Winter 2011

Volume 6, Issue 4

, e r a c h t l a e h n i s r e d a e L

e f i l n i Leaders

When you see 20 patients a day, applying online can be a real lifesaver.

At NJ PURE, we understand how strapped you are for time. As a direct provider of malpractice insurance, we work closely with thousands of physicians. Keeping your busy schedule in mind, we’ve created the industry’s first online application. Just a few simple keystrokes and you’ll be taking advantage of our new discounts. So switch to an insurer that values the same things you do: your time and your money. Visit njpure.com.

Physician Advocate (ISSN 1555-5054) is published quarterly (winter, spring, fall, summer) by the Medical Society of New Jersey (MSNJ), 2 Princess Road, Lawrenceville, NJ 08648. Free to MSNJ Members. Periodicals postage paid at Trenton, NJ, and at additional mailing offices. POSTMASTER: send address changes to Physician Advocate, 2 Princess Road, Lawrenceville, NJ 08648

“All good things must come to an end.”

Michael T. Kornett Chief Executive Officer

— Chaucer, 1374 AD

don’t believe any major decision made affecting one’s lifestyle is done without thoughts and events I that lead to a conclusion.

In my case, I have been a very fortunate man, but of late I’m realizing that “life is a one way ticket.”

And, it’s time to get my ticket punched and step off the train. At the December, 2010 Board of Trustees meeting I announced my resignation as the Chief Executive Officer of the Medical Society of New Jersey effective June 30, 2011. I want to be a guy who plays ball with his grandchildren, grows flowers, gets back to running and, most of all, repay my wife for all of the years that have separated our lives with my work. My unknown tradeoffs are calling me to future destinations that make me more and more excited as I keep thinking about them.

This was not an easy decision since my challenges and experiences have rewarded me with so many friends who I have come to enjoy on and off the playing field. Their wisdom and advice has helped in good times and troubled waters. I appreciate my adversaries that I’ve gone up against throughout my career as well. The role they played in my life allowed me to think differently, take risks, and never be afraid of competition. And more importantly, never take the competition personally. Some of my biggest rivals are now some of my closest friends and I became a better executive because of them.

I have learned over the years to listen to the other guy before jumping into the fray and I believe that I have become more sensitive to listen to what I may have dismissed over the years as I followed my personal ambitions.

I stepped aboard the Medical Society of New Jersey train as somewhat of a “hired gun” and am leaving with a feeling that I’ve helped lay the tracks towards a whole new platform. I am prepared to pass the controls on to a new engineer that will move MSNJ to a whole new level.

The Board of Trustees and my Executive Staff have both been supportive and I will miss my daily interactions. The staff is like none that you will ever find in the business world with a passion and desire in making MSNJ the best medical society in the country. I believe that they’ve accomplished that. I’m confident that their work ethic and pursuit of excellence on behalf of the membership will continue to lead MSNJ towards future success. While I’m prepared to stay in office for a smooth transition beyond June 30th, I look forward to having personal communications relative to the Medical Society and life in general.

To the membership of the Medical Society of New Jersey I would like to say thank you for allowing me to carve out my own spot in the illustrious history of this 245-year old organization. This letter doesn’t mean “goodbye,” it means “I’ll see you around.”

With warmest regards and affections, Michael T. Kornett Chief Executive Officer

1

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

Michael T. Kornett Resigns as Head of the Medical Society of New Jersey Lawrenceville, NJ — The Medical Society of New Jersey’s chief executive officer Michael T. Kornett announced to the Board of Trustees that he will step down effective June 30, 2011. He has led the state’s largest physician organization since 2004.

“After more than 30 years as a CEO and the last seven with the Medical Society [of NJ] I find myself ready for the next chapter in my life,” said Kornett. “I look back with great satisfaction and pride over what we have accomplished as an organization.”

Under Kornett, physicians have re-emerged as leaders in New Jersey, placing them at the forefront in discussions and policies that influence state and national healthcare policies. He also led the fight for the rights of physicians and patients against managed care manipulations and excessive government influence, and grew MSNJ’s membership. During his tenure, national class action lawsuit settlement agreements that leveled the playing field between physicians and insurers and improved business practices were implemented.

Kornett is recognized as a passionate and vocal advocate for the physicians in New Jersey. He built a strong working relationship with the New Jersey Departments of Banking & Insurance and Health & Senior Services through regular working group meetings. He was an intense critic of Horizon Blue Cross’ attempt to convert to for-profit. He drew on his experience as a former managed care CEO to explain why such an attempt only benefited a few corporate executives and was a bad decision for the citizens of New Jersey.

In 2008, Kornett along with other New Jersey healthcare leaders introduced the MSNJ/QualCare Prescription Savings Card to provide uninsured and underinsured patients access to prescription drugs that may not have been affordable otherwise. More than 200,000 cards have been distributed and $3 million worth of prescriptions have been filled for patients in New Jersey.

“In the 244-year existence of MSNJ, Mike Kornett has definitely carved out his own spot in its history,” stated Dr. Donald J. Cinotti, MSNJ’s 218th President. “He took an organization that was in need of restructuring and reestablished it as one of the premier associations in New Jersey. His presence will certainly be missed.”

During Kornett’s time, MSNJ helped to develop the Affiliated Physicians MEWA administered by QualCare. The AP MEWA is a health insurance program designed to allow small employers to join together as one large group and offer a self-insured health plan. He sits on the AP MEWA Board of Directors.

Kornett currently serves as a director for the Physicians Foundation, a national foundation designed to advance the work of practicing physicians and to improve the quality of healthcare for all Americans, where he is responsible for strategic planning. He is also vice-chair of NJ-HITEC, a federally recognized Regional Extension Center designed to help physicians adopt and utilize electronic medical records effectively in their practices and sits on the board of Samaritan Hospice.

"Mike Kornett's leadership has helped New Jersey's physician community to become a powerful voice in healthcare," said Health and Senior Services Commissioner Dr. Poonam Alaigh. "We look forward to working with the Medical Society of New Jersey in this next phase of its leadership as we enter a critical time in our health care environment."

Kornett came to MSNJ in 2004 after serving as Executive Director for the New Jersey Healthcare Financing Authority.

During his illustrious career in healthcare he served as the chief executive officer of JFK Health Systems in Edison, Passaic General Hospital, was a managing director in the New Jersey healthcare division of Ernst & Young, and helped found two publicly-traded managed care companies; Oxford Health Plans and Mastercare.

A search committee has formed to find a successor.

2

Physician Advocate ✦ Winter 2011

MSNJ – Leaders in healthcare, leaders in life What comes to mind when you think of leadership? Are you a leader? When another person thinks of who you are, what you do and how you represent yourself can they identify you as a leader? Through your participation in the Medical Society of New Jersey you’ve taken steps in the right direction to lead, be followed, and develop an agenda for a greater good in an uncertain future.

The Medical Society of New Jersey unveiled its newest campaign for physicians and patients entitled “Leaders in healthcare, leaders in life. It’s designed to bring to light the stories of our members and the lives they lead both inside and outside of medicine. “Leaders in healthcare, leaders in life” is designed not only for membership recruitment and retention, but also for the benefit of New Jersey’s citizens. The outcome of this initiative is to understand that our members have different personalities and interests while still seeking to achieve MSNJ’s mission to …promote the betterment of the public health and the science and the art of medicine…

“The Medical Society (of NJ) has almost 250 years and some of the greatest past and present leaders in advancing the agenda of medicine” stated Donald J. Cinotti, MD, MSNJ’s 218th president. “A campaign such as this one allows us to showcase some of the best and brightest minds our state has to offer and tell the story of the whole person, not just the doctor.”

MSNJ represents close to 9,000 physicians in New Jersey and each have a tale to tell. Many members are authors, politicians, coaches, artists, musicians, world travelers, adventurists, community activists, heads of households, entrepreneurs and more. While known first and foremost as doctors to their patients, member-physicians are also held in high regard outside of the exam and operating rooms.

“Having been in the healthcare industry for more than 30 years I can say that many patients see their doctors as just that…doctors,” added Michael T. Kornett, chief executive officer of MSNJ. “They don’t realize that the talents that our physicians demonstrate in their profession extend well beyond that scope into their respective communities and interests.”

Our models The four physicians and one medical student featured in the campaign all have different stories and backgrounds, yet still have a common goal of caring for the citizens of the Garden State. They are all actively engaged in the profession of medicine and have membership in the Medical Society of New Jersey that bonds them together.

Michael Richardson, MD MSNJ member since 1993 Middlesex County Medical Society Profession: Anesthesiologist Dr. Richardson serves as Director of Anesthesia, Government Relations, & Quality Management as well as Associate Chief of OB Anesthesia at Saint Peter’s University Hospital in New Brunswick. He is also a Clinical Assistant Professor in Anesthesiology and Obstetrics at the Drexel University College of Medicine in Philadelphia, PA. A medical graduate of the University of California, Irvine, California College of Medicine, Dr. Richardson continues his interest in quality management and physician advocacy by serving as a member of the MSNJ Board of Trustees and a longstanding member of the Capitol Club, MSNJ’s political action committee.

He speaks Japanese and travels to Asia particularly Japan, Singapore, Hong Kong and South Korea. While traveling he enjoys reading the classics including Homer’s Iliad.

Dr. Richardson is one of our “leaders in healthcare, leaders in life.”

3

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

MSNJ – Leaders in healthcare, leaders in life (Continued from page 3)

Nelani Pathirana MSNJ Medical Student Membership Section UMDNJ, Newark Profession: Family Medicine Nelani represents an important segment of the population, the medical students. MSNJ is about physicians...past, present and future and as a student at the New Jersey Medical School, Nelani represents all things that are good about the future of medicine in New Jersey.

She is currently a 2nd Lieutenant in the United States Army and has been active in the AMA Medical School Section serving as a regional delegate. She is also on rotation at Walter Reed Army Medical Center in Washington DC. Nelani is a native of West Windsor and graduated from Cornell and is destined to be, if not already, one of our “leaders in healthcare, leaders in life.”

Joseph P. Costabile, MD MSNJ member since 1986 Camden County Medical Society Profession: Vascular Surgery Dr. Joe Costabile has grown up with the Medical Society of New Jersey and continues a family path of excellence by serving as a Board of Trustee member. His father, Dr. Douglas Costabile, served as president of MSNJ in 1990.

Dr. Costabile is a vascular surgeon in South Jersey and an officer in the United States Navy Reserves Medical Corps assigned to the United States Marine Corps. He has served his country several times in the Middle East, particularly in Kuwait, and last year he presented MSNJ with an American Flag that flew over Camp Al Taqaddum, Iraq.

To say that Dr. Costabile is committed to MSNJ is an understatement. While deployed, Dr. Costabile made it point to send a very generous contribution to MSNJ’s Political Action Committee. He has been a vocal supporter for organized medicine and is a regular participant in MSNJ activities.

When not serving his patients or his country, Dr. Costabile keeps busy through daily exercise and housework and can be found surfing and fishing at the Jersey Shore on occasion. He enjoys plumbing, electric and yardwork (as does his wife!) and is enthusiastic about classic music.

Not only is Dr. Costabile a physician and patriot, but we are proud to say that he is one of MSNJ’s “leaders in healthcare, leaders in life.”

4

Physician Advocate ✦ Winter 2011

Nicole Henry-Dindial, MD MSNJ member since 1998 Union County Medical Society, past president Profession: Family Medicine One of Dr. Nicole Henry-Dindial’s strengths is time management. A mother-of-three and a full-time working family practice physician, she also volunteers at Overlook Hospital teaching family practice residents and has been actively involved in holding an office position on the primary care council there as well.

She has served as vice-speaker of the MSNJ House of Delegates and as president of the Union County Medical Society and now co-chairs the MSNJ Demographics & Diversity Committee aimed at looking at the scope of future member-physicians in New Jersey.

She’s a volunteer mom at her kids’ school and makes it a point to exercise regularly – admitting to being quite a Zumba enthusiast. She has appeared on Hometowne TV’s show “Beyond Health” in December 2009 regarding Pediatric Obesity and in February 2010 regarding Adult Obesity.

Dr. Henry-Dindial is influential on many fronts and is one of our “leaders in healthcare, leaders in life.”

David Konigsberg, MD MSNJ member since 2003 Bergen County Medical Society, president Profession: Pediatric Orthopedics Dr. David Konigsberg is a coach, a board member, a physician, a novice wine maker and a surgeon. He serves as the 144th president of the Bergen County Medical Society and is an active member of the Board of Trustees of the Medical Society of New Jersey.

He’s a father of two and makes an impact in his community by serving as a youth baseball and soccer coach. Dr. Konigsberg is dedicated to promoting health and fitness running 10 to 15 miles and lifting weights 2-3 times each week. He is an avid outdoor enthusiast that enjoys golf, skiing and hiking and spending as much time at the shore as possible.

He’s recently taken up winemaking and is currently fermenting a Zin-Syrah blend. We’ll be happy to sample a little when his first batch is complete.

Dr. Konigsberg is a well-rounded MSNJ member with a passion for excellence. We are proud to call him one of our “leaders in healthcare, leaders in life.”

These are not the only members that have a great story to tell. As the “Leaders in healthcare, leaders in life” campaign rolls on we urge the members of MSNJ to tell us their stories. MSNJ knows some of your stories, but we’d like to hear from you about some of your proudest accomplishments or the role you play as a leader in your respective community. We’d like you to share with us any awards that you may have received or any philosophy that you apply to your everyday life. In turn, we will publicize this through our publications, e-news, and social media outlets.

We want to hear from you. The “Leaders in healthcare, leaders in life” is about you, our member. We want to share your stories with members and nonmembers, patients and citizens. We want to show that MSNJ members influence the lives of millions of people on a daily basis personally as well as professionally.

Not only do your membership dues come with effective advocacy, business training and a host of benefits and services, but it also comes with a sense of ownership. This is your Medical Society of New Jersey and these are your colleagues that are leading the way in medicine as well as in their communities.

We encourage you to read the stories of these members, but send us your own story. A downloadable form is available at www.msnj.org for you to fill out and email back to us. For more information email: MyStory@msnj.org.

5

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

The Business of Medicine The role of healthcare in U.S. society is increasingly complex and intertwined with business. That’s why today’s healthcare leaders need a keen understanding of business and finance in addition to diversifying their healthcare knowledge and expertise. Although solid business skills are seen as critical for physicians working in today’s environment, medical residents enrolled in our country’s medical education system learn about the science and art of medicine, but they are not likely to be taught about the business of medicine. As the healthcare crisis continues to grow in the United States, it is important for today’s physicians to understand the economic and financial impact of health care in our country. How is medicine paid for and who pays it?

How does Medicare work, and how does our paper system, influence patient outcomes? Why are more than 45 million Americans uninsured when we are a wealthy nation? What business skills do physicians need to be successful from a business perspective? Health care is big business, and today’s physicians must be business savvy. Physicians who have business knowledge will ultimately benefit patients.

With the political and economic pressures facing the healthcare system, the healthcare institutions and providers are being asked to do more with less. This becomes more complex when you have payers seeking more value for their healthcare dollars.

These market drivers and competitive pressures demonstrate the need to build business strategies that emphasize our strengths. Business strategy is an overall plan by an enterprise to achieve sustainable competitive advantage in the marketplace. Strategy answers fundamental business questions such as “what is our business”, “who are our customers” and “what value do we bring to our customers”, as well as how do we position ourselves for competitive advantage The cost effectiveness of health care delivery has never been more important than it is today. Whether for-profit or not-for-profit, hospitals and health care providers must allocate their resources as efficiently as possible. It is important to understand basic concepts necessary for financial decision making within organizations. How do healthcare organizations determine a project’s financial viability? Concepts such as the time value of money, net present value, internal rate of return, risk-return analysis, and capital asset pricing model are important for operational choices like buying versus leasing a piece of medical equipment to strategic choices such as whether to open a multimillion dollar MRI site. Healthcare executives and physicians need to know how to read and understand financial statements, negotiate contracts, and manage teams effectively.

By Claudia Meer, Ph.D. “The business of medicine has become a stark reality for physicians” said Michael T. Kornett, MSNJ’s chief executive officer.

“A” And while physicians endure years of training to master the art and science of medicine, the business and legalities of the profession cannot be ignored.”

In an effort to improve healthcare delivery through sound management practices, Rutgers University Center for Management Development (CMD) created a Mini MBA™ in Strategic Healthcare Management, the first program of its kind in the country.

Although some physicians receive their MBA degree, many see it as impractical after spending so much time in medical school. The pilot Mini MBA program was developed in 2008 with the help of Nayan Kothari, M.D., chairman of the Department of Internal Medicine at Saint Peter’s University Hospital and program director for the hospital’s Internal Medical Residency Program. With the input from Saint Peter’s physician leaders and administrators, Rutgers CMD designed a course that integrates strategic management of a healthcare facility with business concepts that address the pressing issues faced by a healthcare facility today. Though initially intended as a “grass roots” course for medical residents, it evolved to include both staff and community physicians as well as hospital administrators.

“The Mini MBA is a step in the right direction to further enhance the critical skills of our physicians in an ever-changing healthcare world”, according to MSNJ’s Kornett. Participating in this program gives participants the strategic business skills needed to navigate today’s rapidly changing healthcare management environment and increases the understanding of the pressures exerted by the current healthcare dynamics. Medical and administrative healthcare professionals alike will gain the ability to make informed, data-based decisions that take business considerations into account. Prof. David Finegold, Dean of the School of Management and Labor Relations at Rutgers, and who teaches in the program concurs, “The RutgersSt. Peter’s Mini-MBA in Strategic Healthcare Management is a unique partnership. It is pioneering a new approach to medical education by preparing future doctors and hospital leaders for the business challenges of the changing healthcare landscape.”

The main drive behind the Mini MBA program, taught by thought leaders from Rutgers University and senior healthcare industry leaders, is to help physicians and other medical professionals make more informed decisions. By taking people out of their silos and putting them into an interdisciplinary group, they are exposed to a cross current of new ideas and generate a much higher level of business acumen. The cross pollination of ideas that occurs during these sessions are invaluable. The more everyone becomes familiar with the entire medical system, the more the patients will benefit. This 39 hour program, approved for 39 continuing medical education credits, provides a comprehensive understanding of the economic,

6

Physician Advocate ✦ Winter 2011

financial, and competitive aspects of the healthcare industry.

This includes the management of healthcare facilities, insurance and reimbursement practices, market dynamics and global trends in healthcare.

The main drive behind this program, taught by thought leaders from Rutgers University and senior healthcare industry leaders, is to help physicians and other medical professionals make more informed decisions. By taking people out of their silos and putting them into an interdisciplinary group, they are exposed to a cross current of new ideas and generate a much higher level of business acumen. The cross pollination of ideas that occurs during these sessions are invaluable. The more everyone becomes familiar with the entire medical system, the more the patients will benefit.

This 39 hour program, approved for 39 continuing medical education credits, provides a comprehensive understanding of the economic, financial, and competitive aspects of the healthcare industry. This includes the management of healthcare facilities, insurance and reimbursement practices, market dynamics and global trends in healthcare.

our strengths. Business strategy is an overall plan by an enterprise to achieve sustainable competitive advantage in the marketplace.

Strategy answers fundamental business questions such as “what is our business”, “who are our customers” and “what value do we bring to our customers”, as well as how do we position ourselves for competitive advantage

The cost effectiveness of health care delivery has never been more important than it is today. Whether for-profit or not-for-profit, hospitals and health care providers must allocate their resources as efficiently as possible.

Graduates of the programThose who complete the program are also eligible to receive three gradate credits which can be used toward both the MBA program and the new MBS program at Rutgers, The State University of New Jersey. Rutgers has also created some new specialized graduate degrees combining business and the healthcare industry. The MBA in Pharmaceutical Management is an MBA with courses in pharmaceutical management, marketing and strategic issues geared toward the pharmaceutical industry1. The new Master of Business & Science (MBS) degree is a master of science combining science & business courses. Concentrations including Biotechnology, Drug Development & Discovery, Biomedical Engineering, and others geared towards scientists working in the pharmaceutical and healthcare related industries2.

With the political and economic pressures facing the healthcare system, the healthcare institutions and providers are being asked to do more with less. This becomes more complex when you have payers seeking more value for their healthcare dollars. These market drivers and competitive pressures demonstrate the need to build business strategies that emphasize

The cost effectiveness of health care delivery has never been more important than it is today. Whether for-profit or not-for-profit, hospitals and health care providers must allocate their resources as efficiently as possible. It is important to understand basic concepts necessary for financial decision making within organizations. How do healthcare organizations determine a project’s financial viability? Concepts such as the time value of money, net present value, internal rate of return, risk-return analysis, and capital asset pricing model are important for operational choices like buying versus leasing a piece of medical equipment to strategic choices such as whether to open a multimillion dollar MRI site. Accounting is one of the languages of business. Healthcare executives and physicians need to know how to read and understand financial statements, including the three principal financial statements: balance sheet, income and cash flow statements so that they can make more profitable and ethical business decisions.

Founded in 1947 to provide management education to the public, CMD has been recognized internationally as one of the top U.S. university-based executive education organizations. In addition to a suite of Mini MBA programs, including Strategic Healthcare, BioPharma Innovation, BioPharma Entrepreneurship, Business Essentials, Finance Essentials and 4 marketing Mini MBAs, it offers certificate programs in human resources, and leadership and management. All programs are open enrollment and can be customized for on-site delivery. For more information, visit www. cmd.rutgers.edu or call 732/445-5526.

Claudia Meer received her doctorate degree in adult education from Rutgers University. She is the Director of the Mini MBA Programs sponsored by the Rutgers Center for Management Development and a professor in the Human Resource Management Department of the School of Management and Labor Relations.

1 2

http://mba.rutgers.edu/pharma http://mbs.rutgers.edu

The statements, opinions and representations in this article are attributable to the author(s) alone, and are not necessarily representations of the Medical Society of New Jersey. For questions or comments on the content of the article above please contact the authors directly.

7

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

To Sell/Lease your Medical Practice or Not to Sell/Lease; that is the Question (Issues to Consider in Selling/Leasing to a Hospital) Historical Trends Approximately fifteen years ago hospitals were purchasing medical practices, often for very significant prices. Then, approximately ten years ago, the hospitals gave them back to the physicians for free, primarily because the hospitals had not realized the financial benefits they expected. Today, it is déjà vu all over again with hospitals in the market to purchase or lease medical practices, particularly cardiology and primary care.

The motivations for physicians to sell their practices are the higher reimbursement rates the hospitals can command for the same services the physicians performed in their practices (assuming that any of it trickles-down to the physicians); and the financial, staffing and other assistance the hospitals can provide the practices to cope with their ever increasing administrative burdens.

There are a number of distinctions in how hospitals are currently purchasing medical practices as compared to fifteen years ago. First, hospitals are not offering to pay significant purchase prices, even in those situations where they are purchasing all the practice’s assets out-right.

Secondly, the practices are no longer being totally absorbed into the hospital’s administration and bureaucracy.

Rather, the physician owners and the practice managers/administrators are left in place to operate the practice, subject to only general guidelines and oversight by the hospital administration.

Third, during the prior cycle of practice acquisitions the physicians were paid a fixed salary which was unrelated to their productivity and the fees generated by the practice for the hospital. In the current acquisitions, and in the leasing arrangements discussed below, physician compensation is based totally on productivity.

To Sell or Lease Absent unusual circumstances, we do not recommend an outright sale of the practice; rather, we prefer a lease arrangement. While there are many variations in each practice’s situation, there are a number of major considerations which dictate against an outright sale. The primary one is that the hospital is not going to, and in any event cannot, legally pay the physicians the true value of their practice. The true value to the hospital are the referrals the physicians can generate to it.

Under the various federal anti-kickback laws the hospital cannot pay the physicians more than the fair market value of their practice. Any payment beyond this amount could be considered as a kickback for the physicians’ referrals to the hospital. Also, while there are various methodologies which accountants use to value practices, they are all based on the tangible and intangible assets of the practice itself (i.e. within the four corners of the practice). Consequently, the revenue generated by other physicians to whom the practice refers patients is not, and cannot be, considered in determining the practice’s fair market value.

Another negative is that under the current methodology for these acquisitions, the physicians, in the main, are not relieved of the responsibilities for administering and managing the practice. This negative is particularly true for the practice’s managing physician.

Further, after the acquisition the practice is still considered as a separate operating division or profit center of the hospital. Consequently, the physicians’ compensation is still tied-to the profitability of what was their prior medical practice. Admittedly, there is access to the higher reimbursement rates the hospital can command. However, the real question is how much of that enhanced reimbursement will trickle down to the physicians. This is a particularly troublesome concern as time progresses because once the practice is purchased the physicians become a captive audience of the hospital with little bargaining power.

Finally on negatives, a purchase is for all intents and purposes irrevocable.

Leasing Is Preferable By comparison, a properly negotiated lease arrangement can avoid all the pitfalls of an outright purchase because the practice does not become a captive of the hospital. Moreover, it enhances the probability that going forward the practice will continue to realize its appropriate portion of the expected enhanced revenue.

Lease Agreements There are generally two agreements in a leasing arrangement between a hospital and a medical practice. The Facility and Services Leasing Agreement generally provides for the hospital affiliated medical practice to sublease the office space and to lease all the medical and office equipment and non-physician staff from the practice. The Leased Provider Agreement is for the hospital affiliated medical practice to lease all the physicians from the practice as independent contractors of this affiliated practice.

Establishing a Management Services Company The Facility and Services Leasing Agreement(s) which we have reviewed to date provide that the medical practice lessor 8

Physician Advocate ✦ Winter 2011

will act as the manager for the lessee hospital affiliated practice. There is a potential regulatory issue with this arrangement. Because the medical practice continues to exist as a business entity, albeit just a shell, it is providing management services for another separate entity, the hospital affiliated lessee practice.

Given this concern, and in the interests of creating another revenue stream for the physicians, we recommend that they create a separate management services company. The physician owners of the medical practice are permitted to also separately own this company and to charge a fair market rate for its services and leasing to the hospital affiliated practice.

This company would then separately contract with the hospital affiliated medical practice to provide management services. These services can include the leasing of all medical and office equipment, and all non-physician clinical and administrative/support staff. (The company will have to be licensed by the New Jersey Department of Labor as an employee leasing company.)

If the physicians’ medical practice was previously performing its own billing, in-house with its own employees, then the lease arrangements should provide that the management services company will perform the billing for the hospital affiliated practice. (The company will have to register with the New Jersey Department of Banking and Insurance as a billing company.) Even though billing has become a physician’s worst nightmare, we still recommend this lease arrangement for a number of reasons.

First, obviously, it allows the physicians to maintain a significant amount of financial oversight. Secondly, it eliminates the potential for a gap in billing and reimbursement with a conversion to the hospital performing the billing function. Third, it provides the physician owners with immediately available and reliable financial information on whether, as discussed below, to reopen the Leased Provider Agreement to negotiate increases in compensation for the leased physicians.

Financial Terms of Lease The Leased Provider Agreement will probably compensate the leased physicians based upon a fixed dollar amount for each RVU of medical services they provide. Initially, it is extremely important that the physicians retain an outside expert to assist them in insuring that this formula is fair and reasonable.

Most medical practices do not calculate physician compensation on an RVU basis. Before beginning any negotiations with a hospital, the practice must take the services it performs, (e.g. office visit, procedures), and assign each of them an RVU. Then the productivity of each physician, and the practice as a whole, has to be evaluated in terms of RVUs. Once the practice has estimated the amount of income it generates per RVU, it is then in a position to begin negotiating with the hospital.

We recommend that the Leased Provider Agreement include a yearly reopener provision only for purposes of renegotiating this compensation formula. We appreciate that this is a double-edged sword, and no one has a crystal ball. However, hospitals are establishing or otherwise entering into accountable care organizations which afford the possibility of enhanced reimbursement levels. Accordingly, the expectation is that the dollar value of the services provided by the leased physicians will increase.

In addition, we recommend that the physicians obtain an outside This article was written by: consultant to determine the fair market value for the leased space, equipment and employees, and for the management/administrative Dennis J. Alessi, Esq. and billing services, which the physician-owned management services Chair; Health Care Law Department company will provide to the hospital affiliated medical practice. A and report and certification, that the fees being charged are fair market, Constantina Koulosousas, Esq. should be obtained from this consultant.

Associate, Health Care Law Department Mandelbaum Salsburg Lazris & Discenza, P.C. Additional Lease Terms 155 Prospect Avenue There are quite a number of additional terms which need to be West Orange, NJ 07052 included in any leasing agreements to: (1) insure the maximum phone: 973.736.4600 possible benefits for the lessor medical practice; (2) protect its fax: 973.325.7467 continued existence and independence as much as possible; and dalessi@msgld.com (3) afford the practice the real ability to terminate the lease and continue in existence as a viable business. A detailed description Assistance in preparing this Article of all these terms is beyond the scope of this article. was provided by: Conclusion Michael J. McLafferty, CPA, CHFP, FACMPE Physicians need to appreciate that they have more bargaining clout Partner-in-Charge of the Healthcare Services Group than they might otherwise realize in negotiating lease arrangements Eisner Amper with hospitals. Under the Healthcare Reform Act hospitals are 2015 Lincoln Highway under enormous pressure to participate in larger accountable care P.O. Box 988 organizations. Also, hospitals are in keen competition to expand Edison, NJ 08818 their patient bases in order to increase admissions and other uses phone: 732.287.1000 of their facilities. These factors afford physicians more leverage fax: 732.287.3200 in such negotiations, particularly for those practices with high e-mail: mclafferty@eisneramper.com volumes of patients and referrals.

The statements, opinions and representations in this article are attributable to the author(s) alone, and are not necessarily representations of the Medical Society of New Jersey. For questions or comments on the content of the article above please contact the authors directly.

9

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

THE RISKS OF A RISK RETENTION GROUP

By Eric Poe, Esq., CPA Recently physicians have been offered medical professional liability policies at reduced prices through Risk Retention Groups (RRGs). This has prompted many physicians to inquire as to the material differences between RRGs and traditional admitted and authorized New Jersey insurance carriers in the state. We have identified several key differences below: HOW DOES THIS APPLY TO NJ PHYSICIANS? If an RRG is domiciled outside of the State of New Jersey, as most of the RRGs marketing to New Jersey physicians currently are, they are only required to comply with the regulations in their domiciled state. In such cases, physicians will NOT receive New Jersey state protection under its Guaranty Fund, and the New Jersey Department of Banking and Insurance does NOT regulate and oversee their policy language, rates or financial requirements.

I. STATE GUARANTEE PROTECTION As an RRG, neither the insurer nor its policyholders receive protection from the state Guaranty Fund, which provides defense costs and indemnification for up to $300,000 for each claim that may be filed against you. With the recent insolvency of the state’s largest medical professional liability insurer, MIIX Insurance, this protection provided by the Guaranty Fund proved to be vital for hundreds of New Jersey physicians whose own personal assets would have otherwise been exposed to all such costs from the very first dollar.

II. POLICY, RATES & FINANCIAL SOLVENCY A. POLICY LANGUAGE The policy form an RRG issues may NOT be the same policy form with the same terms you currently receive through your admitted and licensed New Jersey insurer. Therefore, it is incumbent upon a physician to read their policy language and review the terms and conditions carefully. Their coverage and ability to continue practicing medicine depends upon it. This should be done each and every year, as the policy language may change from year to year. Unlike RRG’s, the policy language offered by an authorized New Jersey insurer, and changes thereafter, must be pre-approved by the New Jersey Department of Banking and Insurance for the protection of physicians.

B. RATES Rates are also not subject to the review and regulation by the New Jersey Department of Banking and Insurance. Disputes with rates would need to be sent to a foreign state to determine validity, and rates may fluctuate significantly and more often.

C. FINANCIAL SOLVENCY REGULATIONS RRGs chartered outside of New Jersey are not required to meet the financial solvency examinations and have standards with which each New Jersey licensed and authorized insurer must comply. Other states may have significantly lower capital requirements in order to issue policies.

For example, in Vermont, the minimum capital requirement is only $1 million, which can be achieved by a mere Letter of Credit through a bank. In Montana, the minimum capital requirement for licensure is only $750,000. In contrast, in New Jersey, the minimum capital requirement is significantly higher, and a Letter of Credit cannot be used to meet these requirements.

The statements, opinions and representations in this article are attributable to the author(s) alone, and are not necessarily representations of the Medical Society of New Jersey. For questions or comments on the content of the article above please contact the authors directly.

10

Physician Advocate ✦ Winter 2011

The Medical Society of New Jersey presents an evening with

THE MAX WEINBERG BIG BAND To benefit the families of New Jersey’s deployed citizen soldiers and the public health efforts of the MSNJ Foundation sponsored by

Hyatt Regency New Brunswick, New Brunswick, NJ Friday, May 13, 2011 | 8:00 pm The Medical Society of New Jersey (MSNJ), established 1766, is proud to present an evening with the MAX WEINBERG BIG BAND to benefit the children and families of the New Jersey National Guard’s citizen-soldiers as well as the MSNJ Foundation.

Each year, MSNJ hosts an event for its members as a kickoff to its Annual Meeting and Presidential Inauguration.

On Friday, May 13, 2011, MSNJ will host a fund-raising concert to benefit the NJ National Guard State Family Readiness Council as well as the public health endeavors of the MSNJ Foundation. Tickets for this event will be open to the public. The ticket prices are $99.

ABout MAX WEINBERG He is known as the “Mighty Max” Weinberg and has been the drummer for Bruce Springsteen and the legendary E Street Band for more than three decades.

He is now the boss of The Max Weinberg Big Band a bold, swinging fifteen piece aggregation that continues the traditions established by Max’s musical heroes— among whom, Frank Sinatra, Count Basie, Buddy Rich, Gene Krupa, Doc Severinsen, and Maynard Ferguson lead the pack. Max also spent seventeen years as the leader of what the Washington Post called, “the best band in late night television” heading the Max Weinberg 7 for Late Night and the Tonight Show with Conan O’Brien.

About the beneficiaries The New Jersey National Guard State Family Readiness Council provides support to New Jersey National Guard members or to their families who are facing financial hardships during military deployment. The Council’s main goal is to assist and support our NJNG families through challenging times, such as a typical deployment of eighteen months or longer, by trying

to alleviate any undue stress through a grant program funded by private and public contributions. These funds are vital in keeping National Guard families financially afloat.

The MSNJ Foundation, (the Institute of Medicine & Public Health of NJ) works to improve the health status of New Jersey residents through innovative public health practice and high quality medical care. The MSNJ Foundation works collaboratively with partners in public health and medicine in all areas of government, academia, and the private sector to increase awareness of health initiatives in the Garden State.

11

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

The Medical Society of New Jersey’s 3rd Annual Food & Wine Tasting Featuring Internationally-renowned Chef Georges Perrier

Program: 7:00 pm – Cocktail reception 8:00 pm – Dinner Tickets: $250/person Hotel accommodations: Saturday night discounted rate: Bally’s - $179.00 (plus taxes and fees) Caesars - $199.00 Caesars (plus taxes and fees) Benefits the MSNJ Foundation, the Institute of Medicine & Public Health of New Jersey, a 501(c)3, nonprofit corporation.

Register at www.msnj.org

About Chef Georges Perrier Chef Proprietor of Le Bec-Fin Originally from Lyon, France, a city world-renowned for its culinary arts, Chef Perrier began his accomplished culinary career at age fourteen. He trained with the great chefs at some of the finest restaurants of France including Michel Lorrain of Casino de Charbonnières near Lyon, Jacques Picard of L’Oustau de Baumanière in Provence, and Guy Thivard at La Pyramide in Vienne, owned by the legendary Ferdinand Point.

Chef Perrier arrived in Philadelphia in 1967 as Head Chef for Peter von Starck’s La Panetière. Three years later, Perrier opened his own restaurant at 1312 Spruce Street. He named the restaurant “Le Bec-Fin,” a French idiom for “the good taste.” The small restaurant quickly became a Philadelphia institution. The restaurateur refused invitations to relocate to Manhattan, Los Angeles and Chicago, opting instead to pave the way for Philadelphia’s restaurant renaissance. Visitors to the city considered Le Bec-Fin an essential stop, and regular patrons travel from New York and Washington D.C. for a single meal.

In 1976, Chef Perrier was inducted into the Maîtres Cuisiniers de France, the premier international society of French chefs. Its 200 members include the finest French chefs in the world. In 1989, those members voted Perrier “Chef of the Year” and awarded him with the Silver Toque,

the most coveted trophy in the world of haute cuisine.

In 2005, French Senator Jean Besson bestowed the status of Knight in the National Order of Merit from the Republic of France.

In 1998, Chef Perrier was honored by America’s leading culinary organization when he was awarded Best MidAtlantic Chef by the James Beard Foundation. Chef Perrier has also received many awards for his work with various charities including SCAN (Stop Child Abuse Now), Amyotrophic Lateral Sclerosis (ALS) Association, the Breast Health Institute and the Arthur Ashe Tennis Foundation.

Chef Perrier’s first book, Georges Perrier Le Bec-Fin Recipes, was published in 1997 and contains more than 100 recipes, featuring both the inspired haute cuisine of Le Bec-Fin, as well as the casual bistro fare served in Le Bar Lyonnais. USA Today recently rewarded the restaurant as one of the 10 best French restaurants in the country.

In 2009, Chef Perrier was in Paris, France to receive the highest French honor bestowed on a person which distinguished themselves through civilian or military valor, the Legion d’Honneur. This medal was presented by his good friend and countryman, Monsieur Guy Savoy, Grand Officer of the Legion and master of haute cuisine.

In 2010, Chef Perrier received the Academiciens de l’Annee, the high honor presented by the Academie Culinaire de France.

12

Physician Advocate ✦ Winter 2011

13

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

Don Self

Don Self has been a national medical reimbursement consultant, speaker and author for more than 23 years, helping physicians, non physician providers and clinics ensure their reimbursement is legal and optimized. He will be the keynote speaker at the upcoming MSNJ Annual Meeting on Friday, May 13th at the Hyatt Regency in New Brunswick

PA - How did you get started as a reimbursement consultant to physicians, and why?

DS - I spent the night at a Holiday Inn Express and the next day, I knew what I know now. Ok, seriously, in the mid80’s, I sold pegboard accounting systems and superbills to physicians and saw a need for physicians to stay updated on the codes & changes in reimbursement. Most relied, back then, on whomever sold them forms and since I wanted my clients to get the best product, I would attend Medicare seminars. Before long, I was consulting for free more than selling – and, so in ’87, I started teaching physicians what they needed to be billing for and it grew from there.

I left the sales position I had with the pegboard company and hung out my shingle and went door to door to convince doctors to hire me to help them.

PA - Were you an immediate success or was it difficult to convince physicians you were qualified to help?

DS - Being a father of 3, with a wife devoted to full-time raising children, I spent weekends in the Navy Reserve, taught medical office management classes two nights a week at the Junior college, painted house numbers on curbs other evenings and threw a morning newspaper route at 6:00 am while spending the day seeing the inside of physician reception areas. It took about a year before I could quit the other 4 jobs and devote 100% to the consulting business.

PA - What made you different than other consultants?

DS - One thing was the guarantee we had from day one. I learned from Terry McVey (McVey Associates Seminars) to give a guarantee that others were afraid to give. From day one, I relied on handshakes with clients, avoiding written contracts. If the client was satisfied with my work when I finished, they would pay me and if not – they didn’t owe me.

PA - Do you still give the same guarantee to clients today?

DS - Today, it is evolved into something a bit more enticing for physicians. Today, I only work with primary care practices and the guarantee is that if I cannot help the client increase their net income by at least $50,000 per year, through my consulting, then they do not pay me a penny for my consulting. That is pretty safe on my part though, as my usual client increases their income by $160,000 per year on average.

PA - You said that the Guarantee was one thing that set you apart from others. What else does?

DS - I’m selective about what clients I will help due to my belief in only taking on clients that I believe want the best for

their patients. I have had physicians more interested in the money than in the patient care, and those are usually pretty easy to spot – and I refuse to help them. My philosophy is that if I’m going to help a physician increase their income by $5K to $15K per month, I’m only going to do it with doctors I like, respect and believe that they put patient care first. I may educate everyone on some things but I only do one-on-one consulting with doctors I respect.

PA - In times when everyone is making reductions in their payments to physicians, how do you accomplish that?

DS - The answer varies from client to client. Some offices are not charging for what they are actually doing (either through down-coding or missed charges). Others may not be performing exactly what the carriers want them to be doing or they may be outsourcing specific services to outside vendors instead of performing them in-house.

There are always offices that are practicing today based on incorrect information or myths, so I educate them as to what is fallacy and what is truth in collections, billing, etc. It is amazing to me how many physicians are listening to this or that naysayer saying what they cannot do – and most of the time – they are flat out wrong. Teaching physicians about how Medicare patients are the most profitable of all patients if they are following the current Medicare guidelines is just one way. When physicians and managers learn about ERISA, PQRI, AHRQ and Evidenced-Based Medicine, it is really simple to show them how to increase their income – even and especially in today’s economy. Teaching physicians in the great state of New Jersey that they do not have to sign the contracts forced on them by managed care companies is another.

PA - So where does the legacy end? Do you plan on retiring?

DS - No way! I absolutely love what I do and feel like one of the most blessed people I know. Not only am I helping doctors change how they practice to get better medical outcomes with their patients while increasing their own income, but I love what I do. I’m hoping the Lord gives me at least another 23 years of doing this before I head home.

PA - We have a lot of readers that are not in Family, Internal or Geriatric practices. What about them?

DS - Having done this for 23 years so far, I have had the philosophy that if someone else can do a better job for my client than I, then I refer them to other consultants and there are many out there that are much better than I in so many specialties. If they email me at donself@donself.com I will be more than happy to give them the contact info of other private consultants in the country.

14

Physician Advocate ✦ Winter 2011

Tame the beast.

Running a practice is getting more complicated – and frustrating. And in your gut, you know that buying and managing expensive software won’t make it any simpler. Join 24,000 other providers who use our web-based services for practice management, electronic medical records, and patient communications and we’ll unleash your practice’s potential. More money. More control. Beast tamed. athenahealth is a preferred practice management information system and billing collections services provider of the Medical Society of New Jersey, and members may qualify for a eight percent discount on the implementation 0f athenaCollector if all physicians in the practice are members of Medical Society of New Jersey.

MORE MONEY MORE CONTROL

To learn more call 800.981.5085 or visit www.athenahealth.com/tamethebeast

15

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

2010 October 1, 2009 through December 1, 2010

Atlantic:

Cape May:

Richard A. Menghetti, MD

Rafael Attiya, MD

Bergen:

Essex:

George M. Ajjan, DO Douglas G. Avella, MD Alan R. Baskin, MD Douglas N. Benson, MD Alex Biener, MD Thomas M. Birch, MD William K. Boss, Jr., MD Joseph Disaverio, MD Marc M. Dreier, MD John D. Frattarola, MD Gregory J. Gallina, MD** Peter E. Kagan, MD David E. Konigsberg, MD Paul E. Kovatis, MD Joseph Manno, MD Michael A. Meese, MD Charles Moss, MD Nancy Mueller, MD** Stephen G. Pereira, MD Thomas R. Peterson, MD** Joseph P. Pizzurro, MD John W. Poole, MD** Sidney Rabinowitz, MD Robert S. Rigolosi, MD Gene S. Rosenberg, MD Ruth J. Schulze, MD Payal A. Shah, MD Costa H. Sousou, MD

Michael L. Bilof, MD Anthony P. Caggiano, Jr., MD Roderick J. Clement, MD Mark T. Olesnicky, MD

Burlington: S. Manzoor Abidi, MD Mary F. Campagnolo, MD David A. Ingis, MD Francis J. Lumia, MD Joan Frances O’Shea, MD William A. Rough, Jr., MD

Camden: John P. Capelli, MD Prasanta C. Chandra, MD Joseph P. Costabile, MD Joseph J. Fallon, Jr. William Culp Franckle, IV, MD** Joseph H. Reichman, MD Scott R. Schaffer, MD

Gloucester: Bruce A. Monaghan, MD Thomas P. Obade, MD

Hudson: Donald J. Cinotti, MD C. K. Lowe, MD Steven P. Shikiar, MD**

Hunterdon: Robert C. More, MD* David V. Nenna, MD Stanley A. Sheft, MD

Mercer: Robert E. Brolin, MD Linda G. Gochfeld, MD

Middlesex: Ronnie Z. Bochner, MD* Michael H. Fleisher, MD* Christopher E. Gribbin, MD*** Steven H. Krawet, MD Ted Louie, MD Robert Balvant Patel, MD Niranjan V. Rao, MD* Steven L. Richards, MD Michael J. Richardson, MD Thomas S. Vates, III, MD*

Monmouth: Steven Berkowitz, MD Jason D. Cohen, MD Haralambos Demetriades, MD Walter J. Kahn, MD Jarrod Kaufman, MD Arthur K. Mark, MD Hoan-vu Tran Nguyen, MD Christopher John Spagnuola, MD** John J. Verdon, Jr., MD

16

Physician Advocate ✦ Winter 2011

Morris: Michael H. Bernstein, MD Frank M. Capecci, MD Donald M. Chervenak, MD Margaret Mary Sacco, MD

Ocean: Stewart A. Berkowitz, MD* Michael Spedick, MD

Passaic: Joseph Garcia, MD*** Evangelos Megariotis, MD

Somerset: Gary A. Drascher, MD Keith A. Harmon, MD William M. Sugarmann, MD David Youmans, MD

Union: Paul Carniol, MD** James Z. Cinberg, MD Robert A. Fuhrman, MD David Eli Rojer, MD R. Gregory Sachs, MD** Richard Eric Tepper, MD

Friends of Medicine: Bergen Anesthesia Associates Clark Martin/MBI** Michael T. Kornett Michael Schoppmann, Esq.

*Capitol Club Executive **Capitol Club Elite ***President’s Club ‡ Non-member

The Medical Society of New Jersey’s Annual Meeting May 13 – 15, 2011 Hyatt Regency New Brunswick “ARE YOUR BEST PLAYERS ON THE FIELD?” MSNJ’s tools for success Friday, May 13 7:30 am – 3:00 pm

Registration & Exhibits

8:00 am – 9:00 am

Continental Breakfast, Exhibitors & Door Prizes

9:00 am – 10:15 am

GENERAL SESSION

USING THE PHYSICIAN QUALITY & REPORTING INITIATIVE TO INCREASE YOUR INCOME WHILE IMPROVING OUTCOMES Speaker: Don Self, Don Self & Associates, Inc. Description: Too many people confuse the measly 2% bonus that they hear about with the true benefit of PQRI which is the improved patient care and the $10,000 per month increase in income that is so easy for the primary care provider to achieve by following the new guidelines. This keynote will explain how & why the carriers (not just Medicare - but all carriers) have reduced payments for procedures commonly performed by primary care providers and moved money into the evidenced based areas such as diagnostics, imaging, clinical lab and more. You need to know where and why they moved the money to help you achieve better medical outcomes at an earlier stage - which in turn saves the payers $Billions. They know it is better to pay you more money up front for specific services than to have to pay $thousands per day later for catastrophic care that could have been avoided.

10:15 am – 10:45 am

Exhibitors

10:45 am – 12:00 pm

AM Session I

ICD-10 WORKSHOP Speaker: Tina Cressman, MALS, CPC-I, CPC-H-I, CPC-P, CEMC, CCS-P, MCS-P, MCS-I, CMC, Director, Managed Care Education, Cooper University Hospital Description: The department of Health and Human Services (HHS) has mandated the replacement of the ICD-9-CM code sets medical coders and billers in the United States use now to report health care diagnoses and procedures with ICD-10 code sets, effective Oct. 1, 2013. ICD-10 implementation will radically change the way coding is currently done; the code-set will grow from its current 17,000 codes to more than 141,000, and the format is new with seven alpha-numeric codes instead of five numeric digits. These dramatic changes, and others, will require very significant effort to implement, and the time to prepare for ICD-10 implementation is now. This breakout session will focus on where we are in the implementation process as a group, and where we need to be, to effectively start using ICD-10 on 10/1/2013.

AM Session II MYERS-BRIGGS TYPE INDICATOR & LEADERSHIP WORKSHOP Speaker: Sharon L. Hardy, MA, PCC, Sharon L. Hardy & Associates LLC Description: Understanding your Myers-Briggs type preferences gives you a picture of your operating style and shapes the kind of leader you are. Are you a big picture person or do you want to know the details? Do you like to get more information or just make a decision and get it done? Learn about your Myers-Briggs Type in a fun and entertaining way, and take away tools for communicating with different types most effectively. There will be time at the start of the session for you to take the MBTI self scoring questionnaire.

AM Session III AUDITING, EXTRAPOLATION, & WRITING AN EFFECTIVE COMPLIANCE PLAN Speaker: Catherine Flynn, Esq.; Partner, Weber Gallagher Simpson Stapleton Fires & Newby LLP Description: For years practices have taken their documentation and their office visit coding for granted. In 2011 both private and government payers will put more resources into auditing claims. Will your practice be ready? Some areas of discussion will include: What happens if I am audited? How do I respond or should I respond? What is extrapolation? What are the different federal audit programs and how do they work? Does having a compliance plan make a difference if I am audited?

17

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

12:00 pm – 1:30 pm

Lunch Buffet, Exhibitors

1:30 pm – 2:45 pm

PM Session I

PROFESSIONAL GROWTH AND EFFECTIVE COMMUNICATION FOR MEDICAL PRACTICE MANAGERS/ADMINISTRATORS Speaker: Sharon L. Hardy, MA, PCC, Sharon L. Hardy & Associates LLC Description: As a Medical Practice Manager/Administrator, you have immense impact on the atmosphere, culture and effective functioning of the practice, and a primary role in effectively managing people. How can you decrease stress and build better collaboration and trust in your practice? Learn proven methods for building trust, accountability and increasing satisfaction in your relationships at work and home. You will take away a mindfulness practice, relationship map and the iceberg model to help you and your staff get at concerns more directly and make clear requests and effective promises to each other.

PM Session II DOCUMENTING EVALUATION & MANAGEMENT SERVICES Speaker: Don Self, Don Self & Associates, Inc. Description: Physicians and Practitioners are the target of increased auditing activity by payers across the country.

Evaluation & Management services are one of the most aggressively audited areas of documentation. Physicians and Practitioners get confused by CPT language and payer guidelines and therefore - the majority either under-code (costing them money) or over-code (leaving them open for fraud and abuse accusations). The 2011 CPT update brought significant changes to Evaluation & Management services. Don’t miss this educational workshop and learn how to successfully document the old & the new evaluation & management services.

PM Session III INTERPRETING THE LANGUAGE IN YOUR PAYER CONTRACTS Speaker: Frank Ciesla, Esq., Partner, Giordano Halleran & Ciesla Description: If you are contracted with one or several insurance plans your provider agreement is your revenue source. The terms of these agreements determine how health insurers …

2:45 pm – 3:00 pm

Exhibitors

3:00 pm – 3:45 pm

MSNJ Legislative Presentation

All Aboard the Northeast Regional from Trenton to Washington DC: What you need to know about healthcare happenings from the Garden State to the White House and what’s coming down the tracks.

Speakers: Timothy J. Martin, Associate, MBI GluckShaw & MSNJ Lobbyist; Dean Armandroff, Regional Political Director, American Medical Association 3:45 pm – 4:00 pm

Exhibitors

4:00 pm – 5:00 pm MSNJ SPECIAL SESSION THE FUTURE OF MEDICINE 2001 - 2051 How will medical care be delivered in 2051? Listen to a discussion of emerging diagnostic and treatment technologies in development. How will these innovations impact on medical practice?

5:00 pm – 6:00 pm The MSNJ Foundation, the Institute of Medicine & Public Health of New Jersey Board of Directors Meeting by invitation only 8:00 pm – 10:00 pm The Medical Society of New Jersey presents an evening with THE MAX WEINBERG BIG BAND To benefit the families of New Jersey’s deployed citizen soldiers and the public health efforts of the MSNJ Foundation General Admission - $99/ticket He is known as the “Mighty Max” Weinberg and has been the drummer for Bruce Springsteen and the legendary E Street Band for more than three decades. He is now the boss of The Max Weinberg Big Band a bold, swinging fifteen piece aggregation that continues the traditions established by Max’s musical heroes—among whom, Frank Sinatra, Count Basie, Buddy Rich, Gene Krupa, Doc Severinsen, and Maynard Ferguson lead the pack. Max also spent seventeen years as the leader of what the Washington Post called, “the best band in late night television” heading the Max Weinberg 7 for Late Night and the Tonight Show with Conan O’Brien.

18

Physician Advocate ✦ Winter 2011

10:00 pm

Garden State AB Post-concert afterglow honoring MSNJ’s 218th President, Donald Cinotti, MD sponsored by the Hudson County Medical Society by invitation only

Saturday, May 14 7:30 am – 8:45 am

Breakfast and possible presentation

7:30 am – 3:00 pm

Registration

8:00 am – 9:00 am

Exhibitors

9:00 am – 10:30 pm

MSNJ House of Delegates

Welcome & Opening Remarks Opening Session of the House of Delegates 10:30 am – 11:00 am

Coffee Break & Exhibitors

11:00 am – 12:30 pm

MSNJ House of Delegates

Business Meeting and Elections Outgoing Presidential Address Installation Ceremony & Incoming Presidential Address 12:30 pm

Lunch & Exhibitors

2:00 pm – 4:00 pm

CAPITOL CLUB RECEPTION

5:00 pm – 6:00 pm

Judicial Council Meeting

7:00 pm – 8:00 pm

Inaugural Cocktail Reception honoring Niranjan (Bonki) Rao, MD

8:00 pm – 11:00 pm

Inaugural Dinner & Dance honoring Niranjan (Bonki) Rao, MD sponsored by St. Peter’s University Hospital (Black tie optional) $200/ticket

11:00 pm

Inaugural Afterglow Reception

Sunday, May 15 7:00 am – 9:00 am

County Medical Society Breakfast Meetings

7:30 am – 11:30 am

Registration

9:00 am – 2:00 pm Resolutions

MSNJ House of Delegates

12:00 pm – 1:00 pm

Golden Merit Registration

1:00 pm – 3:00 pm Golden Merit Awards Program MSNJ honors those members who graduated with their medical degrees in the classes of 1960 and 1961. $60/ticket *Program & Schedule of Events subject to change. Please visit www.msnj.org for more updates Refund Policy for Registration Form - All refund requests must be received by May 6, 2011. No refunds will be given after that time. Registration refunds are subject to a 5% cancellation processing fee. Refunds will be issued in the same form payment was made. Cancellations must be received in writing: via email (info@msnj.org), fax (609.896.1884) or mail (MSNJ, Attn: Member Resource Center, 2 Princess Rd., Lawrenceville, NJ 08648). Please allow two weeks from receipt of refund request for processing. If you would like confirmation of receipt of your refund request, please contact the Member Resource Center at 609.896.1766 ext 0.

19

The Medical Society of New Jersey, established 1766 ✦ “Leaders in healthcare, leaders in life”

2011 MSNJ Calendar Contest Winner: Daniel D’Auria, MD

Runners up: Michael Mund, MD Mark Schwartz, MD Monte B. Pellmar, MD Ravi D. Goel, MD Eleanor Gonnella, MD Steven M. Rosner, MD Vijay Gupta, MD Michael Richardson, MD Eva Horn, MD J. Mark Meredith, MD Paul Roberts, MD

Medical Review Officer Training (Special CME Programs) Come learn the technical, legal and business procedures and guidance to act as a Medical Review Officer. This valuable certification and occupational medicine credential is required by some state drug testing laws and the U.S. Department of Transportation.

Comprehensive MRO Training Including Hair, Sweat, Oral Fluid, Alcohol Testing, and AAMRO Certification Exam Steamboat Springs, CO January 14–16, 2011 Washington, DC February 25–27, 2011 NEW! Recertification: Effective October 1, 2010, DOT regulations require all certified Medical Review Officers to maintain their certification and “re-qualify” (i.e., recertify) every 5 years. To re-qualify after October 1, 2010, an MRO must attend a comprehensive MRO training program and pass the requalification exam.

800/489-1839 www.aamro.com 20

Physician Advocate ✦ Winter 2011

MANOR FOR SALE: HOPEWELL, NJ 14 Applewood Drive, Hopewell, NJ 08525 Listed at: $1,357,111 Exquisite estate home for sale in serene custom enclave, with a spectacular view of the Hopewell Valley Golf Course.

This 12-year-old manor home was renovated very extensively with $300,000 in upgrades in 2009.

Old world quality of craftsmanship is complimented with the stunning interior design work of the renowned Deborah Lehman. Elegant and distinctive lighting fixtures from the exclusive Heritage Lighting, Lambertville, NJ. The property was beautifully landscaped by the award winning Landscape Design Group of Doylestown, PA. Mature plantings, flowering trees, blue stone walkways and tree lined circular drive have created an impressive and tranquil retreat that will satisfy even the most discriminating tastes.

Contact: Franke Previte – 908.393.1544 or 732.489.2646 (cell) — MINUTES FROM BOTH NEW MERCER COUNTY HOSPITALS —

Focused.

Experienced.

Success.

Sun National Bank’s healthcare group offers a full spectrum of financing, treasury management and advisory solutions for hospitals, surgical centers and practices.

Find out how we can build a healthy partnership and a strong future together.

Proud Partner of the Medical Society of New Jersey

Sun National Bank

1-800-SUN-9066 • sunnb.com/healthcare • More than 60 NJ locations

Recognized by Forbes as one of America’s most trustworthy companies – 5 years running.