosted six regional events with the Partnership for a Drug-Free New Jersey and several more, reaching thousands of doctors across the state with the message and goal of diversion and addiction prevention.
MSNJ believes in informed consent and our members follow regulations requiring consent for opioids prescribed for chronic pain. But, we continue to oppose S2366 because the science does not support this mandate. The risk of addiction for medication prescribed for acute pain is extremely low. And, because most addiction stems from diversion, S2366 will not be as effective as A709 and S1998. Patients who are legitimately prescribed medicine are not the ones who become addicted. This is why focus on diversion is so important.
Statutory mandates like S2366 also restrict physicians to practices that are considered ideal at one moment in time. But, in reality, doctors are constantly evolving their practices as public health needs change, medical knowledge advances and technology improves. In fact, physicians are changing their prescribing practices and using new tools to ensure medications are used properly. For example, physicians prescribing opioids are requiring patients to sign agreements to adhere to treatment plans so that there is a shared responsibility and understanding of medication protocols.
The public must also remember that doctors prescribe medications for the health and comfort of our patients. Opioids and other medications may be needed after a traumatic event, such as an injury or surgery, or to enable a patient to function day-to-day and enjoy a decent quality of life. As former New Jersey Attorney General Jeff Chiesa said when introducing the PMP, “High levels of prescribing and dispensing of controlled drugs are not necessarily indicators of illegal activity or drug abuse. While working to stop abuse, we must remain mindful of the legitimate uses of medication and ensure practitioners are empowered to meet their patients’ healthcare needs.”
Physicians should not be blamed for the recent heroin surge, but rather supported in their efforts to treat and fight for insurance coverage for their patients. MSNJ will continue to advocate for the improvement of healthcare for our patients and will continue to partner with the Partnership for a Drug Free New Jersey, the Legislature, the Governor and his departments and all interested stakeholders toward our shared goal of preventing diversion and abuse and keeping our state healthy.
Steven Berkowitz, MD, PA, FACS, FAAOS, CIME Installed as 223rd President of the Medical Society of New Jersey
Lawrenceville, N.J. – Steven Berkowitz, MD, PA, FACS, FAAOS, CIME was recently installed as the 223rd President of the Medical Society of New Jersey (MSNJ) at its annual meeting. He has served as a member of MSNJ’s Board of Trustees since 2004.
Dr. Berkowitz is a board certified orthopaedic surgeon and clinical instructor with more than 35 years of experience. He co-founded and currently practices at Seaview Orthopaedic and Medical Associates, with six office locations in New Jersey from Barnegat to Monroe. Additionally, he has served as the clinical instructor for the orthopaedic rotation at the Jersey Shore Medical Center for the past 20 years. He is currently certified by the American Board of Orthopaedic Surgery and American Board of Independent Medical Examiners.
Last year, Dr. Berkowitz was appointed to the New Jersey State Board of Medical Examiners, a position he will hold until 2017. A recognized leader in a number of medical associations and organizations, Dr. Berkowitz served as past president of the New Jersey Orthopaedic Society and currently serves on its Board of Directors as the legislative chairman. Additionally, he is the past president of the Monmouth County Medical Society and now serves as a member of the executive committee. Dr. Berkowitz is also a member of the American Academy of Orthopaedic Surgeons, American College of Surgeons, Arthroscopy Association of North America, and the Eastern Orthopaedic Association.
“Dr. Berkowitz’s experience as a top orthopaedic surgeon and clinical instructor, as well as his involvement in various respected medical organizations makes him exactly the type of president MSNJ needs,” said Larry Downs, CEO of MSNJ. “We are honored to welcome him as our new President. He brings great leadership, guidance and expertise to our organization.”
Dr. Berkowitz graduated with honors from The Cooper Union – Albert Nerken School of Engineering and obtained his medical degree at SUNY Downstate College of in Brooklyn, New York, graduating cum laude. He completed his residency at Maimonides Medical Center and the NewYork-Presbyterian/Columbia University Medical Center, both located in New York City.
He currently resides in Wayside, New Jersey with his wife Pamela. The couple has four adult children, and is expecting their seventh grandchild.
The Medical Society of New Jersey Hosts 2nd Annual Physicians’ Advocacy Conference and House of Delegates Meeting
On Friday, May 1, MSNJ hosted its 2nd Annual 2015 Physicians’ Advocacy Conference and House of Delegates Meeting from 7:30 a.m. – 6:00 p.m., at the Crowne Plaza in Princeton, NJ. This year’s conference, sponsored by Horizon Blue Cross Blue Shield New Jersey and Kern Augustine Conroy & Schoppmann, P.C., was a huge success with 150 registered attendees and a total of 40 sponsors and exhibitors.
Our unique, interactive conference is designed to connect and engage New Jersey’s physicians and review the overall impact of the practice of medicine within the state. As an added benefit to our physician attendees, the conference fulfills AMA continuing medical education credits (4 AMA PRA Category 1 Credits™).
This year’s conference included a number of workshops that focused on a variety of advocacy topics, including: Legislative Advocacy 101; Regulatory Advocacy 101; Everything You Need to Know About ERISA-Regulated Health Plans; and The Future of Maintenance of Certification.
Additionally, the conference featured a number of highly-respected speakers, panelists and moderators from diverse professional backgrounds and expertise.
“We were proud to offer such a stellar line-up of notable speakers, panel members and moderators at this year’s conference,” said Larry Downs, CEO of the Medical Society of New Jersey. “We carefully selected these professionals, all subject matter experts in their respected fields, knowing that they would thoroughly address a number of issues of importance to the physician community.”
Robert E. Andrews, Esq. – former member of the U.S. House of Representatives and former chairman of the Health, Employment, Labor and Pensions Subcommittee of the House Committee on Education and the Workforce – delivered the keynote address.
Other speakers, panelists and moderators included six sitting legislators, like Assemblyman Herb Conaway, MD, Esq. (D-District 7), Chairman of the Assembly Health and Senior Services Committee and the only physician in legislature – and Assembly Minority Leader Jon Bramnick; and two of the most highly respected contract lobbyists in Trenton, Paul N. Bontempo, President and Co-Founder of MBI Gluckshaw, Democratic State Committeeman and former Democratic National Committeeman and AJ Sabath, Partner and Co-Founder of Advocacy and Management Group.
The day ended with a well-attended reception, featuring networking opportunities and delicious food and drink for attendees.
“All those who attended – from physicians and medical students to practice managers and health care specialists – benefited from the information presented at this year’s conference,” stated Dr. Paul J. Carniol, 222nd President of the Medical Society of New Jersey. “We look forward to more successful conferences like this in the years to come.”
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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