New Jersey - Volume XII, Number 10 - October, 2003

CMS AND OTHER PAYERS IMPLEMENT HIPAA CONTINGENCY PLANS

The Centers for Medicare & Medicaid Services (CMS), which enforces the transactions and code sets provisions of the Health Insurance Portability & Accountability Act (HIPAA), has deployed its contingency plan to accept both non-HIPAA compliant and compliant electronic transactions after October 16, 2003. As a result, Medicare and Medicaid claims will continue to be paid notwithstanding some deviation from the HIPAA transactions and code sets standards. Many private payers are implementing similar contingency plans. Physicians should continue efforts to come into compliance, document all compliance efforts made, both before and after October 16th, and should be aware that the contingency plans will be for a limited time period only. Payers have been advised by the New Jersey Department of Banking and Insurance that the statutory requirement to make prompt payment of “clean claims” remains in full effect.

NEW RULES ADDRESS FACSIMILE AND ELECTRONIC PRESCRIPTIONS, UNIFORM PRESCRIPTION BLANKS, AND INTERNET PRESCRIBING

The New Jersey State Board of Medical Examiners (“Medical Board”) has adopted new rules, effective September 15, 2003, governing the transmission of electronic and facsimile prescriptions by prescribers to noninstitutional pharmacies. The rules allow a practitioner or authorized agent to transmit a facsimile or electronic prescription to a pharmacy if the pharmacy has been approved by the patient or the patient's authorized representative and the facsimile or electronic prescription includes all information required by law to be included on a written prescription (except a handwritten original signature is not required for electronic prescriptions). Other proposed rules address New Jersey Prescription Blanks and would impose various reporting, record-keeping and compliance requirements upon prescribers, healthcare facilities, pharmacies and vendors of the prescription blanks.

The Medical Board rule also prohibits a physician from dispensing drugs or issuing a prescription to an individual without first having conducted an examination appropriately documented in the patient record, thus prohibiting such things as Internet prescribing that does not comply with the rule. Excepted from the physical exam requirement is prescribing: 1) in admission orders for a newly hospitalized patient; 2) for a patient of another physician for whom the practitioner is taking calls; 3) for continuation of medications on a short term basis for a new patient prior to the patient's first appointment; 4) for an established patient who, in the physician’s judgment, does not require a new examination before issuing a new prescription; 5) for a patient examined by a healthcare professional who is in collaborative practice with the practitioner; and 6) when treatment is provided by a practitioner for an emergency medical condition.

KACS SEMINARS ADDRESS ASSET PROTECTION, EMPLOYMENT LAW

KACS’ Steve Holt (estate & wealth planning), Douglas Lundblad of Wachovia Wealth Management (Delaware asset protection trusts), Brian Kern of McLachlan Insurance Affiliates (malpractice market), and Paul Donnelly, Healthcare Business Planning Group (retirement & asset protection), are featured speakers in a timely and critical seminar, Preserving Your Wealth: Why Malpractice Insurance is No Longer Enough, sponsored by the Medical Society of New Jersey and the Healthcare Business Planning Group, Oct. 29th (Mt. Laurel).

Other KACS seminars - Employment Law: 10/29, PAHCOM, Piscataway; Tort Reform: 11/7, NJ Ob-Gyn Society, Holmdel; 11/9, NJ Society of Medical Assistants; Call KACS at 908-704-8585 for seminar details.  

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