EBOLA UPDATE

The New Jersey Department of Health (NJDOH) Public Health Infrastructure, Laboratories and Emergency Preparedness (PHILEP) has set up a single point of contact e-mail address to receive questions/issues regarding Ebola.

NJDOH is requesting that healthcare facilities, Medical Coordination Centers (MCCs), Emergency Medical Services (EMS), Local Health Departments (LHDs), Local Information Network Communication System Agencies (LINCS) Agencies, law enforcement, other healthcare continuum stakeholders and anyone needing to reach the 24/7 On-Call Duty Officer at PHILEP regarding Ebola use the following email address: dutyofficer@njlincs.net

Please include "Ebola" in the subject line.

Reporting Reminder for Health Care Providers:

As a reminder, confirmed or suspect cases of any viral hemorrhagic fever, including EVD, should be reported immediately to the local health department where the patient resides. If patient residence is unknown, report to your own local health department. Local health departments are available 24/7. Contact information for local health departments during business hours can be found at: www.localhealth.nj.gov 

Contact information for local health departments after business hours or on weekends can be found at:

http://nj.gov/health/lh/documents/lhd_after_hours_emerg_contact_numbers.pdf

If local health department personnel are unavailable, healthcare providers should report the case to the NJDOH, Communicable Disease Service (CDS) at 609-826-5964, Monday through Friday 8:00 AM - 5:00 PM. On weekends, evenings and holidays, the CDS can be reached at (609) 392-2020.

Reporting Reminder for Local Health Departments:

As a reminder, local health departments that receive notification of a

confirmed or suspect case of any viral hemorrhagic fever, including EVD,

should immediately contact the NJDOH CDS at 609-826-5964, Monday through

Friday 8:00 AM - 5:00 PM. On weekends, evenings and holidays, the CDS can

be reached at (609) 392-2020.

PRESCRIPTION BLANK DEADLINE EXTENDED - NOVEMBER 2, 2014

The Medical Society of NJ asked the Division of Consumer Affairs (DCA) for leniency for practices unable to obtain the new prescription blanks by the original August 18 deadline, due to vendor back-orders. In response to our request, and that of several other groups, the DCA has further extended the deadline to November 2, 2014. Physicians may use the old and/or new prescription blanks through November 2. Only the new prescription blanks may be used effective November 3. Physicians, who have not placed orders for the new blanks, are urged to contact an approved vendor and order immediately. Once you begin using your new prescription blanks, it is important that you destroy your old ones in accordance with DCA guidelines. Please be sure to notify the NJ Drug Control Unit that you have destroyed your old prescription blanks by completing a certification of destruction.

There is no formal deadline for the submission of the Certification of Destruction, however, it should be done within a timely manner after the blanks are destroyed.

Read the DCA's FAQ on prescription blanks.

Update on End-of-Life CME Requirement

Physicians must take two of their required 40 Category 1 CME credits on the topic of end-of-life during each biennial renewal period. MSNJ met with the Board of Medical Examiners this week to discuss the requirement and the process for waivers. The BME expressed its support for the end-of-life training requirement and urged that all physicians take courses on end-of-life. The BME will consider a wide range of topics on end-of-life to meet the new requirement; it has not endorsed specific courses. The BME will not designate certain specialties as exempt from the requirement as the statute requiring end-of-life CME does not support categorical exemptions. However, the BME will accept waiver applications from groups so long as all the members of the group seeking the exemption sign the application.

There is no specific form for the waiver from this or any other exemption or extension of time from CME training requirements. Instead, physicians must send a letter to the BME explaining in detail the reasons that the training has little applicability to his/her practice and that they believe they should be exempt from the training requirement. The BME cautioned that waivers are not freely granted and that historically it has granted extensions of time for CME training, rather than exemptions. Waiver applications must be received by April 30, 2015. MSNJ will update its FAQ on the CME requirement and waiver process.

MSNJ has made arrangements with an on-line resource -  Education in Palliative and End-of-life Care to satisfy the 2 credit end-of-life training requirement via long distance learning - and at a 15% discount to members. Medical Society members, please click here to obtain the promo code.

The following modules are thought to meet the requirements. Each module is designated for 1 AMA PRA Category 1 Credit™ (cost to Medical Society members about $25.50 per credit)

• Gaps and Elements of Care
• Legal Issues
• Whole Patient Assessment
• Physician Assisted Suicide
• Last Hours of Living
• Withholding/Withdrawing Treatment
• Medical Futility

Choose two that meet your needs!

Prescription Blank Deadline Extended

MSNJ asked the Division of Consumer Affairs (DCA) for leniency for practices unable to obtain the new prescription blanks by the August 18 deadline, due to vendor back-orders. In response to our request and that of several other groups, the DCA decided to extend the deadline to September 19, 2014 and allow physicians to use the old and/or new prescription blanks from August 19 through September 19. Only the new prescription blanks may be used effective September 20. Physicians, who have not placed orders for the new blanks, are urged to contact an approved vendors and order immediately. Once you begin using your new prescription blanks, it is important that you destroy your old ones in accordance with DCA guidelines. Please be sure to notify the NJ Drug Control Unit that you have destroyed your old prescription blanks by completing a certificate of destruction .  There is no formal deadline for the submission of the Certification of Destruction form, however, it should be done within a timely manner after the blanks are destroyed.

Discount for Medical Society Members

Endocrinologist Deadline for Certification Application- May 31, 2014

Endocrinologists who perform thyroid ultrasound and ultrasonic guidance for biopsy and are Horizon participating physicians will be required by Horizon to earn an Endocrine Certification In Neck Ultrasound (ECNU) by June 1, 2015. In order to continue to be paid for these services beyond May 31, 2014, physicians must have submitted an ECNU Program Application to the AACE. 

 

Originally, Horizon required that endocrinologists performing these services be certified by January 1, 2014. MSNJ, together with your state and national specialty society, urged Horizon to delay the certification requirement because many physicians were not aware of the requirement and would not be able to become certified before the January 1, 2014 effective date. The year and a half delay was granted in response to those concerns.  

End of Life CME Requirement for License Renewal

There is a change in the renewal process which will affect medical staff and licensed residents who have upcoming renewals (for registrations expiring on 6/30/15).  The New Jersey Board of Medical Examiners now requires physicians to complete 2 hours of education on end-of-life care.  The following requirement must be satisfied by licensees prior to their 6/30/15 renewal date.

State Authority 45:9-7.7. Continuing Medical Education for Physicians:

14.a.  The State Board of Medical Examiners shall require that the number of credits of continuing medical education required of each person licensed as a physician, as a condition of biennial registration pursuant to section 1 of P.L.1971, c.236 ©.45:9-6.1), include two credits of educational programs or topics related to end-of-life care, subject to the provisions of section 10 of P.L.2001, c.307 (C45:9-7.1).


An educational program that satisfies this requirement is available at  www.nj.cme.edu

Physicians, who feel this education does not pertain to their practice, can write to the BME to request a waiver each renewal period.

Division of Consumer Affairs Announce New, Mandatory Security Requirements for Prescription Blanks

Fighting the black-market sale of prescription painkillers, Acting Attorney General John J. Hoffman announced that the State-approved vendors that manufacture the prescription blanks used by New Jersey doctors will soon be required to add new print-based security features.

The security enhancements will include color-changing ink, 0.5-point micro-printing, and a hollow "VOID" hidden word feature, among others.

The New Jersey Division of Consumer Affairs regulates all prescription blanks used by State-licensed physicians, dentists, and other prescribers; and regulates the State-approved printing vendors who supply the prescription pads to prescribers.

The Division adopted, and published this week in the New Jersey Register, new regulations that mandate the enhanced security features. No later than May 18, all State-approved vendors of prescription blanks must stop selling, printing, or delivering the old-form blanks and must exclusively provide the new version. No later than August 18, all State-licensed prescribers must stop using their supply of the old blanks, and must exclusively use the new ones.

The Division developed the new regulations and prescription blank format after conducting research into the prescription security measures used in other states, and discussions with the State-approved printing vendors that currently supply prescription blanks. 

Acting Attorney General Hoffman noted that the requirement for these print-based security measures is the first of two steps outlined by the Division of Consumer Affairs to combat forgeries. The Division intends to further amend its rules, and ultimately require security measures that would be embedded in the paper itself.

The new security measures, required by the regulations adopted today, include:

• Thermochromic ink, which changes color in response to body heat. The heat-activated ink will appear in a small Rx logo on the front of the prescription blank. It will fade when touched, and return to its original color when it cools.

• Microprint, of 0.5-point type or smaller. The front of each prescription blank will include a line of microprint that is readable when viewed at 500 percent magnification, but becomes illegible when scanned or photocopied.

• A hollow "VOID" hidden word feature that is invisible on a genuine prescription blank, but should appear in illegally scanned or copied versions.

• A unique 15-digit identification number for each prescription blank. The alphanumeric code will identify the vendor that created the blank, the vendor's order number, and a six-digit serial number for each separate prescription blank.

• A barcode matching the prescription blank's unique 15-digit identification number. The barcode will enable pharmacists to scan prescription data into the New Jersey Prescription Monitoring Program. The NJPMP, maintained by the Division of Consumer Affairs, records all prescription sales in New Jersey of Controlled Dangerous Substances and Human Growth Hormone. 

• A complete list of all security features will be printed on the back of the prescription blank.

• The new prescription blanks will be green on the front and blue on the back. This will enable them to be more easily distinguished from the old blanks, which are blue on the front and green on the back.

The Division of Consumer Affairs and its Board of Pharmacy, Board of Medical Examiners, and other healthcare professional licensing boards will alert pharmacists and prescribers to the timeline for implementing the new prescription blanks.

Under the New Jersey Criminal Code, the forgery, counterfeiting, or alteration of a New Jersey prescription blank is a crime of the third degree, punishable by a prison term of from three to five years and a fine of up to $15,000.

The new regulation applies only to the use of paper prescription blanks. It does not change the State or federal requirements that pertain to electronic prescriptions. Under rules adopted by the U.S. Drug Enforcement Administration, prescribers and pharmacists may use electronic prescriptions for CDS medications only through a secure system that has been tested by a DEA-approved expert. New Jersey regulations allow the use of electronic prescriptions for CDS or non-CDS drugs, only when they comply with DEA requirements as well as requirements adopted by the State.

For a list of approved printer vendors CLICK HERE

Congress Fails to Repeal SGR- Postpones 24% Payment Cut for a Year

The House and the Senate voted in favor of the "Protecting Access to Medicare Act of 2014." The legislation stops the payment cut of 24% that would have occurred on April 1.  The House passed the legislation by a voice vote on March 27. The Senate passed its identical version of the House bill on March 31 by a vote of 64 to 35. MSNJ, AMA, and virtually all of organized medicine opposed this bill because it failed to repeal the flawed SGR payment formula that will continue to result in annual payment cuts. Over the past year, bipartisan, bicameral policy was developed that would have eliminated the SGR and replaced it with a Medicare payment reform. Congress failed to seize this historic opportunity. Key terms of the legislation follow

Extends the 0.5% payment update through the end of 2014.

Provides a freeze between January 1, 2015 and March 2015

Delays implementation of ICD-10 for at least one year through October 1, 2015.

Practices Must Start Using the New CMS 1500 Claim Form by April 1  

The CMS-1500 Claim Form has been revised to more adequately support the use of the ICD-10 diagnosis code set. The form will now give physicians the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes.

Medicare will only accept the revised version of the form starting April 1, 2014, as will many other payors. 

Horizon Agrees to Delay Certification Requirement for Endocrinologists

In response to a request by MSNJ and the affected national and state specialty societies Horizon has agreed to delay its Endocrine Certification in Neck Ultrasound (ECNU) requirement that would have gone into effect on January 1, 2014. The payment policy would have denied payment for thyroid ultrasound and ultrasonic guidance for biopsy performed by physicians who had not become certified beginning on January 1, 2014. MSNJ asked Horizon to delay implementation of the policy because endocrinologists were not aware of the policy and, even those who were aware, would not have been able to obtain the certification in the time permitted. The delayed policy allows endocrinologists until June 1, 2014 to apply for the ECNU and until June 1, 2015 to have earned the certification. This should give the physicians enough time to become certified and avoid payment denials for these services.