New Jersey - Volume VII, Number 7 - July, 1998
New Jersey - Volume VII, Number 7 - July, 1998
PHYSICIAN SUCCEEDS ON CONSTITUTIONAL CHALLENGE TO MEDICAL BOARD
In a striking rebuke to the Attorney General’s Office, the State Board of Medical Examiners refused to emergently suspend the license of a physician accused of bribing a Newark school board employee. The physician, who is represented by KACS, challenged the Attorney General’s suspension application on Constitutional grounds. The Board, apparently, was moved by the fact that there had been no adjudication of guilt and that there were no allegations of patient harm. The Board, in refusing to suspend the physician, merely required that a forensic accountant review his books once a month to make sure no bribery was ongoing.
MEDICAL BOARD CONSIDERS CHANGES TO PRESCRIPTION DRUG DISPENSING RULE TO RESPOND TO NUTRITION AND VITAMIN SALES
In recent meetings, the New Jersey Board of Medical Examiners has reviewed issues presented by a petition for rulemaking submitted by the National Nutritional Foods Association, asking the Board to amend its rules restricting prescription drug dispensing and sales by physicians, to exclude vitamins and dietary supplements from the definition of drugs in that rule. After considering comments from third parties, it appears the Board will not be amending the rule to exclude vitamin and supplement sales from the seven-day and ten percent (10%) mark-up restrictions that derive from state statute.
The Medical Board will also be issuing new regulations governing practice identification, specifying requirements regarding the new statutory malpractice coverage law, and final adoption of the rule governing delegation of tasks to radiologic technicians.
KERN AUGUSTINE OFFERS HMO AND MEDICARE CLAIMS COLLECTION SERVICE
Recent proposed regulations of the New Jersey Department of Health & Senior Services (see Statlaw Vol. VII, No. 6), clarifying the requirements imposed on HMO’s when contesting or denying physician’s claims, points out the need for physicians to review their unpaid claims and take advantage of their legal rights to institute collection or arbitration proceedings to get paid when claims are "clean." Kern Augustine is launching a Prompt Payment program to assist physicians in doing just that. As explained in the attached informational memo, we will provide certified medical coders to screen claims and assist with corrections, followed by collection proceedings as appropriate. Call Bill Czemeris at 908-704-8585 for more information.
Date: July 10, 1998
From: Steve Kern
To: Kern Augustine Clients
Re: PROMPT PAYMENT
Are you having trouble collecting from Managed Care Plans? Medicare? Kern Augustine will collect your overdue HMO and Medicare payments. And, it will cost you nothing unless we collect!
Here’s how it works. Provide us with copies of your unpaid claims and patient records which have gone unpaid for more than sixty days. Our certified medical coders will screen the claims for compliance with appropriate coding and documentation requirements. If corrections are necessary, we will assist you in revising the submissions to assure that they are "clean," and then resubmit them to the HMO or Medicare on your behalf. If payment is then not made within sixty days, we will institute collection or arbitration proceedings, in accordance with your HMO contract. If the bills are "clean" we will institute collection proceedings immediately.
Our charges are as low as 10% of collection for cases over $100,000 per HMO or other third party carrier. Cases between $50,000 and $100,000 are 15% of recovery. Cases between $5,000 and $50,000 are 25% of recovery.
For more information, please contact Bill Czemeris at 908-704-8585.