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NJCACS LEGISLATIVE INFORMATION
The American College of Surgeons (ACS) advocacy activities at the federal and state level represent the interests of you, the practicing surgeon, and your patients.

Socioeconomic, legislative, and regulatory issues affecting surgery are of paramount concern to us. We develop and advocate health care policy that is in the best interest of patients and physicians through our Division of Advocacy and Health Policy, in Washington, DC, and in state capitols.

We also maintain liaison with the Washington office of other medical and surgical societies. Primarily, we liaise with Congress and federal agencies—including Centers for Medicare & Medicaid Services and Health and Human Services—on important matters to the surgical profession.

We help you navigate through complicated changes that affect surgical practice today through our coding hotline and workshops on practice management/coding issues.

We encourage all surgeons to get involved in advocacy matters. Take action. Protect your patients and your profession. Visit our advocacy web pages often and stay in touch with us

Click to Visit The ACS Advocacy Page
Follow Us On Facebook     Follow Us On Twitter    Follow Us On Instagram





URGENT!!! Download The Letter Below To Send To Your Legislators ASAP!!!


Dear Leader McConnell, Leader Schumer, Speaker Pelosi, and Leader McCarthy:

As Congress continues its efforts to protect patients from surprise medical bills, we hope that you recognize the potentially devastating unintended consequences that certain proposals under consideration could have on smaller and independent physician practices such as ours, and urge you to ensure a thoughtful approach as the various proposals are brought together.

Click Here For Full Letter To Send To Your Legislators

 TO ADD YOUR GROUP'S NAME TO THE LETTER, PLEASE CLICK HERE




The American College of Surgeons (ACS) sent a letter to Congress regarding the surprise medical billing
issue. The letter urges Congressional leadership to not include surprise billing legislation in a year-end

spending package unless two key issues are addressed appropriately:

1. Payment by the health plan to out-of-network physicians cannot be tied to mean or median in network,or Medicare rates.

2. There must be an accessible independent dispute resolution (IDR) system included that allows doctors and health plans to have a fair third party arbiter settle payment disputes. That IDR language must include specific parameters and criteria.

Most importantly, poorly drafted surprise billing legislation should not be used as an offset for other government programs in an end of year funding package. As Congress continues it's work to address this issue, we would urge all Fellows to utilize SurgeonsVoice online to urge members of Congress to consider these ACS-supported principles.

Click Here To Read The Colleges Letter To Legislators




Extortion Scam Targeting DEA Registrants

Extortion ScamDEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel

Click Here For Full Article

Extortion Scam Online Reporting




NEW JERSEY EARNED SICK LEAVE LAW,

Governor Murphy signed a major employer mandate, the “earned sick leave” law (A1827), on May 1, 2018. The New Jersey “earned sick leave” law, which takes effect in six months (October 29th), requires employers to provide earned sick leave to employees in the State. It provides that an employee accrues one hour of earned sick leave for every 30 hours worked and requires an employer to pay for earned sick leave at the same rate of pay, and with the same benefits, as the employee normally earns. The maximum earned leave required is 40 hours a year, which equals 5 days a year for most full time employees. The employer is not required to permit the employee to accrue or use in any benefit year, or carry forward from one year to the next, more than 40 hours of earned sick leave. There is no exemption for small businesses and no distinction of full or part time employees, but there is an exemption for per diem health care workers.


Click For Full Article


The following was received from our lobbyist, Rick Wright, MBI Gluck Shaw.

"The Out of Network Law that Governor Murphy signed into law earlier this summer takes effect on September 1, 2018. As you are aware, members of the Access to Care Coalition, including the American College of Surgeons, have participated in meetings this summer with the following entities in NJ State Government who are charged with the development and promulgation of regulations for the new OON Law. These government entities are as follows: NJ Department of Law & Public Safety, Division of Law, Department of Banking & Insurance and the State Board of Medical Examiners.
Click Here For complete Letter
Clinical Congress 2018 Call for Abstracts: Late-Breaking Clinical Trials

We invite you to submit your scientific research from prospective clinical trials to be considered for a dedicated scientific forum session at the American College of Surgeons Clinical Congress 2018, October 21–25 in Boston, MA. This new session is designed to highlight practice-changing clinical research relevant to the surgeon. The research must be original or previously presented within the past six months and of sufficient scientific and practice importance to be considered for this session.

The submission site is open now and will close at 11:59 pm (CDT) August 1. Notification of acceptance will be sent September 1.

Submit Your Abstract


June 5, 2018
Dear Doctors:

On Friday, June 1, Governor Murphy signed A-2039, the “Out-of-Network” bill into law. While the legislation has seen many iterations over the ten years it was debated, the final iteration includes three key elements:

Full Letter From Justin M. Sambol, MD, FACS President NJACS Click Here

Letter Topics
  • Transparency
  • Balance Billing Requirements
  • “Surprise Billing” Protections and Arbitration

Date: April 3, 2018
To: NJ, ACS Members

From: Justin Sambol. MD,FACS, President
Richard Wright, MBI Gluck Shaw (Chapter Lobbyist)

Re: A-2039/S-485 “Out of Network Consumer Protection, Transparency, Cost Containment & Accountability Act” Update

Yesterday, Thursday, April 12th, both houses of the Legislature passed A-2039/S-485, known as the “Out of Network Consumer Protection, Transparency, Cost Containment & Accountability Act”. The legislation, which was opposed by the American College of Surgeons, New Jersey Chapter and 20 additional members of the Access to Care Coalition, passed by a simple majority of votes in the Senate and a wider margin the Assembly. The Senate vote was 21-13 and the Assembly vote was 48-21. No Republican Legislator in either house voted in favor of either bill. The floor votes from yesterday’s Senate and Assembly voting session are below.
With the passage of this legislation, Governor Phil Murphy has 45 days as of yesterday to take action on A-2039/S-485. If the house of origin, in this case it’s the General Assembly, does not have a Quorum Call on the 45th day, the Governor has until the house of origin has its next meeting after 45 days. The Governor has 3 options with regard to this legislation, he can sign it, Conditionally Veto (CV) it and send it back to the Legislature with recommended changes or give the bill an Absolute Veto (AV) in which the bill is dead unless the Governor is overridden by both houses of the Legislature by a 2/3rds Majority, or 54 votes in the Assembly or 27 votes in the Senate. The most likely scenario is that the Governor will either sign or CV this legislation.
Lobbyists representing the Access to Care Coalition, including MBI-GluckShaw, will meet with members of the Governor’s Office, Office of the Chief Counsel, on Wednesday, April 18th at 1 pm next week to discuss the attached legal opinion which we believe renders part of A-2039/S-485 unconstitutional and to request Governor Murphy CV the bill by installing our suggested amendments in his CV message and send the bills back to the Legislature for reconsideration, which would allow the medical community in NJ to support A-2039/S-485.
The concepts/amendments, not in any order of prioritiy, that we will discuss with Counsel’s Office on April 18th are as follows:

MUST READ Full Letter Click Here

Remove ERISA opt-in
Add Non-severability clause
Add transparency and disclosure requirements for employers offering self-funded plans
Amend inadvertent definition
Amend arbitration to use current DOBI arbitration
Remove penalties
Remove prohibition for waiver of copay/coinsurance

IMPORTANT! CALL TO ACTION OUT OF NETWORK LEGISLATION



Dear Doctors:

The Out-of-Network legislation is scheduled for a VOTE in the Senate, Thursday, April 12th. Please contact the following Senators to seek their opposition to S485.
  • Senator Richard Codey:     973-535-5017
  • Senator Ronald Rice:    973-371-5665
  • Senator Nia Gill:      973-509-0388
  • Senator Nicholas Scutari:    908-587-0404
  • Senator Stephen Sacco:     201-295-0200
  • Senator Brian Stack:     201-721-5263
  • Senator Vin Gopal:     732-695-3371
  • Senator Shirley Turner:    609-323-7239
  • Senator Joseph Lagana:     201-576-9199
  • Senator Nellie Pou:     973-247-1555


ACCESS TO CARE COALITION TALKING POINTS:

New Jersey physicians ask that you please OPPOSE A2039/S485 "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act."

There is NO guarantee or mandate that A2039/S485 will reduce premiums or result in healthcare savings for payers or patients as testified to by the New Jersey Association of Health Plans.

The Senate Budget and Appropriations Committee has determined that there are NO state budget savings that will result from passage of A2039/S485.

A2039/S485 WILL exacerbate New Jersey’s already critical shortage of physicians, particularly specialists like Emergency Room Physicians jeopardizing the health of patients.

Physicians and hospitals are severely LIMITED in their ability to assist patients will medical bills by language in A2039/S485 that actually penalizes them for waiving co-pays and deductibles.


There is a better way:
·S791 (Sarlo) “Requires certain disclosures regarding health care costs; allows SHBP to negotiate directly with providers in certain circumstances; and establishes certain out-of-network patient protections.” was released UNANIMOUSLY by the Senate Budget and Appropriations Committee and will END Surprise Billing and PROTECT patients.


April 11, 2018

Andrea

Andrea Donelan
Executive Director
New Jersey Chapter, American College of Surgeons



ABS Reverses
Course on Certification Requirement
Original Expiration Dates Will Be Honored;
New Certification Process Explained

By MONICA J. SMITH
The initial rollout of the new assessment plan for the American Board of Surgery’s Continuous Certification Program

Click Here For The Must Read Full Article


ACTION ALERT!!!
Stand UP for Practice & Profession!
Tell Your Senator
VOTE “NO” ON S-485!



The Senate Commerce and Budget Committees will both be voting on S-485, the so-called “Out of Network” bill this Thursday, April 5. We need your help TODAY to stop this harmful, pro-insurance legislation.

Step 1:

Find your Senator by visiting www.njleg.org

Step 2:

Call, write, fax, or email your Senators and tell them to VOTE “NO” on S-485! Tell them:

New Jersey is already a hard place to practice

Between increasing practice costs and decreasing reimbursements, New Jersey is already a difficult practice environment. S-485 will only exacerbate this problem by giving insurance companies even more leverage to continue their unfair treatment of physicians.

Huge Insurance Companies already treat Physicians Unfairly

Through decades of unchecked consolidation, a handful of insurance companies now dominate New Jersey ’s healthcare marketplace. These giant companies use their incredible power to force physicians into unfair in-network contracts, and now they are trying to make things even worse by making it impossible to practice Out-of-Network.

S-485 Will Only Help Insurance Companies, NOT PATIENTS

The Insurance Companies themselves have already testified that S-485 will not lower premiums for consumers. All S-485 will do is increase profits for fat cat insurance companies while hurting doctors and patients!

Step 3:

Please be sure to let us know who you’ve contacted, and if you’ve received any response. Thank you for standing up for your profession!

Andrea
njsurgeons@aol.com

Andrea Donelan
Executive Director
New Jersey Chapter, American College of Surgeons
36 Elm Street, Suite 5
Morristown, NJ 07960
(973) 539-4000





Protect Your Medicare Payments
Register Now - ACS General Surgery and Trauma Coding Workshop in New York City

With Medicare and third-party payor policy and AMA CPT coding changes taking effect in 2018, it is imperative that surgeons and their practice coding and billing team have accurate and up-to-date information to protect reimbursement and optimize efficiency.

Register now for the American College of Surgeons Coding Workshop to be held on May 17-19, 2018 in New York, NY. This workshop includes a third day devoted to trauma and critical care coding.
Participants in this coding workshop will not only learn how to correctly report surgical procedures and medical services, but will also have access to the tools necessary to succeed, including coding workbooks to keep for future reference that include exercises, checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits™ for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units.

Register Today

For more information about the 2018 ACS coding workshops, please visit the ACS website
or e-mail practicemanagement@facs.org

Full Article Here Here


Illinois Department of Financial and Professional Regulation
Attn:Craig Cellini
320 W. Washington, 3rd Floor
Springfield, IL 62786


Dear Mr. Cellini:

On behalf of the American College of Surgeons (ACS), I am writing to you to state our opposition to the proposed rule amendments to the Illinois Optometric Practice Act of 1987, which would significantly expand the scope of practice of optometry into the practice of surgery
View The Entire Letter


Protect Your Medicare Payments
Register Now - ACS General Surgery and Trauma Coding Workshop in New York City

With Medicare and third-party payor policy and AMA CPT coding changes taking effect in 2018, it is imperative that surgeons and their practice coding and billing team have accurate and up-to-date information to protect reimbursement and optimize efficiency.

Register now for the American College of Surgeons Coding Workshop to be held on May 17-19, 2018 in New York, NY. This workshop includes a third day devoted to trauma and critical care coding.
Participants in this coding workshop will not only learn how to correctly report surgical procedures and medical services, but will also have access to the tools necessary to succeed, including coding workbooks to keep for future reference that include exercises, checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits™ for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units.

Register Today

For more information about the 2018 ACS coding workshops, please visit the ACS website
or e-mail practicemanagement@facs.org

Full Article Here Here


ACS Health Policy Issues for 2018

There has been a great deal of interest in the health policy challenges facing surgeons and surgical patients every day. To this end, we wanted to provide you with a brief update following two recent meetings – the ACS Health Policy and Advocacy Group (HPAG) and the ACS Board of Regents. Both groups held discussions about more than 40 key health policy issues facing surgeons. Below are some of the issues upon which College leaders chose to place heavy emphasis. Full Article Here

Topics

Administrative Burdens and Regulations

Stop Overregulating My OR Initiative

Interoperability/EHRs

Medicare Physician Payment – MIPS and APMs

Quality Payment Program Resource Center

Ensuring Access to General Surgery
Contact Your Members of Congress Make your voice heard

E/M Documentation Guidelines


Burnout
Surgeon Well-Being


Primary Care Physician Payment Increases


Dear New Jersey Surgeons,

The "Out of Network" bill, A.2039/S.485, is scheduled to be in the Senate Commerce Committee and Assembly Financial Institutions and Insurance Committees next Monday March 5th and is expected to be voted out of the Committees. Take action now to oppose the legislation.

The legislation is a flawed attempt to address the out of network issue but instead would take your bargaining power away when contracting with insurance companies.

Please contact your legislators using the action center and urge them to oppose this legislation. Click here to send an email to your lawmakers now.

Thank you for your advocacy!

Justin T. Sambol, MD, FACS
President,



The New Jersey Chapter will be posting Legislative information of interest to our members from time to time that affects how we practice. Our chapter sees itself as providing a cohesive voice for many surgical specialties in societal and governmental issues related to the practice of surgery in New Jersey and in the nation, by actively engaging in dialogue with state and national political leaders, in the context of initiatives from the American College of Surgeons’ national office.



Protect Your Medicare Payments

Register Now to Attend 2018 ACS General Surgery Coding Workshop


With Medicare and third-party payor policy and American Medical Association (AMA) Current Procedural Terminology (CPT) coding changes taking effect in 2018, it is imperative that surgeons and their practice coding and billing team have accurate and up-to-date information to protect reimbursement and optimize efficiency. To help surgeons succeed, the American College of Surgeons (ACS) has scheduled several general surgery coding workshops in 2018.
Participants in a coding workshop will not only learn how to correctly report surgical procedures and medical services, but will also have access to the tools necessary to succeed, including a coding workbook to keep for future reference that includes exercises, checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits™ for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units.

Register Today
The remaining ACS coding workshops in 2018 are listed below:

  • Orlando, FL, February 22–23
  • Chicago, IL, April 12–13
  • New York, NY, May 17–19*
  • Nashville, TN, August 9–10
  • Chicago, IL, November 1–3*

    For more information about the 2018 ACS coding workshops,please visit the ACS Websiteor e-mail practicemanagement@facs.org

    Click Here For Full Article A Must Read




    Don't forget to submit your abstracts and videos for consideration by March 1!

    The Call for Abstracts and Videos for Clinical Congress 2018, October 21–25 in Boston, MA, is open. Submit abstracts for the Owen H. Wangensteen Scientific Forum or videos for the Video-Based Education Sessions using the link below.

    The last day to submit abstracts and videos is Thursday, March 1 at 5:00 pm (CST).

    Submit your abstracts and videos today! (click to submit)


    Important: Postponement of new AmeriHealth New Jersey policy regarding CPT® consultation codes

    Posted December 28, 2017
    Please be advised that AmeriHealth New Jersey will postpone the implementation of Claim Payment Policy #00.01.64: Consultation Codes, which outlines our reimbursement position on Current Procedural Terminology (CPT) consultation codes.

    We previously communicated that this Claim Payment Policy would go into effect January 1, 2018, which would have aligned with reimbursement standards on certain CPT consultation codes set by the Centers for Medicare & Medicaid Services. However, the implementation of this policy will be postponed, and the Notification has been removed from our Medical Policy Portal .

    Once the new implementation date is determined, we will post a new Notification on our Medical Policy Portal We will also communicate this information in a future Partners in Health UpdateSM article.

    If you have any questions, email us at E-Mail link.
    Be sure to include your name, contact number, and provider ID number in your email.

    CPT Copyright 2016 American Medical Association. All rights reserved.
    CPT® is a registered trademark of the American Medical Association.

    Andrea

    CMS Creates Data Submission System for Quality Payment Program

    The Centers for Medicare & Medicaid Services (CMS) launched a new data submission system (new data submission web page, click to visit) for providers who participate in the Quality Payment Program (QPP). The QPP is composed of two tracks, but in the early years, most providers will participate via the Merit-based Incentive Payment System (MIPS). Providers can now submit all of their 2017 MIPS data through this submission system.

    Providers can submit and update data any time until March 31, with the exception of CMS web interface users, who are required to report quality data January 22 to March 16. As data are entered, providers will see real-time initial scoring within the MIPS performance categories. Data are automatically saved and clinician records are updated in real time. Hence, a clinician can begin a submission, leave without completing it, and then finish it at a later time without losing the previously entered information. Payment adjustments will be calculated based on the last submission or submission update that occurs before the submission period closes March 31.

    Providers use their Enterprise Identity Management (EIDM) credentials to log in and submit data. The CMS website features a user guide with instructions to create an EIDM account.

    For more information about the QPP data submission system, review the CMS fact sheet or view any of the following training videos:



    For more information, email CMS at QPP@cms.hhs.gov,
    or the American College of Surgeons Division of Advocacy and Health Policy at qualityDC@facs.org.

    Andrea

    2017 ACS ClinicaqualityDC@facs.org.l Congress
    Governor's Report - Michael A Goldfarb
    New Jersey Governor
    Click Here For Report



    American College of Surgeons
    Division of Advocacy and Health Policy

    Protect Your Medicare Payments
    Register Now to Attend 2018 ACS General Surgery Coding Workshop


    With Medicare and third-party payor policy and coding changes taking effect in 2018, it is imperative that surgeons have accurate and up-to-date information to protect Medicare reimbursements and optimize efficiency. To help surgeons succeed, the American College of Surgeons (ACS) will hold 7 general surgery and 3 trauma and critical care coding workshops in 2018. The American Medical Association (AMA) Current Procedural Terminology (CPT) codes for general surgery are updated every year, making it essential that health care teams attend an ACS coding course. The first two-day general surgery workshop will take place January 25-26 in Southlake, TX (nine miles from the Dallas Fort Worth International Airport)

    Register Today
    Click Here for Full Article

    For more information about the 2018 ACS coding workshops, e-mail:
    practicemanagement@facs.org



    "To ACS Fellows in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio,
    Oregon, and Rhode Island":

    Your help is needed to understand the impact of a new Centers for Medicare & Medicaid Services (CMS) policy that requires the reporting of postoperative facility and office visits provided to Medicare patients during the global surgical period. Please answer this short 6-question survey even if you are not aware of this policy:

    https://www.surveymonkey.com/r/ACSGlobalCodesSurvey
    (scroll down the page to answer the 6 questions, thank you for your help)

    Watch the ACS Global Codes Data Collection Webinar

    Starting July 1, 2017, CMS requires that surgeons in groups (including physicians and NPPs) of 10 or more in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island report CPT code 99024 for each postoperative visit that they provide related to selected high volume 10- and 90-day global services. If CMS is unable to collect accurate and complete data, then reimbursements for 10- and 90-day global services could be negatively affected in the future.

    This survey will take less than 5 minutes and will provide the ACS Division of Advocacy and Health Policy with data needed to protect reimbursement for global codes in the future.

    Thank you,


    David B. Hoyt, MD, FACS
    Executive Director


    Join ACS Cancer Programs Virtual Hill Day: September 8, 2017

    As you well know, the American College of Surgeons (ACS) Cancer Programs is dedicated to working with Congress and the new Administration on the issues that impact the future of cancer accreditation, research, and funding. At the forefront are ACS-supported initiatives such as supporting access to colorectal cancer screening, palliative care and hospice education and training, additional cancer research funding requests, and a forthcoming House Resolution recognizing the importance of cancer programs accreditation in ensuring quality cancer care. Congress is expected to address a number of legislative issues heading into next year, and we want cancer accreditation to be among them.

      On Friday, September 8, the ACS Cancer Programs will host its first Virtual Hill Day. Aimed at engaging surgeon advocates to help advance the College’s message, we encourage all ACS members to make your voices heard inside the halls of Congress by participating via social media, sharing your stories, and promoting the future of quality cancer care. No matter where you are located around the country, you can make your voice heard during the ACS Cancer Programs 2017 Virtual Hill Day!

    Remember: Congress needs to hear from YOU to better understand how to protect the future of cancer care.

    Make Your Voice Heard!

    Advocate: Use #cancerprogramsday via your preferred social media platform and follow @SurgeonsVoice on Twitter to advocate for policies that have the potential to affect the future of cancer care.

    Take Action: Contact your member of Congress via  SurgeonsVoice or social media to advocate for issues of importance to the future of cancer care.

    Share your story: The most compelling influences on elected officials are the personal stories from their constituents that bring to life everyday challenges facing surgeons and patients. If applicable, share your personal narrative about how cancer education, research, and prevention impacts lives.

    Reference Resources: Utilize the  SurgeonsVoice toolkit as a comprehensive guide to help further your education re: grassroots and political advocacy.

    Social Media Guidelines Choose your platform: Facebook, Twitter, etc. Use #cancerprogramsday on any/all social media platforms to leverage ACS Cancer Programs Virtual Hill Day efforts. Click here for social media samples and tips.  

    Share those selfies: Photo documentation is a great way to illustrate your story and make an impact. Be sure to take pictures when appropriate.

    Strength in numbers: Encourage your colleagues to participate. The more surgeon advocates Congress hears from, the stronger our voice will resonate on Capitol Hill.

    Represent: While we encourage you to share your story far and wide, on September 8, please remember that you are representing the ACS Cancer Programs.

    To learn more, contact:

    Katie Oehmen, Manager, SurgeonsPAC and Grassroots
    (koehmen@facs.org  or 202-672-1503)


    Global codes post-operative data reporting webinar: May 23


    The American College of Surgeons (ACS) will host a webinar Tuesday, May 23, at 7pm EDT, to inform surgeons about a new Centers for Medicare & Medicaid Services (CMS) policy requiring the reporting of post-operative visits provided during the global surgical period. Starting July 1, CMS will require surgeons in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island to report the number of post-operative visits that they provide related to certain 10- and 90-day global services. The ACS strongly urges all surgeons who are required to report to comply with this policy. If CMS is unable to collect accurate and complete data, then reimbursements for 10- and 90-day global services could be negatively affected in the future.

    Join the meeting:
    From your computer, tablet, or smartphone at Click To Join Here
    Dial in at 877-309-2073 (toll free) or 224-501-3217
    Access Code: 926-876-501

    If you have questions regarding the reporting of global codes post-operative data, contact the ACS Division of Advocacy and Health Policy at E-Mail link For more information about this new policy, visit the ACS website or the CMS website


    Medicare Program; Merit based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician - Focused Payment Models
    Click Here for Full Article
    Visit the Quality Payment Website for Additional Information

    CMS Releases List of Global Codes for Postoperative Visit Reporting

    The Centers for Medicare & Medicaid Services (CMS) recently released a list of 293 10-day and
    90-day global codes that some health care practitioners will be required to report when billing
    for postoperative visits. Starting July 1, a health care practitioner who is in a practice with 10
    or more other practitioners and located in one of nine CMS-designated states will be required
    to report American Medical Association Current Procedure Terminology (CPT) code 99024 for each
    postoperative visit furnished within the global period. CPT code 99024 is for Post-operative
    follow-up visit, normally included in the surgical package, to indicate that an evaluation and
    management service was performed during a post-operative period for a reason(s) related to
    the original procedure.
    The nine CMS-designated states are Florida, Kentucky, Louisiana,
    Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island.

    Practitioners will be required to report on 293 global codes listed on the CMS website as opposed
    to all 10- and 90-day global codes. CMS has determined that these codes are furnished by more
    than 100 practitioners per year and are either furnished more than 10,000 times or have allowed
    charges of more than $10 million annually. The agency estimates that the codes describe
    approximately 87 percent of all furnished 10- and 90-day global services and about 77 percent
    of all Medicare expenditures for 10- and 90-day global services under the physician fee schedule.

    Surgeons who have difficulty complying with this policy or who have questions should contact the American College of Surgeons (ACS) Division of Advocacy and Health Policy at regulatory@facs.org More information is available on the American College of Surgeons website and the CMS website.
    CMS Extends Meaningful Use Attestation Deadline to March 13

    The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for
    physicians to attest to meaningful use (MU) of an electronic health record (EHR) system
    in 2016 to March 13. Physicians who attest to MU in 2016 will avoid a 4 percent
    cut in Medicare payments in 2018. Surgeons can register and attest for any 90-day
    continuous reporting period in 2016 using the CMS Registration and Attestation System.
    System. CMS has created a reference guide with instructions on how to use its Identity
    and Access Management System to attest to MU.

    To learn more about the requirements for 2016, visit the American College of Surgeons website, consult the CMS tipsheet, or e-mail mpeltzman@facs.org .



    ACS Federal Legislative Issues


    DEA Reverses Announced Change to Registration Renewal Process


    The Drug Enforcement Administration (DEA) has announced that effective January 1, 2017, they are changing its long-standing policy of allowing a grace period for registrants who failed to file a timely renewal application. The DEA reversed its decision and posted a notice that it is retaining its current policy and procedures, with one minor change, regarding registration renewals.
    The revised announcement states the following:

    REVISED ANNOUNCEMENT REGARDING RENEWAL APPLICATIONS

    Starting January 2017, DEA will no longer send its second renewal notification by mail. Instead, an electronic reminder to renew will be sent to the email address associated with the DEA registration.

    At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows:


    • If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application.

    • DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required.

    • Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration.



    2016 Medicare Fee Schedule



    "MUST READ LEGISLATIVE ALERT,
    WE NEED YOUR HELP"


    As a result of aggressive and persistent ACS legislative and regulatory advocacy, on Wednesday CMS released a drastically improved policy on the collection of data that will eventually be used to revalue global codes. This new policy stands in stark contrast to a completely unworkable plan originally proposed by CMS in July. This dramatic shift by CMS is another example of strong legislative and regulatory advocacy work by the American College of Surgeons. For more details on this policy announcement by CMS, please click below.

    Full article click
    Final Rule
    Please Contact By E Mail For More Information

    "MUST READ LEGISLATIVE ALERT,
    WE NEED YOUR HELP"


    Call or write to your Legislators today!



    The NJ Legislature is considering a measure that would drastically limit the fees levied by physicians for out-of-network services. The law would virtually allow insurance companies to set the rates for physicians based on 100-250% of the Medicare fee schedule through binding arbitration for services rendered to emergency patients.


    Go to : NJ Legislative Contact Information
    (OR CALL THE CHAPTER OFFICE (973) 539-4000) to find your legislators’ contact information. Write or call the legislators representing your place of business and your residence!

    Full Letter and Sample Letter, Look Above Access Online

    Remember, the more constituents they hear from, the stronger voice you give to the NJ Chapter, American College of Surgeons!

    CMS Extends Deadline for Physician Quality Reporting System (PQRS) Informal Review Process CMS is extending the 2014 Informal Review period.

    Individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, PQRS group practices, and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustmentnow have until 11:59 p.m. Eastern Time on December 11, 2015 to submit an informal review requesting CMS investigate incentive eligibility and/or payment adjustment determination. This is an extension from the previous deadline of November 23, 2015.

    All informal review requestors will be contacted via email of a final decision by CMS within 90 days of the original request for an informal review. All decisions will be final and there will be no further review.

    All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP) which will be available September 9, 2015 through December 11, 2015 at 11:59 p.m. Eastern Time.

    Please see 2014 Physician Quality Reporting System (PQRS): Incentive Eligibility & 2016 Negative Payment Adjustment - Informal Review Made Simple (available on the PQRS Analysis and Payment webpage) for more information.

    For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or QualityNet Help Desk e-mail
    Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number (TIN), in e-mail inquiries to the QualityNet Help Desk.



    New Prescription Monitoring Program Law to take effect November 1, 2015:

    Click to Read Full Article


    In order to avoid a penalty under the Meaningful Use (MU) program, eligible professionals must attest that they met the Stage 2 requirements for a period of 90 consecutive days during 2015. However, CMS did not publish the final rule outlining modifications for Stage 2 of MU until October 16, 2015 – meaning that by the time eligible professionals were informed of the modified requirements, fewer than the 90 required days for reporting remained in the calendar year.

    Given the late release of the final rule, for those who are unable to meet the MU requirements in 2015, ACS advocated for Congressional intervention to simplify the exception process, and late last week (moments before adjournment for the year), the U.S. House of Representatives and Senate passed legislation which will allow for “blanket” Meaningful Use relief.

    This legislation, championed by ACS Fellow Tom Price, MD, FACS (R-GA) in the House, and sponsored by Senators Rob Portman (R-OH) and Robert Casey (D-PA) in the Senate, will allow CMS to approve submitted hardship exception applications in a “batch” until March 15. Currently, these applications are examined on a case-by-case basis, and CMS has acknowledged that it would be difficult for the agency to sort through the volume of requests they are likely to receive. By processing the submissions in a “batch,” those applying will receive a blanket hardship exception. It is important to note, while all applications received prior to March 15 will be approved, surgeons still must apply for the exception. Applications for the hardship exception will be available in early 2016

    An approved hardship exception will exempt Fellows from the payment adjustment in 2017.

    If you have any questions about participating in Meaningful Use, please contact by e-mail:
    qualitydc@facs.org


    Informal Review Request Period for the 2016 Value Modifier Open Now Through November 9, 2015

    CMS Enterprise Portal

    How to Obtain a QRUR

    2014 QRUR website

    QRUR Help Desk e-mail or Call 888-734-6433 (select option 3). 

    Click to Read Full Article

    Our Changing Health Care System

    Our Changing Health Care System Since the Inception of the Affordable Care Act:

    A collection of articles and primers from the American College of Surgeons

    ACS Download Page




    Take Action to Protect 2017 Medicare Reimbursement. Instructions in this article may save you from lower Medicare reimbursement in 2017


    Please Read The Full Article!!!

    The application and instructions can be found on the CMS website:
    CMS Enterprise Portal Payment Adjustments & Hardship Information

    To learn more about the hardship exemption application process, visit the following CMS: CMS Enterprise Portal Frequently Asked Questions

    If you have any questions about participating in Meaningful Use, please contact FACS by e-mail:qualitydc@facs.org



    CMS Makes it Easier to Opt Out of EHR Requirements

    The CMS is making it easier for providers to waive out from meaningful use requirements of electronic health records amid a series of proposed changes to the 6-year-old $31.8 billion EHR incentive payment program. In December, President Barack Obama signed the Patient Access and Medicare Protection Act, which expanded providers’ eligibility for hardship exemptions to Stage 2 of the meaningful-use program

    Basically, the law provides the CMS with the authority to batch process hardship applications by categories instead of the case-by-case method used previously. To comply with the law, the CMS posted a new streamlined hardship application, reducing the amount of information that providers must submit to apply for an exception. Eligible professionals will have until March 15 to apply for an exemption. If you have any questions, please contact:

    Kern Augustine Conroy & Schoppmann, P.C.
    1-800-445-0954 or via E-Mail



    In order to avoid a penalty under the Meaningful Use (MU) program, eligible professionals must attest that they met the Stage 2 requirements for a period of 90 consecutive days during 2015. However, CMS did not publish the final rule outlining modifications for Stage 2 of MU until October 16, 2015 – meaning that by the time eligible professionals were informed of the modified requirements, fewer than the 90 required days for reporting remained in the calendar year.

    Given the late release of the final rule, for those who are unable to meet the MU requirements in 2015, ACS advocated for Congressional intervention to simplify the exception process, and late last week (moments before adjournment for the year), the U.S. House of Representatives and Senate passed legislation which will allow for “blanket” Meaningful Use relief.

    This legislation, championed by ACS Fellow Tom Price, MD, FACS (R-GA) in the House, and sponsored by Senators Rob Portman (R-OH) and Robert Casey (D-PA) in the Senate, will allow CMS to approve submitted hardship exception applications in a “batch” until March 15. Currently, these applications are examined on a case-by-case basis, and CMS has acknowledged that it would be difficult for the agency to sort through the volume of requests they are likely to receive. By processing the submissions in a “batch,” those applying will receive a blanket hardship exception. It is important to note, while all applications received prior to March 15 will be approved, surgeons still must apply for the exception. Applications for the hardship exception will be available in early 2016


    An approved hardship exception will exempt Fellows from the payment adjustment in 2017.

    If you have any questions about participating in Meaningful Use, please contact by e-mail:
    qualitydc@facs.org




    New Prescription Monitoring Program Law to take effect November 1, 2015:

    Click to Read Full Article
    CMS Extends Deadline for Physician Quality Reporting System (PQRS) Informal Review Process CMS is extending the 2014 Informal Review period.

    Individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, PQRS group practices, and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustmentnow have until 11:59 p.m. Eastern Time on December 11, 2015 to submit an informal review requesting CMS investigate incentive eligibility and/or payment adjustment determination. This is an extension from the previous deadline of November 23, 2015.

    All informal review requestors will be contacted via email of a final decision by CMS within 90 days of the original request for an informal review. All decisions will be final and there will be no further review.

    All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP) which will be available September 9, 2015 through December 11, 2015 at 11:59 p.m. Eastern Time.

    Please see 2014 Physician Quality Reporting System (PQRS): Incentive Eligibility & 2016 Negative Payment Adjustment - Informal Review Made Simple (available on the PQRS Analysis and Payment webpage) for more information.

    For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or QualityNet Help Desk e-mail
    Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or Taxpayer Identification Number (TIN), in e-mail inquiries to the QualityNet Help Desk.



    2016 Medicare Fee Schedule


    State Advocacy Resources

    Chapter Advocacy Grant Program

    Advocacy Committees

    Health Policy and Research Institute


    IMPORTANT SGR REPEAL!!!!!

    The sustainable growth rate (SGR) is no more.
    The US House of Represenatives voted Tuesday to adopt legislation to end the flawed payment formula that left the medicare program unstable and threatened access to care.

    Click Here for Additional Details

    IMPORTANT!!!!
    YOUR ACTION IS NEEDED NOW!!!
    SGR PATCH


    As of midnight last night, the current sustainable growth rate (SGR) patch expired, meaning the 21 percent cut in Medicare payments is in effect. Every day that the U.S. Senate does not act causes disruptions to physician practices and puts more patients at risk of not getting the care they deserve.

    Last week, the U.S. House of Representatives overwhelmingly passed bipartisan legislation that would permanently repeal the SGR formula, but the Senate failed to act before leaving on a two-week recess.

    While Senate leadership has indicated they will take up the bill upon return on April 13, the clock is ticking. The administration can only hold claims until April 15, leaving a very narrow window of time for the Senate to act before Medicare claims are paid at the drastically reduced rate.

    We need you to keep the pressure on during the recess! Please contact your senators today to remind them that they have unfinished business here in Washington, D.C., and urge them to support H.R. 2 immediately when they return!

    Call your senators district offices:

    Senator Robert Menendez: (973) 645-3030
    Senator Cory Booker: (973) 639-8700
    Or by using the AMA's toll-free Grassroots Hotline: (888) 434-6200
    Send an urgent email to your senators reinforcing the need for SGR repeal now!!!!

    This is urgent! The current SGR patch has expired; physicians are being hit with a 21 percent cut to Medicare - your voice is needed now, more than ever!

    A copy of the bill summary can be obtained by calling the Chapter office and be sure to check out Click to Visit Fix Medicare Now  for all the latest.





    "The NJ Division of Consumer Affairs has extended the date for the FINAL time for, the use of the new prescription blanks. The last date to use the "old"
    prescription blanks is November 2, 2014. The "new" prescription blanks MUST be used as of November 3, 2014.
    The old and new prescription blanks can be used through November 2, 2014.


    If you have not ordered the new prescription blanks do so as soon as
    possible. A complete list of approved vendors can be obtained by calling the Chapter office.
    Approved Vendors List for Download
    For More Information NJ Division of Consumer Affairs

    Should you have any questions, please feel free to contact the Chapter
    office. Thank you for your attention to this matter."

    Andrea Donelan, Executive Director
    52 Elm Street
    Morristown, NJ 07960
    (973) 539-4000
    FAX: (973) 539-9493


    Please Click below to Read the Full Notification:

    Effective October 6, 2014 "Hydrocodone Combination Rescheduled as Schedule II Controlled Dangerous Substance"

    For additional information, please visit:

    Drug Enforcement Agency: www.deadiversion.usdoj.gov
    The Drug Control Unit: www.njconsumeraffairs.gov/drug
    Board of Pharmacy: www.njconsumeraffairs.gov/pharm



    The following was received from the NJ State Board of Medical Examiners relative to the End-of-Life CME requirement. Should you have any questions, please do not hesitate to contact the office. Thank you for your attention to this matter.


    End-of-Life Statement, New Jersey State Board of Medical Examiners July 10, 2014

    "Beginning with the next license renewal period June 30, 2015, all physicians will be required to have CME credits in end-of-life care. The following is a statement released by the NJ SBME. “The New Jersey Board of Medical Examiners requires 100 continuing medical education credits, of which at least 40 of such credits shall be in Category I.

    Commencing with this biennial renewal period which started on July 1, 2013 two of the 40 credits in Category I courses shall, pursuant to P.L. 2011, c. 145 (C.45:9-7.7), be in programs or topics related to end-of-life care.

    The Board is aware that many hospitals and a wide variety of other CME providers are offering a variety of courses that will satisfy this 2 hour requirement. If a licensee believes that this mandate has little applicability to his/her practice area, waivers or extensions can be requested. The licensee, within 60 days of the expiration of the biennial renewal period, (i.e., by April 20, 2015) needs to send to the Board office, by certified mail, return receipt requested, or other proof of delivery, a letter explaining why such waiver/extension is applicable. If granted, the extension or waiver is effective for the biennial licensure period in which the extension and/or waiver is granted. If the reason(s) which necessitated the extension and/or waiver continues into the next biennial period the licensee shall apply to the Board for the renewal of such extension and/or waiver for the new biennial period.”



    DEADLINE TO APPLY FOR EHR HARDSHIP EXEMPTION IS JULY 1, 2014:

    Penalties loom for eligible professionals (EPs) who are unable to successfully participate in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Program by July 1 and for EPs who participated in calendar year (CY) 2011 or 2012 but not in 2013. These EPs face a potential penalty of a 1 percent reduction in their total Medicare Part B fee-for-service payment amount in CY 2015. To avoid the penalty, these EPs should apply for an EHR hardship exception by July 1. If EPs are unsure whether they will receive an upcoming penalty, they can use this CMS interactive tool. If EPs find that they do not qualify for an exception, they should begin their 90-day reporting by July 1, 2014, and submit any attestation to CMS by October 1, 2014. Additional tools and information.




    SGR UPDATE! - NEW JERSEY PRESCRIPTION BLANK UPDATE!!

    New Jersey Prescription Blanks (NJPBs) Information
    Notice of Extension Page

    Medicare Meaningful Use in 2013 Extension
    Must Read Deadline February 28, 2014


    The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative
    update to the MPFS that was to be effective January 1, 2014. That reduction was
    averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014.

    CMS is hopeful that there will be congressional action to prevent the negative update from taking effect on April 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (i.e., through April 14, 2014). This hold would only affect MPFS claims with dates of service of April 1, 2014, and later. The hold should have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any Congressional actions.


    SGR UPDATE! - NEW JERSEY PRESCRIPTION BLANK UPDATE!!


    Medicare Meaningful Use in 2013 Extension

    The Centers for Medicare and Medicaid Services (CMS) announced that the original
    planned date by which all physicians who are attesting for Medicare Meaningful Use
    in 2013 has been extended from 11:59 pm ET on February 28 to 11:59 pm ET
    March 31. CMS delayed the date because the attestation system has been experiencing
    a number of problems which have precluded some physicians from
    submitting their attestation data. Concerns were raised that physicians would
    miss the attestation deadline and thus the opportunity for an incentive
    unless more time was given. Physicians who are seeking to attest should visit
    the