New Jersey - Volume XII, Number 1 - January, 2003

PHYSICIANS PLANNING JOB ACTION BEGINNING FEBRUARY 3, 2003

Outraged by the State’s failure to pass tort-reform legislation to address drastic increases in malpractice insurance premiums, New Jersey physicians plan to stop providing all non-emergent and non-urgent care on February 3, 2003. The scheduled action is a continuation of grassroots efforts throughout the State to protest the failure of the legislature to address the problem. The Medical Society of New Jersey and KACS, as its General Counsel, have been engaging in intense discussions with the Governor’s office to obtain meaningful relief, hopefully before February 3, and will provide necessary legal services to physicians during this crisis. MSNJ will also distribute communications among the various grassroots efforts, coordinate public relations and rally public opinion. MSNJ is also calling upon all physicians in New Jersey to march on Trenton on Tuesday, February 4, 2003 to demonstrate their resolve, and the need for immediate action by the legislature and the Governor to include controlling runaway jury verdicts by placing a cap of $250,000 on non-economic damages.

HIPAA PRIVACY POLICIES & PROCEDURES MANUAL TO BE AVAILABLE

KACS has developed a policies and procedures manual which incorporates the new privacy guidance issued in December by the U.S. Department of Health and Human Services’ Office for Civil Rights, and which is applicable to the small physician practice. The materials will be available next month, for download, free of charge to members of the Medical Society of New Jersey. Established KACS clients who are not members of MSNJ may also access the information, which will be available both through www.drlaw.com and www.msnj.org. KACS also provides defense of HIPAA complaints, at no additional charge, as part of the Physician Advocacy Program™ – KACS’s prepaid legal services plan, endorsed by the MSNJ. Upcoming HIPAA seminars presented by KACS: 2/19 - Tri-County Chapter, NJ Psychiatric Ass’n (Essex Co.); 2/25 - Atlantic Cape PAHCOM (Atlantic Co.); 2/26 - Essex/Union/Morris Co. Medical Societies (Essex Co.); 3/20 - Gloucester Co. Medical Society (Gloucester Co.). Call KACS for information on KACS seminars and the Physicians’ Advocacy Program.

MIDDLESEX COUNTY PLASTIC SURGEON SENTENCED TO STATE PRISON

As reported in Statlaw (Vol. XI, No. 10), the NJ Office of Insurance Fraud Prosecutor convicted a Middlesex County plastic surgeon of fraudulently billing over $1.2 million to private insurance companies. The surgeon has now been sentenced to three years in state prison, and ordered to pay $421,000. The surgeon billed for cosmetic procedures as though medically necessary, billed for procedures not performed or not performed as billed, and billed for surgeries as if another doctor, who did not participate as a provider with a managed care plan, had conducted the surgery. A Bergen County physician also has recently pled guilty to health care claims fraud for his role in a scheme to defraud the Medicaid Program of more than $290,000 for medications never dispensed.

HOSPITAL AND PHYSICIANS GROUP SETTLE FALSE CLAIM CHARGES

A South Dakota oncology group has agreed to pay $525,000 to settle charges first brought by a “whistle-blower” that it leased space from a hospital at below-market rent and received free goods and services from the hospital, in violation of the federal Stark Law. The hospital will also pay $6 million to settle the charges. The parties also failed to have a written agreement, a basic requirement of Stark compliance. 

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