New Jersey Healthcare Blog

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Annual Fee On Insurers To Impact Small Businesses

As part of the Affordable Care Act, beginning in 2014, health insurance companies will be charged additional fees and costs, including a $63 per person tax on each person covered.  Because the vast majority of large businesses (200 employees or more) are self-insured and do not use managed care plans, the Congressional Budget Office is […]

New Requirements For Providers And Certain Types Of Vendors

Generally, a Business Associate Agreement is a written agreement between a Covered Entity (Doctor, Clinic, Hospital, HMO, etc) and a Business Associate that establishes the permitted and required uses and disclosures of personal health information by the Business Associate.  Most often, a Business Associate is a vendor who creates, receives, maintains or transmits personal health […]


Attached is a Washington Post article and an Associated Press article which highlight, from the patient beneficiary point of view, one of the next big issues in the Affordable Care Act implementation.  That issue is the narrowing of the provider networks which will significantly reduce the patient beneficiary’s choice of providers.  This could result in […]

The ObamaCare Rollout Debacle Impact on Providers

While the media is focused on the impact on the patients/beneficiaries, the failures of the rollout have significant impact on the providers. One of the most significant impacts is the cancellation of numerous health insurance policies (so far approximately 800,000 in New Jersey) and a necessity for these individuals to have obtained new insurance policies […]

Issue of Future Reimbursement Follow-Up

Following up on Tuesday’s blog is a link to a Modern Healthcare article (which you may need a user name/password for) regarding the issue of tying “quality” to physician reimbursement. In addition, in light of the ObamaCare rollout fiasco, both the failure to have people enroll as well as the insurance cancellations, it appears that […]

Issue of Future Reimbursement

Attached is a link to the news release regarding Horizon’s announcement for ACOs and PCMHs.  One of the most important parts of the article is the quote from Linda J. Schwimmer where she stated, “(This will only work) if the providers actually do manage patients well and have all the things that drive down cost.”  […]

Physician Payment: The Issues Never End

In light of all of the issues facing the Congress—the budget, the debt ceiling, the sequester—an issue of substantial importance to providers is the automatic Medicare cut to fees paid to providers which will go into effect on January 1, 2014.  The implementation of the Sustainable Growth Rate (SGR) will impact the ability of physician […]


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