for members only - njpms · 2017-07-11 · new jersey podiatric medical society january/february...

12
New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality Reporting (PQRS) Data The Centers for Medicare & Medicaid Services (CMS) are pleased to an- nounce the 2015 PQRS data submission timeframes: EHR Direct or Data Submission Vendor (QRDA I or III) - 1/1/16 - 2/29/16 Qualified Clinical Data Registries (QCDRs) (QRDA III) - 1/1/16 - 2/29/16 Group Practice Reporting Option (GPRO) Web Interface - 1/18/16 - 3/15/16 Qualified Registries (Registry XML) - 1/1/16 - 3/31/16 QCDRs (QCDR) XML) - 1/1/16 - 3/31/16 Submissions ends at 8:00 p.m. eastern time on the end date listed. An Enter- prise Identity Management (EIDM) account with the “Submitter Role” is re- quired for the PQRS data submission methods. Please see the EIDM System Toolkit for additional information. NJPMS Ranks 8th Nationally Here are the rankings as reported by APMA as of November 2, 2015: 1. New York - 1,145 members 2. California - 1,043 members 3. Florida - 971 members 4. Pennsylvania - 791 members 5. Ohio - 669 members 6. Illinois - 652 members 7. Texas - 648 members 8. New Jersey - 633 members 9. Georgia - 298 members 10. Massachusetts - 297 members The full listing can be reviewed on page 52 of the APMA News - No- vember/December 2015 issue. APMA National and Leadership Dinner Slated for Philadelphia Registration is open for the APMA National Scientific Meeting which will be held in Philadelphia July 14 – 17, 2016. Early bird registration, for $399.00, began January 4 th and continues through March 4 th . Beginning March 5 th , the fee increases to $499.00. After June 1 st , the fee becomes $599.00. Registra- tion for life members is $199.00 until March 4 th and increases to $299.00 af- ter that date. Young APMA members (those in practice ten years or less) as well as APMA residency directors will be charged $299.00 to register. Podi- atry students and APMA resident members can attend on a complimentary basis. All registrants signed up by April 18 th qualify for a $500.00 travel ex- pense voucher offered by APMA. Refer to the APMA website www.apma.org/the national for specific registration details. In regards to the NJPMS Leadership Dinner, our annual event is scheduled in conjunction with the APMA National Scientific Meeting and will be held Saturday evening, July 16, 2016 at the Philadelphia Marriott Downtown. Richard Leichter, DPM of Red Bank will be installed as the 97 th NJPMS President. Jacob Reinkraut , DPM becomes NJPMS President Elect. Krupa Patel, DPM and Gregory Rubinstein, DPM climb the ranks to NJPMS vice president and treasurer respectively. The Society’s secretary position will then be available. Candidates interested in filling this slot should forward their Notice of Declaration to the NJPMS executive office after receiving the election process guideline which was emailed February 3rd. A formal invitation to the dinner will also be emailed in the near future. Mark your calendar and be part of our “historic” evening in a historic Ameri- can city. Spring Seminar Revised Slated Now for April 6th The NJPMS spring seminar date has been changed from March 2 nd to April 6 th . This revision was neces- sary due to schedule conflicts with speakers. Detailed registration information will be emailed shortly. The full- day seminar will be held at The Bat- tleground Country Club in Ma- nalapan, NJ. Registration begins at 7:30 a.m. Breakfast, lunch, an after- noon ice cream break and one-on- one time with vendors are all includ- ed in the $149.00 registration fee. Sign up before March 25 th to avoid the $20.00 increase in the registra- tion fee. Mark your calendar and plan to at- tend this informative educational program.

Upload: others

Post on 11-Jul-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

New Jersey Podiatric Medical Society January/February 2016

FOR MEMBERS ONLY

CMS Announces Submission Timeframes for 2015 Physician Quality Reporting (PQRS) Data

The Centers for Medicare & Medicaid Services (CMS) are pleased to an-

nounce the 2015 PQRS data submission timeframes:

EHR Direct or Data Submission Vendor (QRDA I or III) - 1/1/16 -

2/29/16

Qualified Clinical Data Registries (QCDRs) (QRDA III) - 1/1/16 -

2/29/16

Group Practice Reporting Option (GPRO) Web Interface - 1/18/16 -

3/15/16

Qualified Registries (Registry XML) - 1/1/16 - 3/31/16

QCDRs (QCDR) XML) - 1/1/16 - 3/31/16

Submissions ends at 8:00 p.m. eastern time on the end date listed. An Enter-

prise Identity Management (EIDM) account with the “Submitter Role” is re-

quired for the PQRS data submission methods. Please see the EIDM System

Toolkit for additional information.

NJPMS Ranks 8th Nationally

Here are the rankings as reported by

APMA as of November 2, 2015:

1. New York - 1,145 members

2. California - 1,043 members

3. Florida - 971 members

4. Pennsylvania - 791 members

5. Ohio - 669 members

6. Illinois - 652 members

7. Texas - 648 members

8. New Jersey - 633 members

9. Georgia - 298 members

10. Massachusetts - 297 members

The full listing can be reviewed on

page 52 of the APMA News - No-

vember/December 2015 issue.

APMA National and Leadership Dinner

Slated for Philadelphia

Registration is open for the APMA National Scientific Meeting which will be

held in Philadelphia July 14 – 17, 2016. Early bird registration, for $399.00,

began January 4th and continues through March 4th. Beginning March 5th, the

fee increases to $499.00. After June 1st, the fee becomes $599.00. Registra-

tion for life members is $199.00 until March 4th and increases to $299.00 af-

ter that date. Young APMA members (those in practice ten years or less) as

well as APMA residency directors will be charged $299.00 to register. Podi-

atry students and APMA resident members can attend on a complimentary

basis. All registrants signed up by April 18th qualify for a $500.00 travel ex-

pense voucher offered by APMA. Refer to the APMA website

www.apma.org/the national for specific registration details.

In regards to the NJPMS Leadership Dinner, our annual event is scheduled in

conjunction with the APMA National Scientific Meeting and will be held

Saturday evening, July 16, 2016 at the Philadelphia Marriott Downtown.

Richard Leichter, DPM of Red Bank will be installed as the 97th NJPMS

President. Jacob Reinkraut , DPM becomes NJPMS President Elect. Krupa

Patel, DPM and Gregory Rubinstein, DPM climb the ranks to NJPMS vice

president and treasurer respectively. The Society’s secretary position will

then be available. Candidates interested in filling this slot should forward

their Notice of Declaration to the NJPMS executive office after receiving the

election process guideline which was emailed February 3rd.

A formal invitation to the dinner will also be emailed in the near future.

Mark your calendar and be part of our “historic” evening in a historic Ameri-

can city.

Spring Seminar Revised Slated Now for April 6th

The NJPMS spring seminar date has

been changed from March 2nd to

April 6th. This revision was neces-

sary due to schedule conflicts with

speakers.

Detailed registration information

will be emailed shortly. The full-

day seminar will be held at The Bat-

tleground Country Club in Ma-

nalapan, NJ. Registration begins at

7:30 a.m. Breakfast, lunch, an after-

noon ice cream break and one-on-

one time with vendors are all includ-

ed in the $149.00 registration fee.

Sign up before March 25th to avoid

the $20.00 increase in the registra-

tion fee.

Mark your calendar and plan to at-

tend this informative educational

program.

Page 2: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

A publication of the

New Jersey

Podiatric Medical Society

2 King Arthur Court

Suite C

North Brunswick, NJ 08902

Tel: (732) 967-9003

Fax:(732)-246-2162

Website:

www.njpms.com Email: [email protected]

Editor

Herman Hammerschmidt Jeffery Katz, DPM President

Richard Leichter, DPM President-Elect

Jacob Reinkraut, DPM Vice President

Krupa Patel, DPM Treasurer

Greg Rubinstein, DPM Secretary

Sharon Monter, DPM Imm. Past President

Herman Hammerschmidt

Executive Director

Lorraine Fenenic

Financial Administrator

Barbara Kreitzman

Administrative Assistant/Receptionist

Deborah Mucisko

Events Coordinator

Mission Statement

The NJPMS is a professional medical

society founded in 1905, whose pur-

pose is to advance the profession of

Podiatric Medicine in the state of New

Jersey; to advance and promote the art

and science of Podiatry; to elevate and

maintain professional standards; to

safeguard the integrity of its member-

ship; to establish mutual relationships

and understanding between the

podiatric and other medical professions;

to inform and establish a credible

relationship with the public.

The NJPMS and its official publication of

For Members Only assumes no respon-

sibility for the statements or opinions

appearing under an author’s name or

for articles reprinted from other

publications.

For Members Only The President’s Message

Jeffery Katz, DPM, President

2

It’s the beginning of a new year and I would like to wish all of

you and your families a Healthy and Happy New Year. I, like

most of you, have been accustomed to making a few resolutions

and trying to set some goals. Forgetting about all the common

ones having to do with diet and exercise, I’ve been focusing on

what changes can I bring to my practice to help me navigate through the dense

fog created by regulatory statutes, government regulations and the insurance

companies. Often times as I laughingly look and shake my head at some of

the requirements the medical profession is saddled with, I think back to the

days of “The New Math”. I can remember telling my kids that I could show

them how to get to the answer of their math question, but I had no idea of how

to do it the way they were being taught. In a similar fashion, I often question

the rationale for some of the current rules and regulations that we have to fol-

low and if any of these things were tested in the real world before being be-

stowed upon us.

Anyway let’s not dwell on the things that we can’t control. Let’s look at the

half-filled portion of that glass and what NJPMS is trying to do to help each

and every one of us stay afloat. The Society is beginning to move forward

with the podiatric assistant radiology course. We have been in contact with

TUSPM regarding setting up the online curriculum.

As of last year, all divisions of NJPMS voted in favor of joining the First Na-

tional Guild for Health Care Providers of the Lower Extremity, Guild #45

AFL-CIO. At the NYSPMA seminar in New York City on January 23rd, we

met with representatives of the AFL-CIO to discuss issues of importance to

our membership and ways that they may provide assistance in helping us to

achieve our goals. For those of you who have not sent in your Guild dues,

please do so.

In discussions with representatives from PICA, we have been informed of ef-

forts they are making in trying to lower malpractice premiums in New Jersey.

Governor Christie signed into law the bill expanding physician dispensing to

include vitamins and nutraceuticals. S2997/A4133 would permit physicians

and podiatric physicians to dispense and charge for certain nutritional supple-

ments. Current law generally restricts physicians from dispensing more than a

seven-day supply of most drugs, including nutritional supplements, and limits

administrative charges to patients to 10 percent of a drug's cost. The new law

exempts vitamins and nutraceuticals from those provisions.

It’s important, and at times difficult, to try to keep up with all of the things that

affect our ability to practice our profession. In publishing For Members Only

we attempt to include all relevant information presented and discussed at our

regular board meetings. Please make the time to review all of the articles pre-

sented in the publication.

Remember that this year there will not be a Region 3 APMA meeting in Atlan-

tic City. Instead, the meeting will be in conjunction with the APMA National

Meeting in Philadelphia July 14th-17th. Please be sure to register for the early

bird discount.

As always, any member of NJPMS is welcome to attend any of our Board of

Trustees meetings. And last but not least, for those of us who've been around

since the 70's and 80's, there is nothing new about what's been coming down

from the insurance companies. It's like I said earlier it's just the "New Math".

Remember, we are the experts in the treatment of foot and ankle disorders.

Page 3: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

3

New Jersey Hospitals Facing Medicare Funding

Cuts of Approximately $23 Million

Recently, it was announced that the federal government penalized nearly every

hospital in the state of New Jersey due to the fact that too many Medicare pa-

tients had to be readmitted within a month of their discharge. New Jersey is

the state with the highest percentage of hospitals penalized in the country. On-

ly one (1) hospital, Bergen Regional Medical Center in Paramus, received no

penalty. The Medicare funding cuts make up roughly 2.5 percent of a hospi-

tal’s Medicare payments. Medicare provides more than $3 billion in annual

funding to New Jersey’s hospitals, making it the largest source of their reve-

nue. The New Jersey Hospital Association (“NJHA”) estimates the cuts will

yield a loss of $23 million for the state. Aline Holmes, Senior Vice President

at the NJHA, estimates that two-thirds of the state’s hospitals decreased their

readmission rates this year, but others still have some work to do.

Federal Appeals Court Rules on Patient Assignment of Health Insurance Benefits

On September 11, 2015, the United States Court of Appeals for the Third Cir-

cuit ruled, in North Jersey Brain & Spine Center v. Aetna, Inc., that a patient’s

assignment of health insurance benefits, without a specific reference to a right

to file suit, sufficed to give the provider standing to bring an action under §

502(a), 29 U.S.C. § 1132(a), of the Employee Retirement Income Security

Act of 1974 (“ERISA”). This reversed a prior ruling of the United States Dis-

trict Court for the District of New Jersey that such assignment was insufficient

to confer standing on the provider under ERISA. The ruling clarifies the

standard for ERISA standing in the Third Circuit, which had previously been

ambiguous. Aetna argued that a prior Third Circuit decision, Community Med-

ical Center v. Local 464A UFCW Welfare Reimbursement Plan, recognized a

distinction between assignment of benefits and an assignment of a legal claim

to those benefits. In the North Jersey Brain case, the Third Circuit rejected

this distinction, holding that, “as a matter of federal common law, when a pa-

tient assigns payment of insurance benefits to a healthcare provider, that pro-

vider gains standing to sue for that payment under ERISA. An assignment of

the right to payment logically entails the right to sue for non-payment.

Source: StatLaw, Volume XXIII Number IX - September 15, 2015

Medicare Extends Deadline

to Appeal Two Penalties

The Centers for Medicare & Medi-

caid Services (CMS) have extended

the deadlines for physicians and

group practices facing two different

Medicare penalties in 2016 to request

an informal review if they believe the

government made a mistake. The

penalties, which whittle down reim-

bursement, are levied under Medi-

care’s Physician Quality Reporting

System, (PQRS) and the Value Based

Payment Modifier (VBM) program.

The original deadline for an informal

review of both penalties had been

November 9th. Now it is November

23rd.

In PQRS, Medicare penalizes physi-

cians for unsatisfactory reporting of

clinical quality data. The penalty in

2016, based on performance in 2014,

will lower fee-for-service payments

by 2%. Physicians, medical groups,

and accountable care organizations

can learn if they are due for a pay cut

by obtaining a PQRS feedback report

for 2014. The CMS website explains

how to obtain the report. Requests for

an informal review can only be made

online through the Quality Reporting

Communication Support Page of

CMS. CMS promises a decision,

which is final, within 90 days.

Source: PM News

November 11, 2015, #5,521

Publisher-Barry Block, DPM,JD

Podiatry Patient Information Brochure Available Online to Society Members

by Marc Haspel, DPM

Past NJPMS President and Communications Committee Chairman

A new informational brochure for podiatry patients will soon be

available for downloading on the NJPMS member-protected web-

site www.njpms.com. The publication, entitled “Today’s Podia-

trist”, was developed by the NJPMS Communications Committee

as an informative, up-to-date and cost efficient patient handout that

can easily be displayed in any podiatric office. Via the website,

NJPMS members can also personalize the back panel of the bro-

chure by adding their name, address and phone number for conven-

ient patient access. Hard copies of this publication have been avail-

able to members at NJPMS seminars and division meetings.

Uninsured Rate Drops To 9%, CDC Data Shows

The Wall Street Journal reports that

about nine (9) percent of Americans,

or 28.5 million people, were without

health coverage in the first half of

2015, according to new figures from

the Centers for Disease Control and

Prevention’s National Center for

Health Statistics. The number is a

significant drop of 7.5 million people

from a year earlier, when the unin-

sured was 11.5 percent.

Source: Louise Radnofsdy

Wall Street Journal via the

Daily (11/6/15), PM News

11/10/15, #5,520, Publisher-

Barry Block, DPM, JD

Page 4: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

Bako Integrated Physician Solutions

6240 Shiloh Road

Alpharetta, GA 30005

Telephone: 855.4Bako.CTS

Fax: 770.475.0528 www.BakoCTS.com

Mr. Thomas Sager, Account Manager, NJ

[email protected]

Boenning & Scattergood

4 Tower Bridge, 200 Barr Harbor Drive, Suite 300

West Conshohocken, PA 19428-2979

Mr. Brian J. McGrath, Senior Vice President

Private Client Group

Phone: 610.832.5292

Toll Free: 1.800.883.1212

Fax: 610.832.1232

Cell Phone: 215.813.8238

[email protected]

www.boenninginc.com

J.M. Patton Associates, Inc. — Insurance Brokers

1608 Walnut Street, Suite #902

Philadelphia, PA 19103

Mr. James Wiley - Telephone: 1.800.229.7609 x 104

www.jmpatton.com

Endorsed PICA Malpractice Program Manager

Kern Augustine Conroy & Schoppmann, P.C.

1120 Route 22 East

Bridgewater, NJ 08807

Attorney at Law Telephone: 908.704.8585

www.drlaw.com

Mr. Daniel Giaquinto, J.D. Legal Counsel to the Society

Endorsed Legal Defense Plan

The NJPMS Corporate Member Family Let us recognize and thank our corporate sponsors. They support and assist your society with their efforts. Please utilize

their services and products.

Medline Industries, Inc.

1 Medline Industries

Mundelein, IL 60060

Mr. Tim Dakil, Vice President Surgeon Preference Division

Telephone: 847.643.3927

Fax: 866.325.9159

Email: [email protected]

Advanced Wound Care, Orthopedic Soft Goods

PICA Group

3000 Meridian Blvd. #400

Franklin, TN 37067

Ms. Sunday Elam, Account Manager

Telephone: 800.251.5727; 615.371.8776 ext.2223,

Fax: 615.370.9021

Practical Billing Solutions, LLC

225 Route 35, Suite #208

Red Bank, NJ 07701

Ms. Luanne Wainwright-Erskin - CEO

Telephone: 732.383.4190

Fax: 732. 383.4171

Email: [email protected]

www.practice-alt-com.

Billing Services

Source Staffing Solutions, Inc.

2 Carnegie Road

Lawrenceville, NJ 08648

Mr. Scott Balyer, Vice President of Staffing

Telephone: 609.895.9700

Fax: 609.964.1929

Email: [email protected]

Billing, Management, Payroll & Human Resources, Staffing,

Computer Consulting and Training

The Manta Group

P.O. Box 785

Farmingdale, NJ 07727

Mr. Raymond Posa, President

Telephone:732.919.0944

Fax: 732.835.5901

Email: [email protected]

Technology Consulting Firm — EMR

The Gandelman Agency

684 Whitehead Road

Lawrenceville, NJ 08648

Telephone: 609-695-1496

Fax: 609-695-7889

Mr. Perry Gandelman, CEO

[email protected]

www. TheGandelmanAgency.com

Insurance: Property & Casualty, Long-Term Care, Disability

NJPMS’ 110th Year

4

CME Notice of Retention

Please note that all members must retain their original

CME documentation for a period of seven years. Addi-

tionally, you should neatly maintain your file in a safe

and easily accessible location should the State Medical

Board request to examine the original documents.

Please summarize your Category II credits by submitting

to NJPMS a total of contact hours on a quarterly basis.

These are non-verifiable and a summary total is accepta-

ble.

Do not hold your Category I and Category II credits and

submit them at the end of the licensure cycle. This over-

whelms the NJPMS administrative office and places un-

necessary burden on them. Please submit them quarterly!

You should forward only copies of those documents to

NJPMS. Please call the executive office at 732-967-9003

if you have any questions.

Our 13th year without a dues increase!

Page 5: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

Free NJPMS Seminar Offer Any member who successfully assists NJPMS in adding a corporate member to our

society will be entitled to attend a free NJPMS seminar of their choice.

5

Are You a Life

or Senior Member?

To qualify as a senior APMA mem-

ber:

you must be in good standing

for 15 consecutive years

must be 62 years of age

or have been forced to curtail

practice due to illness

in practice no more than 20

hours per week

Thus you qualify for 50% dues.

A life member is as follows:

completely retired, 65 years of

age and a member in good

standing for 15 years

OR

a member in good standing for

25 consecutive years and retired

OR

a member in good standing for

50 years

A life member is exempt from dues

and assessments. For the current

fiscal year, all Society life members

are exempt from paying registration

fees for all NJPMS-sponsored semi-

nars.

We at NJPMS wish to again reiter-

ate these points for clarity. Mem-

bers must inform the society to be-

come eligible for these categories.

Any questions may be directed to

the executive office at 732-967-

9003. Thank you.

Life Members Offered

Free NJPMS Seminars

The NJPMS Board of Trustees, at its

meeting on January 14, 2015, voted

to permit NJPMS life members to

attend NJPMS seminars free of

charge for a one-year trial.

This decision does not include Re-

gion III or The Podiatry Institute

programs since they are not NJPMS

exclusive seminars. Life members

should still complete and submit the

seminar registration form to ensure

that adequate seating is available.

NJPMS Insurance Committee Member Notice

by Alan Warren, DPM, Insurance Committee Chairman

The Insurance Committee has been receiving an increased number of requests

for explanations of ‘why was this denied’ type issues, which lack adequate

information to enable an informative response.

To help the Insurance Committee help you, when requesting assistance re-

garding claims, please provide the following minimum generic data:

—Which insurance carrier

—Which CPT-4 and ICD-10 codes utilized

—Which explanation of benefits reason for line item denial(s)

In the event of receipt of request from the Insurance Committee for additional

information, please follow-up and submit the requested information as

promptly as possible. Without the requested additional information, the Insur-

ance Committee will be unable to provide further assistance. Please note: due

to liability issues, neither NJPMS nor the NJPMS Insurance Committee is

able to instruct as to what specific codes, or what specific charges, should be

used, only objective general guidelines. That information may be available

from your billing service and/or professional service representatives from the

insurance carrier.

Membership is advised to always have on hand copies of LCD/policy from

each insurance carrier to which they submit claims applicable to the services

they provide, to assure they are in compliance with protocols, as well as to

assist in attestation of compliance in the event of a post-payment audit. Most

carriers will provide free notification of policy changes via email to providers,

it is strongly recommended membership subscribe to all applicable email lists

to assure they are up-to-date with the carrier’s policy.

Continued on page 11

CMS’ National Fraud Prevention Program Authorizes

Unannounced Site Visits for Medicare

Part A/B Providers and Suppliers

In 2011, CMS implemented a site visit verification program using a National

Site Visit Contractor (NSVC). The site visit verification program is a screen-

ing mechanism to prevent questionable providers and suppliers from enrolling

or maintaining enrollment in the Medicare program. The NSVC will conduct

unannounced site visits for Medicare Part A/B providers and suppliers. The

site visit may be either an observational site visit or a detailed review to verify

enrollment related information and collect specific information based on pre-

defined checklists and procedures determined by CMS. During an observa-

tional visit, the inspector engages in minimal contact with the provider or sup-

plier and does not inhibit the daily activities that occur at the facility. The in-

spector may take photographs of the facility as part of the site visit. During a

detailed review, the inspector will enter the facility, speak with staff, take pho-

tographs, and collect information to confirm the provider’s or supplier’s com-

pliance with CMS standards. Inspectors performing the site visits will be CMS

subcontractors and shall possess a photo ID and a letter of authorization issued

and signed by CMS that the provider or supplier may review. We urge all

practices to contact our firm in the event of an unannounced site visit to ensure

the CMS contractors do not investigate beyond their scope or abuse their pow-

er. Source: StatLaw, Volume XXIII Number VIII-August 15, 2015

Page 6: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

6

State Medical Board Update Physician Publicly Reprimanded for Failure to Cooperate

A physician failed to respond to three (3) successive letters from the State

Board of Medical Examiners over the course of a year that requested patient

records and a narrative response concerning allegations raised by a former

patient. The patient alleged payments made by her and her insurance company

resulted in an overpayment of $400.00 to the physician, which the doctor

failed to refund despite numerous requests from the patient, her health advo-

cate and the doctor’s own billing service. Upon reviewing the medical rec-

ords, the Board noted multiple inconsistencies and deficiencies. The Board

also found the billing records troubling, noting that the patient’s office visit

bills were increased without any explanation and an “Itemized Payments” list

only showed patient payments and not the insurance payments that were re-

ceived. Concerning the overpayment of $400.00, the physician admitted re-

ceiving the three notices from her billing company to issue a refund to the

patient but stated to the Board that she felt entitled to back-charge a higher

fee. The physician also testified that she felt entitled to keep the overpayment.

The Board reprimanded the physician for her conduct, ordered her to cease

and desist from her billing practices, required her to change her office’s elec-

tronic medical record system, ordered her to refund the $400.00 overpayment

to the patient, ordered CME courses and assessed a penalty of $2,000.00 for

the deficiencies in conduct.

Physician Suspended for Overprescribing Opioids

A family practitioner recently en-

tered into a Consent Order with the

Board after appearing before a Medi-

cal Review Practitioner Panel

(“Panel”). The Panel was convened

to review the facts and circumstances

surrounding the death of a former

patient who overdosed on opioids

prescribed by the family practitioner.

The Panel found that he provided

grossly negligent care to the patient

in prescribing excessive amounts of

opioids in the four months prior to

the patient’s death. The Panel further

found that the physician failed to

consider the combination effects of

the drugs prescribed to the patient

and failed to consider or investigate

whether the patient was abusing the

prescribed drugs. Additionally, the

Panel found that the physician failed

to make referrals to a psychiatrist,

knowing that the patient had made

several suicide attempts and was

continuously diagnosed with depres-

sion and anxiety. The physician was

also found to have repeatedly violat-

ed the Board’s regulations on record-

keeping by failing to adequately doc-

ument and monitor prescriptions

written for the patient and by failing

to document the results of examina-

tions performed on the patient.

Physician Publicly Reprimanded After Hospital Privileges Were Revoked for Sexual Harassment

A physician was recently called before the Medical Practitioner Review Panel

(“Panel”) after it received an Adverse Action Report from the physician’s em-

ployer. The physician’s privileges at the hospital were revoked following

complaints of sexual harassment. Various female staff members had alleged

that the physician made inappropriate comments with sexual innuendo,

touched them without invitation and made inappropriate comments. Although

the physician denied many of the allegations and alleged the comments at-

tributed to him were snippets of conversations being taken out of context, the

Board found sufficient evidence to reprimand the physician. The Board fur-

ther ordered the physician to immediately cease and desist from using inap-

propriate and/or sexually charged language and conduct in professional set-

tings or with professional co-workers. The physician was also required to pay

a civil penalty in the amount of $10,000.00, ordered to successfully complete

both professional boundaries and ethics courses and required to continue to

enroll and follow all recommendations from the Physician Assistance Pro-

gram (“PAP”) for no less than one (1) year.

Physician Disciplined for Selling Art Work and Herbal Supplements to Patient

A psychiatrist was recently disciplined after the Board received a complaint that the psychiatrist had engaged in improp-

er behavior by selling at least six (6) personal paintings and books of artwork, and non-therapeutic herbal supplements to

his eighty-nine (89) year-old patient. The physician appeared before the Preliminary Evaluation Committee (“PEC”)

which found that the psychiatrist did not secure the level of medical malpractice insurance coverage required by statute

and was deficient in continuing medical education (“CME”) credits for the last reporting period. The Board ordered the

psychiatrist to cease and desist from engaging in private practice in NJ until he procured the level of medical malpractice

insurance coverage required by law. The physician was further ordered to cease and desist from the preparation and sale

of natural herbal medications. The Board further ordered a full refund to the patient for all monies paid to him for his

paintings and books of artwork, which totaled $13,500.00. The physician was also assessed penalties in the amount of

$8,000.00 for misrepresenting completion of CME requirements and for failure to procure the statutorily-required level

of malpractice insurance.

Source

For All Four Articles:

State Board of

Medical Examiners Reporter

Fall 2015

Volume 4, Issue 4

Page 7: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

7

Uninsured Rate Drops

To 9%, CDC Data Shows

The Wall Street Journal reports that

about nine (9) percent of Americans,

or 28.5 million people, were without

health coverage in the first half of

2015, according to new figures from

the Centers for Disease Control and

Prevention’s National Center for

Health Statistics. The number is a

significant drop of 7.5 million people

from a year earlier, when the unin-

sured rate was 11.5 percent.

Source: Louise Radnofsky

Wall Street Journal via the

Daily (11/6/15), PM News

11/10/15, #5,520, Publisher-

Barry Block, DPM,JD

Obama Signs Law Giving Providers

MU Hardship Exemptions

President Obama recently signed into law the Patient Access and Medicare

Protection Act, which makes it easier for eligible professionals and hospitals

to apply for hardship exemptions from Meaningful Use electronic health rec-

ord requirements. In particular, the law provides EPs and EHs with relief

from financial penalties for failing to meet State 2 MU requirements this

year, ensuring that providers have “flexibility in applying the hardship excep-

tion for Meaningful Use for the 2015 EHR reporting period for 2017 payment

adjustments.”

To avoid a penalty, physicians and hospitals had to attest that they met the

requirements for MU Stage 2 for a period of 90 consecutive days during cal-

endar year 2015. However, the Center for Medicare and Medicaid Services

did not publish the 2015-2017 modifications rule for Stage 1 and 2 of MU

until October. As a result, by the time providers were notified of the require-

ments, fewer than the 90 required days for reporting remained in the calendar

year. The APMA will be forwarding the form when available.

Source: Greg Slabodkin, Health Data Management (12/29/15)

PM News, December 31, 2015 #5,564 Publisher-Barry Block DPM, JD

The Stimulus Act Started a

Cyber Crime Wave of Medical Data Theft

Six years after the American Recovery and Reinvestment Act of 2009 opened

the floodgates to digitized medical records, so-called “protected health infor-

mation” is now the most precious commodity in pilfered consumer data—

fetching up to 10 times the price of a stolen credit card number on the “Dark

Web.” A report from International Data Corporation forecasts that 1 in 3 con-

sumers will have their health data compromised next year due to weak cyber-

security.

Starting this year, Medicare-eligible providers who aren’t “meaningful users”

of electronic medical records will begin facing penalties. Without a corre-

sponding push to compel investments in security, however, the majority of

medical providers incorporated EHR into legacy systems that lacked the tech-

nology required to protect it. This created an open pathway for thieves who

once would have faced a locked door.

Source: Christoher Moraff, The Daily Beast (12/21/15)

PM News, December 31, 2015 #5,564 Publisher-Barry Block, DPM, JD

Podiatrist is

“Hardest to Fill” Job

On December 16th, The American

Staffing Association (ASA) released

its Skills Gap Index listing the hard-

est-to-fill occupations in the United

States for the third quarter of 2015.

The top 10 positions were:

1. Podiatrists

2. Photographic process workers and

processing machine operator

3. Occupational therapists

4. Heavy and tractor-trailer truck

drivers

5. Psychiatrists

6. Forest fire inspectors and

prevention specialists

7. Internists, general

8. Physical therapists

9. Speech-language pathologists

10. Occupational therapy assistants

The ASA Skills Gap Index was es-

tablished by the American Staffing

Association, using a hiring indicator

developed by ASA corporate partner

CareerBuilder. The hiring indicator

measures the level of difficulty to fill

a specific occupation based on de-

mand, supply of active candidates,

and all individuals working in that

occupation.

Source: Advanced Healthcare

Network (12/30/15)

PM News, January 2,2016 #5,566

Publisher-Barry Block, DPM, JD

CMS Announces Submission Timeframes for 2015 Physician Quality Reporting System (PQRS) Data

Continued from page one (1)

Eligible professionals who do not satisfactorily report quality measure data to

meet the 2015 PQRS requirements will be subject to a negative PQRS pay-

ment adjustment on all Medicare Part B Physician Fee Schedule (PFS) ser-

vices rendered in 2017.

For questions, please contact the QualityNet Help Desk 1-866-288-8912 or via

email at [email protected] from 7:00 a.m. - 7:00 p.m. central time.

Complete information about PQRS is available at http://www.cms.gov/

Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.

html.

Page 8: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

8

Labor Working for Podiatry

by George Nassoor, DPM

Guild Board Member, New Jersey

NJPMS Past President

Politics make strange bedfellows,” wrote Charles Dudley Warner, an American essayist and novelist, around the later

1800’s. Many of you have commented to me over the years that you have no common interests with Labor or the Labor

movement. Several times I have been told that podiatric physicians are professional physicians and have no business as-

sociating with unions or labor. Luckily, the majority of our members around New Jersey and in seven other states see the

actual truth of the matter.

The Office and Professional Employees International Union (OPEIU), which we are members of, recently made a contri-

bution to Republican Congressman Brad Wenstrup, DPM from Ohio as well as Senator John Tester, a Democrat from

Montana, in the amount of $5,000 each. These donations came from OPEIU’s PAC account. No podiatric physician has

given any amount of money to that PAC, nor has our Guild donated any money to that PAC fund. Therefore, that

$10,000 came from Union members from other professions. These Union members donated their money to help fund the

campaign of a Republican podiatric physician because one of their associated unions (in this case, our Guild) needed to

support a Congressional member who is sponsoring a bill that will bring parity to our members who serve in the VA.

Union members understand parity; they understand equal pay as well. Charles Dudley Warner understood how politics

works; he understood that sometimes individuals or groups need to get together to support their common goals. Further-

more, he understood that sometimes those individuals or groups would not consist of people whom society would be-

lieve fit together.

Our Guild continues to work with OPEIU and the AFL-CIO to achieve our common goals. The OPEIU has been work-

ing to educate and emphasize podiatry’s value and podiatric physicians’ training and expertise. Lately, OPEIU respond-

ed to our needs during the conversion to ICD-10. This is not an issue except for physicians; nevertheless, OPEIU made

ICD-10 Pocket Guides available to every one of its podiatric members. Furthermore, our Guild has successfully used the

large scale of the AFL-CIO to achieve purchasing power for services a relatively small organization like NJPMS would

not otherwise be able to provide. The emergency roadside assistance service, identity theft protection, dental plans and

discounts for AT&T Wireless and Wells Fargo Home Mortgages are just some examples of the benefits currently availa-

ble to members through OPEIU.

Additionally, please note, I am always available to answer your questions or clarify the big picture. I am also available if

you just want to complain about how podiatric physicians shouldn’t associate with unions. We live in a union state and

also have many elected officials, both state and local, that are union members.

A list of OPEIU benefits available to NJPMS members is listed below. This information will be added to the NJPMS

website in the near future.

Please remember to forward your Guild membership dues to the executive office. These funds were forwarded on your

behalf and must be returned to the NJPMS Deep Reserve. Let us work together and move forward.

OPEIU Membership Benefits

Effective July 1, 2014, all Guild 45 members in good standing are eligible for a $7,000 life insurance benefit and a

$7,000 AD&D benefit.

Up to two (2) towing/service calls per year (valued at up to $100 each) applicable to all family members living in

the same household.

Identity theft protection through InfoArmor (valued at $150 per year).

Eligibility for the Howard Coughlin Memorial Scholarship Fund providing full-time scholarships of $6,500 ($3,250

1st year - $3,250 2nd year) and part-time scholarships of $2,650 ($1,325 1st year - $1,325 2nd year.) Selections are

made among applicants on a lottery basis.

Eligibility for the John Kelly Labor Studies Scholarship Fund providing scholarships up to $3,250 for ABMSP

members and associate members (total for all OPEIU members together is 10 scholarships.)

Eligibility for the Romeo Corbeil/Gilles Beauregard Memorial Scholarship Fund “Summer Camp” program for chil-

dren, stepchildren or a legally adopted child between the ages of 13 and 16.

Page 9: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

9

Page 10: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

10

Page 11: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

2015-2016 Board of Trustees/Advisory Board

President Jeffery Katz, DPM

Vineland (856) 691-1287

[email protected]

President-Elect Richard Leichter, DPM

Red Bank (732) 747-2111

[email protected]

Vice President Jacob Reinkraut, DPM

Ridgewood (201) 445-2288

[email protected]

Treasurer Krupa Patel, DPM

Westfield (908) 232-3346

[email protected]

Secretary Greg Rubinstein, DPM

Teaneck (201) 836-7173

[email protected]

Immediate Past President Sharon Monter, DPM

Pt. Pleasant (732) 295-1211

[email protected]

President’s Advisory Board

Marshall Feldman, DPM

Rahway (732) 388-2375

[email protected]

Harvey Karpo, DPM

Woodbury (856) 845-3668

[email protected]

George Nassoor, DPM

Phillipsburg (908) 454-3770

[email protected]

James Ricketti, DPM

Hamilton Square (609) 587-1674

[email protected]

Christian Robertozzi, DPM

Newton (973) 579-1300

[email protected]

Sharon Root, DPM

Succasunna (973) 252-8787

[email protected]

Division Chairpersons

Northern Division (Co-chair) Diane Guadara, DPM

Hackensack (201) 488-8599

[email protected]

Northern Division (Co-chair) Franklin Levinson, DPM

North Bergen (201) 868-2400

[email protected]

Southern Division Harvey Karpo, DPM

Woodbury (856) 845-3668

[email protected]

Western Division Alan Warren, DPM

Parsippany (973) 334-5928

[email protected]

Atlantic Division Emma Bryan, DPM

Smithville (609) 404-3200

[email protected]

Capital Division David Dondero, DPM

Lambertville (609) 397-0631

[email protected]

Central Division Elliott Lehrer, DPM

Monroe Twp. (609) 655-2222

[email protected]

Eastern Division Monica Spencer, DPM

Westfield, NJ (908) 232-3346

[email protected]

February 10, 2016 Executive Meeting

March 16, 2016 Executive and

Board of Trustees

March 18 - 21, 2016 APMA House

of Delegates

April 13, 2016 Executive and

Board of Trustees

May 18, 2016 Executive Meeting

June 1, 2016 Golf Tournament

June 15, 2016 Executive and

Board of Trustees

July 14 - 17, 2016 APMA National

Scientific Seminar,

Philadelphia, PA

August 17, 2016 NJPMS Leadership

Meeting

September 21, 2016 Executive and

Board of Trustees

October 19, 2016 Executive Meeting

November 16, 2016 Executive and

Board of Trustees

2016 Board Schedule

NJPMS’

110th Year

Save the Date!

APMA National Meeting

July 14 - 17, 2016

Philadelphia, PA

NJPMS Insurance

Committee Insurance Notice

Continued from page seven

Effective January 12, 2016, Mi-

crosoft discontinued support for

‘older’ versions of Internet Explorer,

specifically versions earlier than IE

11 are no longer supported. The im-

pact of this is use of an obsolete, un-

supported browser will likely result

in inability to access secure websites,

such as NaviNet. It is strongly rec-

ommended that members utilize cur-

rent, updated definitions for both

your internet browser and antivirus

programs when you go online.

11

Page 12: FOR MEMBERS ONLY - NJPMS · 2017-07-11 · New Jersey Podiatric Medical Society January/February 2016 FOR MEMBERS ONLY CMS Announces Submission Timeframes for 2015 Physician Quality

Dates to Remember

State

NJPMS Professional Marketplace

Northern NJ…. Morris County. 31-

year-old established, respected office with four DPMs. Large referral base from PCPs, Vascular, Peds and Orthopedists. A well-rounded hospital-and-surgical center based podiatry practice encompassing all aspects of foot and ankle care. Large number of new patients weekly, solid surgical schedule. Large modern office with digital x-rays and EMR. Involved with residency program. Looking for a personable individual with strong ethics and high motivation. Seeking serious associates only leading to partnership. Must have PMSR/RRA or equivalent train-

ing. Very competitive compensation pack-age. Starting July 2015. Please email CV and reference to [email protected] (1/16)

Podiatry Office Equipment …. Practice recently closed in North Jersey. Some Equipment is still available: electri-cator, Kidde tourniquet, oxygen tank, x-ray view boxes, instruments, lead apron, some walking boots and a few surgical shoes. Photos available. If you are local feel free to email Dr. Sharit for an ap-pointment at [email protected]. (1/16)

Office for Sale….Twenty-year-old part-

time office in Hudson County. Great location, great opportunity to expand. Currently working one and a half days a week. Excellent patient load and reasonably priced. Please send inquiry to NJPMS, 2 King Arthur Court, Suite C, PO Box 1005, North Brunswick, NJ 08902. (1/16)

For Sale….Pad Net vascular testing

machine. The unit is three years old and in brand new condition. Priced to sell! Send an email to: [email protected]. (1/16)

Practice/Position Wanted…. ABPS Board Certified podiatrist with over

20 years experience in foot & ankle sur-gery looking for either a buy-in situation to be a partner or to purchase a busy practice. Central Jersey most desirable but will travel a reasonable distance for the right situation. I already have hospital privileges in North and Central Jersey. I am available almost immediately. Please e m a i l : m e d p o d 1 0 0 @ g m a i l . c o m . (1/16)

For Sale….Whitehall Whirlpool with

tub. Good working condition. $300 or best offer. Please call 973-477-2833. (1/16)

“Alone we can

do so little;

together we can do so

much.”

Helen Keller 12

Part-time position Central NJ….Well established podiatry prac-

tice is looking for a hard working and

motivated individual to work in all as-pects of podiatric medicine and sur-gery. Please send CV to: [email protected]. (1/16)

Surgical Instruments for Sale….Complete set of surgical in-

struments, including osteotome set, rongeur, double action bone cutter, weitlander, stats, needle holder, etc. All instruments are in perfect condition. Best offer. 50 instruments available. Please email to: [email protected]. (1/16)

Associate Position Full Time….Do you have eight arms and

12 legs? Can you handle a challenge? Associate wanted for amazingly busy practice. Must be surgically trained but conservatively minded. The skies the limit! Wonderful environment and great support team. Great pay with potential for expansion in Bergen County, New Jersey. Please email CV to:njfootankle @yahoo.com. (1/16)

Position Available….Part-time-

Jersey shore. Seeking a podiatrist to serve residents of long-term care/subacute rehab facility in Ocean Coun-ty. Perfect opportunity for a person looking to supplement their income.

Must have good work ethic, be hard working, board certified/qualified, have knowledge of billing and have malprac-tice insurance. Please forward CV to: [email protected] (1/16)

NJPMS/APMA Dues

Payment Reminder

FINAL PAYMENT IS DUE JAN-

UARY 15, 2016. IF PAYMENT

WASN’T SENT, IT IS NOW

PAST DUE!!

Outstanding payment statements

were recently mailed.

Remember to place your invoice

number or full name on the check.

Because APMA and NJPMS engage

in certain restricted lobbying activi-

ties, 5% of your National Dues and

State Dues are not deductible as an

ordinary and necessary business ex-

pense, if otherwise deductible.

If you are having a problem paying

your dues, please contact Lorraine

Fenenic, 732-967-9003, ext. 104

or email her at: [email protected]

to discuss many payment options that

may be available to you.

We are here to help!

2016 Seminar Dates

Wednesday, April 6th

Spring Seminar

Wednesday, August 17th

Leadership Forum

Wednesday, September 28th

Fall Seminar

Wednesday, December 7th

Medicare Update

The seminars will be held at the Bat-

tleground Country Club, Manalapan,

New Jersey. Please mark you calen-

dars!

2016 Golf Dates June 1st, Robertozzi Golf Tourna-

ment at the Pine Barrens Golf

Course, Jackson, NJ.

October 5th, Nine and Dine Golf

Day at the Battleground Country

Club, Manalapan, NJ.

Medical Association:

Bans Pharmaceutical Ads

The American Medical Association

this week called for Congress to

ban pharmaceutical advertising,

arguing that it hurt consumers and

increased drug prices. The pharma-

ceutical industry, meanwhile, de-

fended its practices.

Source: Association Now Daily

News, 11/19/15