ja n ua ry 2 012
Campus Eye Group Vision for Life The Only Destination Patients Need to Have for Complete and Continuous Ophthalmic Care Also in this Issue • Proposed Legislation Requiring Surgical Practices to be Licensed Passes House and Senate But Not Signed by Governor Christie • CMS Releases 2012 Medicare Physician Fee Schedule • From a Patient’s Point of View-What Doesn’t Kill You Makes You Stronger
Princeton Insurance knows New Jersey, with the longest continuous market presence of any company offering medical professional liability coverage in the state. Leadership: Over 16,000 New Jersey policyholders Longevity: Serving New Jersey continuously since 1976 Expertise: More than 55,000 New Jersey medical malpractice claims handled Strength: Over $1 billion in assets and $353 million in surplus as of December 31, 2010 Service: Calls handled personally, specialized legal representation, knowledgeable independent agents, in-office visits by our skilled risk consultants Knowledge: New Jersey-specific knowledge and decades of experience Innovation: Three corporate options, specialty reports, practitioner profiles, office practice toolkits, optional data privacy coverage
Publisher’s Letter Dear Readers, Welcome to the January issue of New Jersey Physician. Changes are coming soon. We are hard at work setting up our new website which will have our current issue featured each month along with an archive of past issues. Additionally there will be a section for late breaking news, so plan on visiting us often. We will also give readers the option of receiving our publication either by regular mail in hard copy, viewing online, or by email. We will soon allow you to communicate with us regarding how to best provide you with the state’s only voice for physicians. I have known Tom Touzel for many years. He has shared with me the battle he waged against his own cancer and the amazing results that have been achieved. Tom is a very determined person who gives every effort in life his full attention. I thought this story about him, originally published in a Canadian newspaper, might prove to be valuable to our physician readers to see serious illness from the other side. I hope you find it inspiring. Bollinger Insurance has taken a strong stand in the professional liability community, recently acquiring Argent Professional Agency as well as The Woodland Group, Allied Insurance Services Agency, and The Szerlip Agency. These acquisitions will make Bollinger one of the nation’s leading insurance agencies. They have formed
Published by Montdor Medical Media, LLC Co-Publisher and Managing Editors Iris and Michael Goldberg Contributing Writers Iris Goldberg Leon Smith, MD Leslie Thomas, CPA Anthony M. Rainone, Esq. Joseph Conn Keith Roberts, Esq. Debra C. Lienhardt, Esq. John Fanburg, Esq. Mark Manigan, Esq. Joseph Gorrell, Esq. New Jersey Physician is published monthly by Montdor Medical Media, LLC., PO Box 257 Livingston NJ 07039 Tel: 973.994.0068 Fax: 973.994.2063 For Information on Advertising in New Jersey Physician, please contact Iris Goldberg at 973.994.0068 or at igoldberg@NJPhysician.org
a new professional liability agency within the company which will be headed by Henry Kane and Brian Kern of Argent. Recently, legislation was passed by both the state house and senate requiring
Send Press Releases and all other information related to this publication to igoldberg@NJPhysician.org
surgical practices to be licensed. The matter is not law yet as Governor Christie has
Although every precaution is taken to ensure
not signed the ruling, thereby “pocket vetoing” the legislation.
accuracy of published materials, New Jersey
CMS has published the 2012 medicare physician fee schedule, which you will find inside. Unless there is further action, the new schedule calls for a 27.4% reduction in reimbursements on March 1. If the past is any indication of the future I wouldn’t count on these reductions taking place.
Physician cannot be held responsible for opinions expressed or facts supplied by its authors. All rights reserved, Reproduction in whole or in part without written permission is prohibited. No part of this publication may be reproduced or transmitted in any form or by any means without the written permission from Montdor Medical
We had the pleasure of meeting one of the most comprehensive opthalmic
Media. Copyright 2010.
practices in the state, Campus Eye Group. The vision of Dr. E. Bruce DiDonato, CEG is a full service vision center, offering the services of many sub-specialists within opthalmics who practices in one location. State-of-the-art technology includes the
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With warm regards,
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Michael Goldberg Co-Publisher New Jersey Physician Magazine
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Campus Eye Group Vision for Life
The Only Desitination Patients Need to Have for Complete and Continuous Ophthalmic Care CONTENTS
Health Law Update
Patient Point of View
New Jersey cancer docs form network
Argent Professional Insurance Agency, LLC announces its acquisition by Bollinger, Inc.
What doesnâ€™t kill you makes you stronger.
COVER STORY 2
New Jersey Physician
Cover Photo: E. Bruce DiDonato, Founder and President of Campus Eye Group
Surgery Center Liability Specialists 30 Technology Drive, Warren, NJ 07059
Argent Professional is New Jerseyâ€™s leading medical professional liability insurance agency, specializing in Ambulatory Surgery Centers, and other healthcare facilities. Our knowledge, expertise and access to all of the major NJ markets helps to ensure our clients find the best possible coverage at the lowest available rates.
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Campus Eye Group Vision for Life
The Only Desitination Patients Need to Have for Complete and Continuous Ophthalmic Care By Iris Goldberg
In today’s healthcare arena, patients have
Over time, technology was put into place in
and so we did, with the development of our
the opportunity to receive treatment from
order to provide state-of-the-art treatment for
retina center in 1989,” he reports. “And for more
an ever-growing number of physicians who
nearly every condition affecting the eye.
than 20 years now, we have been providing
have been highly trained in sub-specialized
everything right here,” Dr. DiDonato adds,
areas within a particular branch of medicine.
“During the 1980s, if you needed anything other
referring to the addition of virtually all specialty
While the benefits of this in terms of the
than glasses, contacts or perhaps a cataract
medical and surgical treatment for the eye as
level of care patients receive is obvious, the
operation or other small procedure, you had
well as the most innovative optical services
logistics for managing all of the trips to the
to go to a major university medical center,”
various locations that are often required can
Dr. DiDonato, relates. He shares that often
be challenging. Comprehensive vision care in
the patient would have an evaluation on the
Today, Campus Eye Group has evolved into a
particular, especially as patients grow older,
first visit and then be required to travel back,
multi-specialty, interdisciplinary eye care prac-
usually involves treatment from more than one
sometimes a considerable distance, days or
tice, including its own impressive Medicare-cer-
even weeks later for the appropriate treatment.
tified, AAAHC-accredited ambulatory surgery
This was prominently in the mind of E. Bruce
Dr. DiDonato remembers that he and others
specialized ophthalmic surgeons perform ev-
DiDonato, O.D., back in 1981, when he founded
in the field at the time were frustrated by the
ery conceivable surgical procedure for the eye.
Campus Eye Group. Dr. DiDonato invited
inefficiency of this system and the tremendous
skilled eye care providers from numerous sub-
inconvenience for patients. “I wondered why
Campus Eye Group’s ASC was actually
specialties to practice with him in one location.
no one had brought sub-specialty care here
developed in 1985 when Dr. DiDonato realized
center (ASC), where fellowship-trained sub-
the importance of providing the safest and most technologically advanced environment for his patients who were having cataract surgery. “I wanted to have more control over the outcomes,” he relates, citing concerns about possible complications. Since then, the ASC has been continuously updated with the most sophisticated laser and computerized equipment in the region, enabling the surgeons at Campus Eye Group to perform many advanced eye surgeries as well. Some of these include corneal transplants, treatment of diabetic retinopathy, macular degeneration and glaucoma. Additionally, eye muscle and eyelid plastic procedures are performed by Campus Eye Group’s skilled subp During LASIK vision correction, the surgeon creates a precise thin hinged corneal flap that is pulled back to expose the underlying corneal tissue.
New Jersey Physician
A great many of the patients who are treated at Campus Eye Group come for vision correction. In fact, there have been patients who have traveled from all over the United States and even some who have flown in from other countries to undergo LASIK laser vision correction surgery with the renowned experts at the Campus Eye Group. Their vast experience coupled with the latest LASIK technology has helped countless patients achieve 20/20 vision or better throughout the years.
Overview of Services Provided by Campus Eye Group • V ision Correction Cataract Surgery with Premium IOL Implants Lasik Laser Vision Correction PRK Laser Vision Correction Phakic Intraocular Lens (IOL) Surgery • C ornea Services Corneal Transplants DSEK Pterygia removal with amniotic tissue graft • R etina Services Laser treatments, Medical Care and anti-oxidant therapy to slow or reverse progression of Macular Degeneration Use of innovative medications and up-to-the-minute laser technology to treat Diabetic Retinopathy Latest techniques for treatment of Retinal Detachment
For patients in and around Mercer, Middlesex and numerous other
• G laucoma Treatments Advanced technology for early detection Minimally invasive laser therapy Surgical procedures to reduce intraocular pressure and prevent vision loss Shunt Implantation
counties in New Jersey and in fact, many who come from locations
throughout the tri-state area, Campus Eye Group has served as an all-
• O culoplastic Surgery Blepharoplasty (surgery to correct Ptosis or drooping eye) Surgical correction of Entropian and Ectropian (folding inward or sagging outward of lower eyelid) Eyelid reconstruction
p A specialized laser is used to reshape the cornea and the flap is then repositioned onto the underlying cornea without sutures.
inclusive hub, providing routine, medical, optical and surgical eye care, eliminating the need to travel to numerous ophthalmic facilities in order to address all of their eye care needs. “We do everything here that is done in tertiary and university care centers with the exception of oncology,” Dr. DiDonato emphatically states. He also points out the tremendous savings that are realized when insurance companies make payments to ASCs as compared to those made to hospitals as another significant advantage that Campus Eye Group offers. Brian M. Cohen, O.D. is Director of Clinical Services at Campus Eye Group. Dr Cohen discusses the comprehensive scope of the practice. “We have more than 30 doctors on staff here,” he remarks. “In fact, we’re one of the largest practices in the country,” Dr. Cohen states. In terms of the services offered, Dr. Cohen emphasizes that from routine eye care to the most advanced surgeries and treatments and everything that falls between, Campus Eye Group’s team of experts, equipped with the most innovative technology, provides it all. “We really are a one-stop location for complete eye care,” he says. (See Fig. 1)
• O cular Aesthetics Botox Injectable fillers for wrinkle removal • O ptical Services Hundreds of fashion and designer frames Advanced extra thin and light lenses Newest progressive bifocals IZON® lenses for high definition Safety and sports glasses Lens treatments including: UV protection, photochromic, polaroid, scratch resistance, anti-glare and fashion tints Prescription and non-prescription sunglasses • H earing Services Hearing evaluations with leading-edge diagnostic equipment Dual sensory evaluations Sophisticated hearing aids Licensed audiologist on staff
may not be good candidates for laser vision correction surgery, the physicians at Campus Eye Group can perform surgery to implant phakic IOLs for vision correction. These innovative devices, which are similar to contact lenses, are placed within the eye as an additional lens. Following this procedure, which takes less than 30 minutes, most patients experience improved vision immediately. In addition to the abundant volume of patients who are treated at the Campus Eye Group each year for cataract surgery and vision correction, many
p The lens with the cataract is removed
performed on site by the specialty-trained LASIK eye surgery is appropriate for the
implants (IOLs) to replace the lens that has
ophthalmic surgeons on staff. Dr. Cohen shares,
majority of patients who suffer from poor vision
become clouded, including ReStor, Technis
“What sets us apart from some other practices
due to myopia (nearsightedness), hperopia
Multifocal, Toric and Crystalens.
is the specialty care we offer. Many conditions
(farsightedness) and/or astigmatism. During
that a general ophthalmologist might refer out,
the brief outpatient procedure the surgeon
AcrySof ReStor and Technis are multifocal
first creates a precise thin-hinged corneal flap.
IOLs, which restore vision at all distances. The
Next, the flap is pulled back to expose the
Toric IOL corrects pre-existing astigmatism and
For example, corneal tissue can be affected by
underlying corneal tissue. A highly specialized
improves distance vision. The Crystalens is an
a number of serious eye conditions, such as
excimer laser then gently ablates (reshapes)
accommodating lens implant engineered to
keratitis, which is inflammation of the cornea
the cornea. The flap is then repositioned onto
correct presbyopia as well as nearsightedness
and keratoconus, in which the eye’s surface
the underlying cornea without sutures.
weakens causing the cornea to curve outward.
At Campus Eye Group custom LASIK is
Before the availability of these premium IOLs
corneal disease where the endothelium
achieved through wavefront technology that
many patients who underwent cataract surgery
becomes less able to control the cornea’s fluid
uses light projected on the back of the retina
still needed to wear eyeglasses at times,
content. Damage to the corneal tissue can lead
to create measurements of each patient’s
especially for reading. Today, the significantly
to impaired vision that often cannot be treated
growing number of cataract patients who opt
with laser vision correction.
waveprint is as unique as a fingerprint and
for these upgraded IOLs return for follow-up
enables the surgeon to customize the LASIK
visits delighted to report that they no longer
At Campus Eye Group, a fellowship-trained
procedure for each patient based on the
wear glasses at all.
cornea specialist who has performed thousands
we treat right here.”
Fuch’s Dystrophy is a progressive, inherited
information it provides.
of corneal procedures will do a comprehensive For some patients without cataracts who
Thousands of patients undergo cataract surgery at Campus Eye Group’s ambulatory surgery center each year. Leaving the facility with vision that has been restored or perhaps is better than it ever was is the outcome for a great number of patients. “Cataract surgery today has become a refractive procedure,” Dr. Cohen explains. “Patients’ expectations today are much higher than they were even five years ago,” he adds. In order to provide the best and most customized result for each individual patient, the surgeons at Campus Eye Group offer the latest and most sophisticated premium intraocular lens
New Jersey Physician
p The new lens is being placed into the eye
evaluation to determine the best treatment
may be asymptomatic initially, eventually the swelling of the retina interferes with vision. Left untreated, diabetic retinopathy can lead to blindness. The priority at Campus Eye Group’s retina center is to closely monitor diabetic patients with advanced testing in order to detect and treat this devastating condition as early as possible. With revolutionary medications and the most current laser technology, patients who are treated at Campus Eye Group for diabetic retinopathy are spared further progression of disease and can p A multifocal intraocular lens replaces the lens that was clouded.
also have a reversal of its severity.
remedy for each individual patient. If surgery is
aggressive wet AMD, caused by the abnormal
In some patients conditions affecting the retina
indicated, it is performed on site in the state-of-
formation of new blood cells, early detection
can cause the retina to separate or detach from
the-art ambulatory surgery center.
and treatment is crucial.
the underlying tissue. Retinal detachment
Progression of cornea disease may eventually
At Campus Eye Group an individualized
loss if not treated immediately. Dr. DiDonato is
can lead to sudden and permanent vision corneal
treatment plan is developed for each patient
pleased to inform that Campus Eye Group has
transplant surgery, during which a cornea
that may include a combination of laser
procured the technology to begin performing
obtained from a donor eye bank is expertly
treatments, Avastin or other drug injections,
retina reattachment on site. This service will
transplanted to the affected eye. A newer
and/or vitamin supplements to slow down or
be available imminently and will certainly be
partial transplant procedure, DSEK, which
in some cases, even reverse the progression of
a significant benefit for any patient or referring
stands for Descemet’s Stripping Endothelial
macular degeneration. “We are in our fourth
physician who suspects a retinal detachment.
Keratoplasty is now being performed at
generation of medications that are injected,
Campus Eye Group as well. During DSEK, using
which arrest the disease and in 15 percent of
Glaucoma, which affects the optic nerve, is
microsurgical techniques, the thin corneal
cases, vision actually improves,” Dr. DiDonato
another serious eye condition that requires
inner layer called Descemet’s membrane is the
is pleased to report.
immediate treatment to avoid permanent vision
only layer transplanted, along with endothelial
loss. However, glaucoma is a slowly progressing
cells, rather than the full corneal thickness as
Patients with diabetes are at great risk for
disease that can be managed quite effectively if
is done in the traditional transplant procedure.
developing diabetic retinopathy, a condition
caught early on and provides another example
The remainder of the patient’s healthy cornea
in which the blood vessels in the retina become
of the exemplary specialty care available at
is left in tact. DSEK is less invasive than the
damaged and leak blood. Although patients
Campus Eye Group.
standard corneal transplant and requires less recovery time. Many patients seen at Campus Eye Group come to be treated by its team of retina specialists. When retinal tissue is damaged by injury or disease, the ability of the retina to transmit light may be compromised, leading to vision loss or even blindness. For individuals who are over the age of 65, macular degeneration (AMD), which is a partial deterioration of the part of the retina known as the macula, is the leading cause of blindness. Whether suffering from dry AMD which is caused by a gradual breakdown of cells in the macula or the rarer and more
p Besides his role as President of the practice, Dr DiDonato makes time to treat patients January 2012
These aberrations have a significant impact
New Jersey and beyond has been the mission
on the quality of vision affecting things like
at Campus Eye Group since it was founded
depth perception, crispness, contrast, color
three decades ago. Dr. DiDonato and the other
perception and night vision. From this data a
expertly trained specialists who have joined
unique “eyeprint” is derived. Like fingerprints,
him throughout the years have continuously
no two individuals have the same one. In fact,
each eye has its own unique print. Campus Eye
technologically advanced eye care available
Group patients who are found to be appropriate
today. As Campus Eye Group begins another
candidates for the Izon® technology receive
decade, the vision of a future with endless
eyeglasses that provide vision correction
possibilities for its patients is crystal clear.
created solely for them that is far superior to what they were able to have with standard
Campus Eye Group is located at 1700
Whitehorse-Hamilton Square Road, Hamilton, NJ 08690. For more information or to make
Preserving as well as enhancing the gift of
an appointment call (609) 587-2020 or visit
sight for hundreds of thousands of patients in
p Dr Cohen administers the IZON® exam
The skilled surgeons offer advanced testing and effective treatment options to arrest glaucoma before significant damage can occur. Depending upon the type and severity of glaucoma in each individual case, eye drops, minimally invasive laser therapy and/or surgery to reduce intraocular pressure are used. In addition to the comprehensive spectrum of routine and specialty eye care, patients who visit Campus Eye Group have access to an impressive array of optical services. Besides hundreds of the latest fashion and designer eyeglass frames, Campus Eye Group offers the latest technology in lenses and lens treatments. A revolutionary development in eyewear vision correction has recently allowed the skilled opticians at Campus Eye Group to customize each individual prescription to match every patient’s unique optical requirements. Izon® High-Resolution Lenses are produced using information from measurements obtained in the traditional way and also a revolutionary computerized capability to measure tiny microscopic irregularities or aberrations that oftentimes distort light as it passes through the cornea and lens and onto the retina.
New Jersey Physician
p Izon technology produces unique “eye prints” (top) for each patient, which are used to create customized lenses for vision without aberrations.
Health Law Update
Provided by Brach Eichler LLC, Counselors at Law
Medicinal Marijuana Program Rules Take Effect; BME Clarifies Position on Prescribing Marijuana On December 19, 2011, the rules governing New
vised from the BME’s originally proposed rules.
untoward side effects, physical problems or
Jersey’s Compassionate Use Medical Marijuana
The revisions came in response to controversy
psychological problems. Notwithstanding this
Act went into effect. The adopted rules – origi-
surrounding the Legislature’s interpretation of
clarification, if such problems do arise, then the
nally proposed by New Jersey’s Department of
the BME’s rule as requiring physicians to pe-
prescribing physician is required to either (1)
Health and Senior Services (DHSS) – are iden-
riodically attempt to wean patients off of their
modify the dose of marijuana, (2) undertake a
tical to those proposed by DHSS in February
medicinal marijuana. The revised rules retain
trial of other drugs or treatment modalities or
a provision requiring physician reassessment
(3) discontinue the use of marijuana. Addition-
of the patient’s medicinal marijuana use every
ally, a physician who is required to take action
In addition to DHSS’s rules, the New Jersey
three months. However, the new rule makes
must also consider referring the patient for in-
State Board of Medical Examiners (BME) ad-
clear that physicians can continue to prescribe
dependent evaluation or treatment in order to
opted its own rules concerning the prescrip-
medicinal marijuana if it is helping the patient
achieve the patient’s objectives.
tion of medicinal marijuana, which were re-
reach his or her treatment objectives with no
CMS Releases 2012 Medicare Physician Fee Schedule CMS published the Medicare Physician Fee
ated with the second and any subsequent
Records incentive program have been up-
Schedule (MPFS) for calendar year 2012 late
advanced diagnostic imaging tests per-
dated and modified to allow for increased
last year. Payments under the MPFS are based
formed on the same patient on the same
upon the Sustainable Growth Rate formula im-
day. For 2012, this policy is expanded to
•T he quality and cost measures that will
posed under the Balanced Budget Act of 1997.
apply to the professional component as
be used in establishing a new value-based
Based on that formula, the 2012 MPFS provides
well, with payment being reduced by 25%
modifier have been finalized, which will
that Medicare’s payments to physicians will be
for the professional component associ-
ultimately be used to reward physicians
reduced across the board by 27.4%. However,
ated with the second and any subsequent
for providing higher quality and more effi-
on December 31, 2011, President Barack Obama
advanced diagnostic imaging tests, includ-
cient care, commencing with specific phy-
signed legislation which delays the implemen-
ing MRI, CT and ultrasound.
sicians and physician groups in 2015 and
tation of the reduction until February 29, 2012.
• The Geographic Practice Cost Indices will
Unless there is further action, Medicare pay-
incorporate different data sources to deter-
•P roviders are required to conduct a health
ments will be reduced as of March 1, 2012.
mine the various cost differences among
risk assessment as part of the Medicare
localities in connection with the physician
patient’s annual wellness visit, and Medi-
Some of the other key provisions of the MPFS
work RVU, the practice expense RVU and
care will increase payment for the HCPCS
the malpractice RVU.
codes associated with the health risk as-
• The Multiple Procedure Payment Reduc-
•C ertain aspects of the Physician Quality
tion policy currently reduces payment by
Reporting System, the e-Prescribing incen-
50% for the technical component associ-
tive program, and the Electronic Health
expanding to all physicians by 2017.
sessment to take into account the additional time and paperwork involved.
Health Law Update
Proposed Legislation Requiring Surgical Practices to be Licensed Passes House & Senate But Not Signed by Governor Christie On January 9, 2012, legislation that would have
quired to register with DHSS and obtain either
enactment. The bill provided, however, that
required surgical practices to be licensed by
certification by CMS as an ambulatory surgery
surgical practices in operation prior to the date
DHSS as ambulatory care facilities was passed
provider or ambulatory care accreditation from
of enactment would not have been subject to
by both the New Jersey Senate and Assem-
an accrediting body recognized by CMS.
the ambulatory care facility assessment or to
However, Governor Chris Christie did
DHSS regulations pertaining to physical plant
not sign the bill into law by January 17, 2012,
This bill would have repealed the registra-
and functional requirements for ambulatory
thereby “pocket-vetoing” the legislation.
tion requirement and instead mandated that
der the “Codey Law,” surgical practices are not
all surgical practices be licensed by DHSS as
required to be licensed. Instead, they are re-
ambulatory care facilities within one year of its
New Jersey Bill Would Require Certain Advertising Disclosures A bill originally introduced last June in the
The bill requires that:
•C ertain health care professionals who pro-
New Jersey Legislature, which requires certain
•A person licensed to practice medicine or
vide information regarding health care ser-
health care professionals, working in an of-
surgery by the State Board of Medical Ex-
vices on an internet website that is directly
fice, to disclose to patients their name, type of
aminers, who is also certified in a medical
controlled or administered by that profes-
license and highest level of academic degree
specialty, must disclose, while working in
sional or that professional’s office person-
(A4185), was recently reported out of the As-
an office, the name of the certifying board
nel, must prominently display on that in-
ternet website their name, type of license
sembly Regulated Professions Committee. The bill requires that information must either be
• Advertisements by a health care profes-
prominently displayed in the office of such a
sional for health care services must include
health care professional or in writing to a pa-
the professional’s name, type of license and
The bill was not addressed in the last day of the
tient on the patient’s first office visit.
highest level of academic degree
legislative session held on January 9, 2012.
and highest level of academic degree
N.J. Cancer Docs Form Network By Jaimy Lee
A group of physician practices in New Jersey
Associates; Hematology Oncology Associates
compassionate care, cutting-edge therapies
has formed an oncology physician network
of North New Jersey; Hope Community Cancer
and clinical trials while reducing the cost of
that comprises more than 70 cancer-care
Center; Monmouth Middlesex Hematology
cancer care,” said Dr. Andrew Pecora, president
specialists and 500 employees at 20 care sites
Oncology; Northern New Jersey Cancer
of the network.
within the state.
Associates; Sparta Hematology Oncology; The
Regional Cancer Care Associates, based in
Center for Cancer; and the practices of Dr.
Pecora is the chief innovations officer and
Kenneth Nahum and Dr. Usha Niranjan.
vice president of cancer services at the John
Hackensack, N.J., expects to treat about 90,000 patients each year, according to a news release.
Theurer Cancer Center, which is part of the “Regional Cancer Care Associates physicians
Northern New Jersey Cancer Associates
and staff accept our responsibility to work
network, according to a spokesman for
The network is made up of 10 oncology
with insurance companies, our hospitals
Regional Cancer Care Associates.
and referring physicians to provide patients
New Jersey Physician
Health Law Update
New Jersey Bill Phases Out Tax on Cosmetic Medical Procedures: Awaiting Governor Action A bill recently passed by the New Jersey legis-
as well as the administrative burden that the tax
lature would phase out New Jersey’s cosmetic
places on providers who are required to collect
medical procedure gross receipts tax. The tax,
initially passed in 2004, currently imposes a 6% gross receipts tax on the purchase of cos-
The bill (A-3646/S-1988) would begin reduc-
metic medical procedures, defined as those
ing the current 6% rate on such procedures
procedures performed in order to improve an
to 4% starting on the first day of the calendar
individual’s appearance where such proce-
quarter after the bill is passed. The rate would
dures do not significantly serve to prevent or
then drop to 2% on or after July 1, 2012. The
treat illness or disease. This includes cosmetic
tax would subsequently be eliminated for pro-
surgery, hair transplants, chemical peels and
cedures performed after July 1, 2013. During
cosmetic dentistry, as well as a host of other
the final voting day of this legislative session on
procedures. The tax is paid by the individual
January 9, 2012, both the general assembly and
receiving the cosmetic procedure and collect-
the senate voted to approve the bill, and it has
ed by those billing for the procedure. The bill
now been sent to Governor Christie for signa-
is meant to reduce the cost of such procedures
ture or veto.
Let Brach Eichler’s Health Law Practice Group Help You Chart a Strategic Course For Your Health Care Business Health care providers have long come to rely on the attorneys of Brach Eichler to navigate the regulatory environment at both the state and federal levels. Now that health care reform is being implemented, Brach Eichler is ready to help you make sense of the significant changes, the statutory framework and the ramifications for health care providers in New Jersey. Health Law Practice Group Todd C. Brower Lani M. Dornfeld
John D. Fanburg Joseph M. Gorrell
Richard B. Robins Jenny Carroll Chad D. Ehrenkranz
Carol Grelecki Debra C. Lienhardt Kevin M. Lastorino Mark Manigan
Lauren Fuhrman Eric W. Gross Rita M. Jennings
Leonard Lipsky Isai Senthil Edward J. Yun
101 Eisenhower Parkway • Roseland, New Jersey 07068 • t. 973.228.5700 • f. 973.228.7852 • www.bracheichler.com January 2012
New Jersey Statehouse NJ Bill Would Require Health Care Workers to Get Flu Shots By Susan K. Livio
Beginning in the fall, medical professionals
testifies to their decision not to get vaccinated,
oppose any vaccine mandate. “This opens
who come into contact with patients would
according to the bill.
the door for vaccine mandates for adults.
have to get a flu shot under a bill that won final legislative approval Monday evening.
Records will be maintained regarding who has All health care facilities would have to report its
received this vaccine and who has declined
annual compliance rate to the state Department
it,’’ according to an email sent Friday by the
Health care facilities would have to provide a
of Health and Senior Services, according to the
New Jersey Coalition for Vaccine Choice to its
vaccination program for its employees by the
would have to get the vaccine, show proof they
The bill passed, despite calls from anti-vaccine
The Senate passed the bill 36-3 just before 6
got it on their own, or sign a statement that
groups urging people to tell lawmakers to
p.m.; the Assembly passed the bill last month.
start of the next flu season in the fall. Employees
Singer Bill to Require Study of Looming Doctor Shortage in NJ Approved by Senate Health Committee Legislation sponsored by Senator Robert Singer
Singer’s legislation, S-173, was introduced in
discussing the redistribution or expansion
(R-30) which would require the Commissioner
response to a report issued by the Physician
of residency slots to address shortages in the
of Health and Senior Services to convene a
Workforce Policy Task Force in 2010 which
state and investigating ways to include more
planning summit to examine an expected
predicts a shortfall of nearly 3,000 doctors
community hospitals in resident rotations
shortage of physicians practicing in New Jersey
in the Garden State by 2020, including 1,000
in family medicine, internal medicine and
has been approved by the Senate Health,
primary care physicians and 1,800 specialists.
The legislation seeks to address that shortage
“The summit proposed by this legislation
“A recently completed report predicts that
by requiring the Commissioner of Health and
would bring together experts from across
within the next decade, New Jersey will face a
Senior services to convene a strategic planning
the state to determine the most effective way
shortage of thousands of physicians practicing
summit comprised of relevant State agencies,
to prevent or minimize the looming doctor
in family care and important specialties,” said
boards and key stakeholders, including
shortage,” added Singer. “Once we have their
Singer. “Unless we get to work now to prevent
recommendations, we will be able create and
that shortage, many New Jerseyans may soon
teaching hospitals in the state.
Human Services & Senior Citizens Committee.
enact a plan to ensure that New Jersey trains
find themselves without doctors or unable to
and retains enough doctors to meet all of our
obtain appointments or treatments when they
The summit would be charged with analyzing
New Jersey Physician
Argent Professional Insurance Agency, LLC Is Acquired by Bollinger Argent Professional Insurance Agency, LLC
prospect of creating one professional liability
professional liability insurance for physicians
announces its acquisition by one of the nation’s
division within Bollinger, and are honored to
and healthcare facilities, accountants and
leading insurance agencies, Bollinger, Inc.
be tasked to lead it,” commented Henry Kane,
“Bollinger is a leader in virtually every area of
ARM, President, Argent. Bollinger, Inc. is headquartered in Short
the insurance industry, and with the acquisition of Argent, we feel we have solidified our place
The acquisition also comes at a time when
Hills, NJ with branch offices in Greenwich CT,
on top of the professional liability market as
many professionals – particularly in healthcare
New York NY, Monticello NY, Philadelphia PA
well,” remarked Jack Windolf, CLU, CPCU,
– are experiencing widespread consolidation
and additional NJ locations in Moorestown,
Bollinger Chairman and CEO. This acquisition
and regionalization. “As the clients we serve
Sparta, Vineland and Wall. The firm has over
will make Bollinger one of the largest
throughout a number of professions continue
440 employees and is currently ranked as the
professional liability insurance agencies in the
to expand geographically, and diversify into
nation’s 17th largest insurance broker.† It is one
nation, combining Argent’s vast network and
new areas with new exposures, we are thrilled
of the 2009 Best Places to Work in Insurance.††
seasoned leadership, with Bollinger’s extensive
to be able to partner with Bollinger . Having
resources and national presence.
access to Bollinger’s
Bollinger has formed a new professional
resources helps ensure that our clients’ needs
wide range of customers, as well as specialty
liability division within its agency in recognition
will be met for many years into the future,”
insurance programs for golf and country clubs,
of its new role as a leader in the niche. In
noted Brian Kern, Esq., Co-Founder of Argent.
amateur sports, and schools and colleges.
also recently acquired other agencies with
Argent Professional Insurance Agency, LLC,
For more information on Bollinger, Inc.
was founded in 2009 by Henry Kane, ARM,
The Woodland Group and Allied Insurance
and Brian Kern, Esq., and has grown rapidly to
Services Agency. “We are excited by the
become one of New Jersey’s leading writers of
Bollinger provides business and personal insurance and employee benefit programs to a
addition to acquiring Argent, Bollinger has expertise,
† As reported
What Doesn’t Kill You, Makes You Stronger
By Justin Bromberg
bleeding started and I stopped taking Coumadin and it kept on bleeding,” he recalled. “Within a week, I was in the hospital.” His first surgery took place in Miami in April 2005, and Touzel recalls his doctor coming in post-operation and uttering a few simple sentences. “He said, ‘So Tom, can you hear me and understand me?’ I said, ‘Sure.’ He said, ‘Well, it’s not pretty. What you need to do is go home and get your s--t together.’ That’s literally what he said - and he walked out of the room.” Touzel decided right then and there that the diagnosis would not control his life. He began researching cancer care centres that deal with bladder cancer and decided on the M.D.
what you need to do,’ that’s when you lose.
Anderson Cancer Center in Houston, Texas.
after deciding several years ago that he would
“It’s important to get involved in your own
The surgeon he would see was Dr. Colin
not succumb to bladder cancer, chose to fight
care and be involved with doctors and nurses
Dinney, though the latter didn’t know it yet.
it, and won.
and technicians and so on, so that you
om Touzel learned one of life’s most important lessons, perhaps unintentionally,
Touzel, who lives in Vankleek Hill but travels
understand what’s going on and you can better
“I went into the clinic and they told me they
communicate to them what’s going on.”
weren’t taking any new patients,” said Touzel. “So I went back to admissions and said, ‘I know
abroad on a regular basis, said despite having to undergo regular checkups for his health, he
Touzel was first diagnosed with bladder cancer
there’s a great turnover in patients. I will sit here
lives a relatively fit and active lifestyle - and he
in the spring of 2005, when he visited his
and wait until Dr. Dinney comes to me.’
primary physician in Fort Lauderdale, Florida. At the time, he was taking a blood thinner
“The next morning I went back there, and
His advice? Take your care into your own
(Coumadin) after suffering a stroke about a
around 11 o’clock, he came over and said, ‘Mr.
hands and be relentless.
decade earlier - and wrongly assumed the
Touzel, I understand you’re pretty persistent.’
blood in his urine was linked to the medication.
I said, ‘I am, because I want a winner. I don’t intend to lose this battle and I want you on my
“No matter what you’re dealing with, especially with cancer, the proactive are the survivors,”
“I never thought to discuss it with my doctor
he said. “When you sort of walk in and say, ‘Do
until one time, when I was in Korea and the
New Jersey Physician
Touzel had with him his MRIs, scans and
and metastize and spread?” he noted.
reports, but nevertheless was scoped again at
“Whether you’re in Canada or the U.S. - both medical systems work - you still need to learn
M.D. Anderson. The clinic would not offer a
But what gives him such a positive outlook on
how to work the system,” he said. “You can’t
definite prognosis, only saying its team would
his condition, Touzel was asked.
just sit back and let the system work you. When
do the best it can do - along with robotic surgical procedures and drugs.
you have an issue that needs special attention, “There are some truths that are absolute,”
you need to demand special attention from
he stated. “The proactive are the survivors.
primary physicians - and you’re entitled to it.
“I just started with treatments there, including
The people that engage their own illness and
two surgeries, and was rendered clean and
treatment are the ones that come out on top.
“It’s the same thing down here [in the U.S.]
declared clean,” he said. “A couple of years
That’s all I know but I’m grateful that I’m happy
with Medicare and insurance; most companies
ago, I reached my five-year point of being clean
and healthy and have a great family and live a
have restrictions on the doctors themselves,
and [Dinney] said, ‘Okay, are you ready for a
on who’s included in their plan, and you have
prognosis? If you keep doing exactly what we
to make demands. Speak up and say, ‘I am a
tell you to do, I can promise you will not die of
This week, Touzel also celebrates a noteworthy
human, I am covered by you and that is what I
milestone: once an alcoholic, he is now 38
want - and I want the best.’”
years clean in Alcoholics Anonymous. Asked One year into the treatment, Dr. Dinney asked
about what inspires him to be so forthcoming
Touzel refers to that approach as “speaking up
him to serve as a patient advocate for bladder
- and public - about his disease, he says being
and attacking the system, making it do what it’s
cancer. Touzel said he was initially concerned
involved in that group and abstaining from
supposed to do for you.”
it would be “like giving people ice and water,”
alcohol taught him an important lesson that he
but he quickly learned it meant being part of
readily referred to after his battle with cancer.
“I am not a religious guy, but I’m pretty spiritual,” he continued. “I’m not a Sephardic Jew or a
“a very complex group of people that acts as “I learned very early in AA that the key to
born-again Christian or a radical Buddhist, but
survival is sharing,” said Touzel. “Sharing, not
we have to somehow develop a sense of faith...
“It’s not about battles but translating what
being afraid to share you story and your fears
and that’s really where the freedom for all of us
they’re feeling and thinking, making sure their
and I’ve always done it. That’s sort of the way
comes, is engaging and embracing the faith -
questions are answered, their needs are met,
it is with cancer, too. The fact that I’m cancer
wherever we find it.
no bulls--t, up front and honest,” he said. “I’ve
free today is something that can give hope to
been doing that for five years now and I’ve
someone, someday, who is just embarking on
“We are powerless over all kinds of things in
become involved with other advocates and
this world, and cancer is one of them, but we’re
referees between doctors and patients.”
not powerless in dealing with it. People need to
many other disease sites.”
search out the optimum in treatment and care
Take your care into your own hands and be relentless.
and go for it.” Those are the so-called words of wisdom from a man who, at an age where most people settle into retirement, now travels the world as a judge for dog shows. Touzel relocated to
“They say, ‘Look, an old fart with wrinkled hair
Vankleek Hill several years ago after operating
Bladder cancers is one of the cancers of which
has beat it’ and they have hope then. They also
a kennel in Pointe-Fortune for 20 years, noting
there is no cure, meaning it requires regular
see patients walking around with no colour in
“this area is really home.”
care and management. Touzel continues to be
their face and that’s frightening - so we need
examined every three months and will likely do
to keep the hope up for all these people.
He doesn’t spend much time in the gym, but
so for the rest of his life - as there’s always the
Everybody is entitled to hope and faith.”
calls himself “fairly fit and active” as well as grateful to live the lifestyle he does - and when
chance it’ll “pop up” again.
Words of advice
he’s tired of flying on airplanes, to be nestled
“We all have cancer cells floating around in our
Touzel’s advice, again, is to be proactive - and
comfortably in eastern Ontario.
systems and one of the great mysteries is: what
don’t assume you can just sit back and let the
triggers them to grow and become tumours
system take care of you.
“Be proactive - if not, you’re giving up.” January 2012
Food for Thought
Super Bowl Sunday Buffalo Wings Roseland, New Jersey By Iris Goldberg Michael and I have been attending Super Bowl par-
Fast forward to Super Bowl 2012. Giants vs. Patriots.
was surprised to see him walk into my hospital room.
ties since we moved to New Jersey. Back then, as
Even I am excited. Friends who live in Roseland have
It was only half-time. “Why are you here?” I asked. “I
many as ten couples, each with anywhere from one
taken on the annual event. There are five couples.
couldn’t enjoy it without you,” he answered with a
to three children in tow, gathered at one particular
Two are from the original group. We are now “ma-
straight face and the utmost sincerity.
home in Livingston every year. They had a big play-
ture” adults ranging in age from late 50s to early 60s.
room down in the basement where all the kids could
The moment we arrive, Michael heads straight for the
I am looking forward to attending many more Su-
go (be banished to is more accurate), leaving the
den where the other men are already settled. I take
per Bowl parties with Michael in the years to come.
adults upstairs to enjoy the game, each other and the
my spot at the kitchen table. Does this sound famil-
Wherever and with whomever we find ourselves seat-
food and drink. While this would seem to be a fine
iar? Wait, it gets better.
ed, Super Bowl Sunday has come to be about good
plan on paper, it actually played out like this:
people, good food and this year- a team that brought I sit next to a lovely woman who I like very much but
us all to our feet. Although I have to say, I kind of
It would take about five minutes until a fight broke
only see from time to time at various events – wed-
missed the kids.
out downstairs, requiring at least two moms to ref-
dings and funerals mostly. She has a full-time career
eree. The men were already congregated in the den
as do I. She immediately pulls out her cell phone to
in front of the television, never to be seen or heard
show me a picture of her granddaughter and I re-
from again until it was time to collect the kids and
spond by sharing every detail of my daughter’s preg-
go home. The women would sit around the kitchen
nancy. Next, a third woman reveals the plans for her
table, snacking and commiserating. Every so often,
son’s upcoming “destination” wedding.
one or two moms would run downstairs to negotiate a settlement. Also, a child or two would find his or
By this time the game has started and the men are
her way upstairs now and then to complain or to just
screaming every few minutes. We are watching on
get some TLC.
a smaller TV in the kitchen which has a time delay so we hear the mens’ shouts before we actually see
When the women did have a chance to talk, the topic
what has occurred. It doesn’t really matter because
was almost always something about their children.
we are only half-watching. While we are conversing
Toilet training, the “terrible twos,” sibling rivalry,
we are feasting on a variety of scrumptious delights.
Michael’s Super Bowl Sunday Buffalo Wings
Someone has made a multi-layered creation of gua-
intellectual development (most of us were former
camole, bean dip, salsa, Monterey Jack, shredded let-
Chicken wings - separated into two main
teachers), pre-school programs, etc., were the most
tuce and other ingredients that I’m sure I am forget-
pieces, and toss out the tip
common subjects. In the days when the kids had not
ting. There was a lovely crudite with a tangy dressing
Salt, Pepper, Garlic Powder, Flour
yet started school, we were all stay-at-home moms
and a variety of chips, nuts, cheeses, etc. Our contri-
Oil for frying in a sauté pan
so this was truly our main focus. I must admit, there
bution was the wings.
were many years when I didn’t even know which teams were playing.
Michael had spent most of the afternoon preparing about 40 of these beauties. They were a hit! Just the
Now for the food! The fare was always the same. Our
right amount of heat and the meat was perfectly
hostess, Barbara found a way to make Super Bowl
seasoned and cooked. I was so proud of him that I
Sunday a charitable event. She purchased “sloppy
glanced toward the den hoping to catch his eye. No
Joes” and all of the sides from a deli that contributed
such luck. He was caught up in the excitement of the
part of their profit to a cancer-fighting organization.
game and the camaraderie of other men.
The only items that varied were the nibbles. Usually,
1 cup of Frank’s Original Flavor Hot Sauce (must be Frank’s, do not substitute) One stick of butter Celery Good blue cheese dressing such as Marie’s In a large bowl, place the chicken, generously add the salt, pepper and garlic powder, mix together. Put enough flour into bowl to lightly coat the wings by stirring. Heat the oil to about 375º and cook the wings to a golden
each couple contributed something. Whatever there
I suddenly remembered one Super Bowl Sunday
brown. Place them in a heat proof bowl, Mix
was – nachos, miniature franks in blankets, crudite –
many years before, when I did not join Michael and
the Frank’s Hot Sauce in a separate pan with
everything tasted delicious, especially when accom-
the kids at the usual party. I was in the hospital re-
the melted butter and stir until combined. Pour
panied by a bloody Mary or a glass of wine. I remem-
covering from surgery. I had encouraged him to go
the sauce over the cooked wings. Serve with
ber I particularly enjoyed the tangy buffalo wings that
without me, thinking it would be good for him to
the celery and blue cheese dressing on the side.
were a tradition on this special Sunday.
spend an enjoyable few hours away from the hospi-
Can be cooked ahead and warmed in the oven
tal, watching the game in the company of his pals. I
when ready to serve.
New Jersey Physician
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