New Jersey Healthcare Blog

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Legislature Expands Codey Law Exception for Lithotripsy Referrals

The New Jersey Legislature recently amended N.J.S.A. 45:9-22.5 (known as the “Codey Law”) to expand the scope of facilities where lithotripsy referrals may be made.  The Codey Law generally prohibits physicians from referring patients to health care services with which the physician or his or her immediate family has a financial interest, but provides for […]

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 […]

SGR Update

It is expected that when Congress returns after Labor Day that it will continue to address the issue of the Sustainable Growth Rate (SGR).  The good news of the proposed legislation is that it will eliminate the lookback covering an extensive period of time, since Congress deferred, on an annual basis, the implementation of the […]

Sustainable Growth Rate: Here We Go Again!

As you can see from CMS’ notice CMS intends to process bills after January 1, 2013 at the lower Medicare reimbursement rate if the issue is not resolved prior to that date.  Does this mean administration expects that a resolution of the issue will not be retroactive? Regrettably, resolving the Sustainable Growth Rate issue for […]

Physician Payment Rates

As we discussed in many prior blogs [(1) http://www.njhealthcareblog.com/2012/11/post-election-update-regarding-the-affordable-care-act/; (2) http://www.njhealthcareblog.com/2012/08/update-on-sustainable-growth-rate/; (3) http://www.njhealthcareblog.com/2012/02/no-valentine-to-physicians-from-congress-as-sgr-issue-remains-unresolved/; (4) http://www.njhealthcareblog.com/2011/12/imminent-withholding-of-medicare-physician-payments-appears-likely/; (5) http://www.njhealthcareblog.com/2011/12/still-no-action-on-sustainable-growth-rate-fix/; (6) http://www.njhealthcareblog.com/2011/11/update-of-sustainable-growth-rate/; (7) http://www.njhealthcareblog.com/2011/10/healthcare-reform-developments/; (8) http://www.njhealthcareblog.com/2011/10/sustainable-growth-rate-sgr/; (9) http://www.njhealthcareblog.com/2011/07/another-round-of-potential-physician-reimbursement-redutions/; (10) http://www.njhealthcareblog.com/2011/05/sustainable-growth-rate/; (11) http://www.njhealthcareblog.com/2011/05/medicare-balance-billing/; (12) http://www.njhealthcareblog.com/2011/04/the-confluence-of-the-sustainable-growth-rate-and-the-deficit/; and (13) http://www.njhealthcareblog.com/2010/10/blog-%E2%80%93-medicare-trust-fund-solvent-thru-2029-maybe/], if it is not addressed, the Sustainable Growth Rate will result in physician compensation being substantially reduced on January 1, 2013.  […]

Massachusetts Health Care Plan Update

As pointed out in our previous blogs { http://www.njhealthcareblog.com/2012/08/massachusetts-health-care-plan/; http://www.njhealthcareblog.com/2012/07/massachusetts-provider-payment-controls-a-harbinger-for-the-future/; http://www.njhealthcareblog.com/2012/05/new-efforts-unveiled-to-control-payments-to-massachusetts-health-care-providers/; http://www.njhealthcareblog.com/2012/03/%e2%80%9cromneycare%e2%80%9d-a-precursor-of-%e2%80%9cobamacare%e2%80%9d/; http://www.njhealthcareblog.com/2011/10/government-coercion-as-a-vehicle-to-alter-healthcare/}, the State of Massachusetts, which enacted legislation that was the precursor to PPACA, has now passed legislation attempting to contain the cost of healthcare.  The primary cost containment vehicle is an attempt to contain payments to providers. In light of PPACA, it […]

Massachusetts Health Care Plan

As we have stated in prior blogs, the health care plan developed in the State of Massachusetts is a model which must be watched as a precursor of what most likely will happen under the Affordable Care Act (“ACA”).  As we previously pointed out in my July 3rd blog, legislation is pending in Massachusetts which […]

Update on Sustainable Growth Rate

Legislation has been proposed in regard to the Sustainable Growth Rate (“SGR”) to avoid adversely affecting physician payment for another year, effective January 1, 2013.  The Congressional Budget Office (“CBO”) has scored the proposal.  The CBO has determined that “a one-year Medicare physician payment “patch” that would block a scheduled 27 percent reimbursement cut Jan. […]

Healthcare Providers Reporting To Motor Vehicle Commission

A bill set for a vote tomorrow in both Houses of the New Jersey Legislature would permit certain healthcare providers to report to the Motor Vehicle Commission information regarding patients with an alleged impairment.  The information to be reported would include the name, age, address and description of the alleged impairment of any person sixteen […]

Still No Action on Sustainable Growth Rate Fix

In a recent blog post, we have alerted our readers to the fact that the issues surrounding the Medicare Sustainable Growth Rate (SGR) formula remains unresolved.  If Congress does not act prior to December 31, 2012, a reduction of approximately 27% in the Medicare fee schedule for physicians will automatically go into effect.  In an […]

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