New Jersey - Volume VIII, Number 2 - February, 1999
New Jersey - Volume VIII, Number 2 - February, 1999
PROMPT PAYMENT LEGISLATION AWAITS GOVERNOR’S SIGNATURE
Prompt payment bills have passed the legislature and, once the versions have been reconciled, will await the Governor’s signature. Senate Bill 323 sets a payment schedule of 40 days for paper claims and 30 days for electronic claims, requires carriers to acknowledge receipt of a claim submitted electronically no later than two working days after receipt, and requires carriers to notify claimants within 30 days if a claim is denied and the reasons for denial. Assembly Bill 2121 requires payers to report to the State information about claim denials and late claim payments and allows the State to take enforcement action in the event of an unreasonably large number of rejected, denied or unpaid claims by a payer. Passage of this legislation was a priority for the Medical Society of New Jersey. In conjunction with the Medical Society, Kern Augustine offers a program to assist you in collecting managed care payments. Contact Bill Czemeris at 908-704-8585 for information.
MEDICAL BOARD TO PROPOSE NEW PROFESSIONAL PRACTICE REGULATIONS
After almost two years of review and revision, the NJ State Board of Medical Examiners has adopted substantial revisions to its 1992 professional practice regulations governing everything from professional practice forms to sales of goods and devices. It is anticipated that the proposal will reflect the federal Medicare and Medicaid rules related to patient referrals and kickbacks. In addition, the proposal should expressly allow for the use of limited liability companies for physician practices, require majority ownership by medical doctors who are co-owners in a professional practice with non-MD practitioners, allow for sales of products or devices without a 10% cap on mark-up (but still imposing charge restrictions), and prohibit compensation arrangements for space, facilities, equipment, personnel, marketing or management services where the payment is based on a fixed percentage of, or otherwise dependent upon, the income of the professional practice (with certain exceptions, including productivity bonuses and collection agency contracts). A public comment period will be provided when the rules are formally proposed.
MEDICARE PART B CARRIER SWITCH TO TAKE EFFECT MARCH 1ST
Effective March 1st, Empire Medicare Services will be the Medicare Part B carrier for New Jersey, replacing Medicare Xact. Medicare Xact will remain the carrier for Pennsylvania. Watch for information from Empire in February regarding new addresses, telephone numbers, and carrier identification number. According to representatives from both Empire and Medicare Xact, there will be few other changes, at least for now. Most of the Medicare Xact staff will now be working on behalf of Empire and the Lawrenceville office will remain open as the "on-site" New Jersey office for Empire.