New Jersey - Volume VI, Number 6 - June, 1997

MEDICAL BOARD PUBLISHES MEDICAL ASSISTANT INJECTION RULE

The State Board of Medical Examiners has published a regulation, which takes effect immediately, allowing certain Certified Medical Assistants to give IM and subcutaneous injections in particular settings where a physician is readily available and has ascertained that the Certified Medical Assistant has met all the requirements established by the Board. This regulation is the culmination of a long struggle by the New Jersey Society of Medical Assistants and the Medical Society of New Jersey to gain official recognition of the expanded training and role of the Certified Medical Assistant. This Firm is proud to have been instrumental in bringing their efforts to fruition. Physicians are reminded, though, that the regulation is NOT a blanket authorization for all medical assistants to give injections; physicians must be careful to assure that they delegate such activities only to Certified Medical Assistants qualified under the regulation and document those qualifications in case there is later a question. A seminar will be offered, at various locations, on the scope and application of the regulation in a practice setting, including a form to assist practices in documenting medical assistants' qualifications. Interested physicians, medical assistants and practice managers should contact the Firm for further information.

"WHISTLEBLOWER" LAW PROTECTS PATIENT CARE ADVOCACY

New Jersey's Conscientious Employee Protection Act was amended, effective May 12, 1997, to extend the protections of that law to any licensed or certified health care professional who takes certain actions out of a concern for the well-being of patients. An employer is prohibited from taking retaliatory action (such as discharge, suspension, demotion or other adverse action regarding the terms and conditions of employment) against an employee for disclosing, or threatening to disclose, to a supervisor or public body, an activity, policy or practice of the employer that the employee reasonably believes constitutes improper quality of patient care. Under the Act, "improper quality of patient care" means any practice, procedure, action or failure to act, with respect to patient care, by a health care provider, which violates any law, rule, regulation, formal ruling or any professional code of ethics. And no retaliatory action can be taken against an employee who provides information to, or testifies before, any public body conducting an investigation, hearing or inquiry. The amendment was sought, in part, because of the perception that many health care employees are being pressured to accept seriously inadequate staffing levels and to delegate their responsibilities to unqualified, non-professional staff.

OIG FRAUD ALERT FOCUSES ON BILLING CONSULTANT PRACTICES

A recent "fraud alert" issued by the Department of Health & Human Services' Office of Inspector General instructs the OIG's Special Agents to monitor agreements of which they become aware that involve consulting firms contracting with health care providers (mostly hospitals, for now) promising to maximize Medicare reimbursements for a percentage of the resulting revenue increases. The OIG believes such arrangements are ripe for upcoding, unbundling and other abuses.