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January 20, 2015 Regulatory Developments

January 23, 2015 | No Comments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on January 20, 2015:

  • On January 20, 2015 at 47 N.J.R. 252, the Department of Human Services published notice of its proposed readoption with amendments to its existing rules and the proposal of a new rule governing short term care facility standards

M&A And The ACA

January 21, 2015 | No Comments
Posted by Frank Ciesla

Co-Authored By Ari Burd and Patrick Convery

As most employers already know, the Affordable Care Act (a/k/a ObamaCare or the ACA) now imposes health care insurance coverage requirements upon certain employers which have a certain number of full time and full time equivalent employees (“FTEs”).  Therefore, it is imperative that consideration be given to whether parties involved in any merger or other acquisition transaction are currently subject to the requirements of the ACA (and if so, whether they are in compliance with such requirements), or will otherwise be subject to the requirements of the ACA following the consummation of the transaction. Read more

January 5, 2015 Regulatory Developments

January 12, 2015 | No Comments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on January 5, 2015:

  • On January 5, 2015 at 47 N.J.R. 107, the Department of Human Services published notice of its adoption of amendments to its rules governing advance directives for mental health care.
  • On January 5, 2015 at 47 N.J.R. 118, the Department of Banking and Insurance published notice of its adoption of amendments to its rules governing advance Small Employer health Benefit Plans.
  • On January 5, 2015 at 47 N.J.R. 120, the State Board of Pharmacy published notice of its adoption of amendments to its rules governing minimum standards for container integrity.
  • On January 5, 2015 at 47 N.J.R. 232 through 233, the Department of Health published notice of its cancellation of the Certificate of Need calls for the following services: adult and pediatric comprehensive rehabilitation services; intermediate and intensive care bassinets and changes in membership of maternal and child health consortia; pediatric and specialized long-term beds and services; and psychiatric beds and services.

EXPANSION OF LIMITED LICENSED PRACTITIONERS

January 6, 2015 | No Comments
Posted by Frank Ciesla

As of January 1, nurse practitioners in New York with over 3,600 hours of clinical practice will no longer be required to have a written collaborative agreement with a physician nor will they be required to submit patient charts to a physician for review.

As pointed out in many prior blogs, we are seeing the expansion on a state-by-state, inconsistent basis of the ability of limited licensed practitioners to provide expanded health care services.

December 15, 2014 Regulatory Developments

December 24, 2014 | No Comments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on December 15, 2014:

  • On December 15, 2014 at 46 NJR 2415, the Department of Health published notice of its re-adoption of the licensure regulations applicable to ambulatory care facilities.
  • On December 15, 2014 at 46 NJR 2416, the Department of Health published notice of its re-adoption of amendments to its rules and its adoption of new rules governing the Tobacco Control Program.
  • On December 15, 2014 at 46 NJR 2416, the Department of Banking and Insurance published notice of adoption of amendments to its rule governing open enrollment under the individual health benefits program.
  • On December 15, 2014 at 46 NJR 2418, the Governor’s Council on Alcoholism and Drug Abuse published notice of re-adoption with amendments to its rules governing the activities of the Council.

CMS Announces Payment Cuts For Failure to Meet Meaningful Use Requirements

December 19, 2014 | No Comments
Posted by Beth Christian

As reported by the Wall Street Journal this week (http://www.wsj.com/articles/medicare-to-cut-payments-to-some-1418955589), approximately 257,000 health care providers (most of them physicians) will be receiving notifications from the Centers for Medicare and Medicaid Services that the rates that they paid under both Medicare and Medicaid will be reduced by 1% in 2015.  The reduction is being imposed because the providers failed to comply with the Federal “meaningful use” requirements for use of electronic health records.  An additional 1% reduction will be imposed on providers who failed to prescribe medications electronically.  The payment adjustments are scheduled to continue for those providers who continue to be non-compliant in future years.

Sustainable Growth Rate

December 18, 2014 | No Comments
Posted by Frank Ciesla

Congress has gone home for the rest of this term without solving either the Sustainable Growth Rate issue or providing the additional compensation previously provided to primary care providers to take care of Medicaid patients by paying them the Medicare reimbursement rate.

These are two issues that we have previously addressed in blogs.  It is clear that this Congress did not want to address the SGR issue, nor does Congress want to increase the budget, by providing additional funding for the limited number of Medicaid procedures provided by “primary care doctors” so that that reimbursement rate would equal the Medicare rate.

With the expansion of the Medicaid population under the Affordable Care Act, this will clearly mean many fewer physicians will be willing to take care of Medicaid patients and that these patients will be forced either into hospital clinics or other alternative delivery systems, if they are to get care.

EXPANSION OF SCOPE OF LIMITED LICENSED PRACTITIONERS

December 17, 2014 | No Comments
Posted by Frank Ciesla

Monday’s New York Times editorial page highlights the issue of expanding the scope of practice of limited licensed practitioners and cites a study from the British health care system.  The article favorably reports the use of nurse midwives rather than doctors in noncomplicated deliveries.  The editorial indicates that the use of physicians in noncomplicated cases adds to the cost.  As pointed out in my many prior blogs, there is a constant drumbeat for the expansion of the scope of practice of limited licensed practitioners, to provide more and more of the health care, that will be demanded by the population going forward.  In light of the media attention given to the Affordable Care Act, the public will have an expectation that they will have access to health care services, but they may be surprised that it is not provided by a physician but by a limited license practitioner.

On a separate note, the New Jersey Senate Health Committee has approved legislation expanding the scope of practice of physician assistants.  The legislation still needs approval by both the full Senate and Assembly.

December 1, 2014 Regulatory Developments

December 12, 2014 | No Comments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on December 1, 2014:

  • On December 1, 2014 at 46 NJR 2299, the Office of Administrative Law published notice of its proposed re-adoption with amendments to its rules and the proposal of a new rule governing contested cases before the Office of Administrative Law.
  • On December 1, 2014 at 46 NJR 2302, the Office of Administrative Law published notice of its proposed re-adoption with amendments to its rules governing Office of Administrative Law procedures (including procedures applicable to petitions for rule making).
  • On December 1, 2014 at 46 NJR 2314, the Department of Banking and Insurance published notice of its proposed amendments to its rules governing individual health benefits coverage.
  • On December 1, 2014 at 46 NJR 2317, the Department of Banking and Insurance published notice of its proposed amendments to its rules governing the small employer health benefits program.
  • On December 1, 2014 at 46 NJR 2336, the Department of the Treasury published notice of its proposed re-adoption and re-codification with amendments to its existing rules and the proposal of new rules governing the Office of the Ombudsperson for the Institutionalized Elderly.
  • On December 1, 2014 at 46 NJR 2368, the Department of Human Services published notice of its re-adoption of its rules governing the Special Medicaid Programs Manual.
  • On December 1, 2014 at 46 NJR 2378, the Department of Health published a notice that a petition for rule making had been filed by Ken Wolski, RN, MPA, Executive Director of the Coalition for Medical Marijuana – New Jersey, Inc.  The petitioner requests that the Department make certain amendments to the medical marijuana program rules.  The petitioner requests that the Department: (1) eliminate the fee to apply for issuance of or renewal of a primary giver identification card; (2) eliminate the sales tax on medical marijuana; (3) delete certain physician registration and certification requirements; (4) add post traumatic stress disorder to the definition of conditions eligible for medical marijuana prescriptions; and (5) deleting certain physician approval requirements if parents want to obtain medical marijuana for their child.

EXPANSION OF THE SCOPE OF PRACTICE FOR LIMITED LICENSED PRACTITIONERS

December 10, 2014 | No Comments
Posted by Frank Ciesla

In yesterday’s blog, I talked about the expansion of the scope of practice for limited licensed practitioners (psychologists) being considered by the New Jersey Legislature.

Because of the actions of the U.S. Drug Enforcement Agency in reclassifying hydrocodone, such reclassification took away the right of optometrists to write prescriptions for such drugs.  There is now legislation pending to restore the ability of optometrists to write prescriptions for such a drug.  This has brought an objection from the state medical society.

This is a rare instance in which, and probably as an unforeseen consequence, the ability of limited licensed practitioners (optometrists) have been diminished.  Obviously, taking away their ability was not done by the state which sets forth, by legislation, the scope of practice, but by the U.S. Drug Enforcement Agency in reclassifying the drug.

In light of the trends that we are seeing nationwide, it is probable that the state will expand the license of the optometrist to enable them to continue to write prescriptions for the drug.

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