2018 Announcements

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IMPORTANT! CALL TO ACTION OUT OF NETWORK LEGISLATION 

Dear Doctors:
 
          The Out-of-Network legislation is scheduled for a VOTE in the Senate, Thursday, April 12th.  Please contact the following Senators to seek their opposition to S485.
 
Senator Richard Codey:     973-535-5017
Senator Ronald Rice:         973-371-5665
Senator Nia Gill:                973-509-0388
Senator Nicholas Scutari:  908-587-0404
Senator Stephen Sacco:      201-295-0200
Senator Brian Stack:           201-721-5263
Senator Vin Gopal:             732-695-3371
Senator Shirley Turner:      609-323-7239
Senator Joseph Lagana:      201-576-9199
Senator Nellie Pou:             973-247-1555
Senator Jeff Van Drew:       609-465-0700
 
ACCESS TO CARE COALITION TALKING POINTS:
 
·        New Jersey physicians ask that you please OPPOSE A2039/S485 "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act."
 
·        There is NO guarantee or mandate that A2039/S485 will reduce premiums or result in healthcare savings for payers or patients as testified to by the New Jersey Association of Health Plans.
 
·        The Senate Budget and Appropriations Committee has determined that there are NO state budget savings that will result from passage of A2039/S485.
 
·        A2039/S485 WILL exacerbate New Jersey’s already critical shortage of physicians, particularly specialists like Emergency Room Physicians jeopardizing the health of patients.
 
·        Physicians and hospitals are severely LIMITED in their ability to assist patients will medical bills by language in A2039/S485 that actually penalizes them for waiving co-pays and deductibles.
 
  There is a better way:
 
·        S791 (Sarlo) “Requires certain disclosures regarding health care costs; allows SHBP to negotiate directly with providers in certain circumstances; and establishes certain out-of-network patient protections.” was released UNANIMOUSLY by the Senate Budget and Appropriations Committee and will END Surprise Billing and PROTECT patients.
 
 
Out of Network-Call to Action 

The Out of Network bill is up for a vote in both Assembly and Senate Committees this Thursday, April 5, 2018.
 
Please click the button below to contact your legislators using the link below. 



Out of Network-Call to Action 

The legislature is about to take your bargaining power away when contracting with insurance companies.  The Out of Network bill is scheduled for a vote next week.
 
Please contact your legislators using the link below. 

www.msnj.org/advocacy

Thank you for your advocacy!

Important: Postponement of new AmeriHealth New Jersey policy regarding CPT® consultation codes 

Please be advised that AmeriHealth New Jersey will postpone the implementation of Claim Payment Policy #00.01.64: Consultation Codes, which outlines our reimbursement position on Current Procedural Terminology (CPT) consultation codes.

We previously communicated that this Claim Payment Policy would go into effect January 1, 2018, which would have aligned with reimbursement standards on certain CPT consultation codes set by the Centers for Medicare & Medicaid Services. However, the implementation of this policy will be postponed, and the Notification has been removed from our Medical Policy Portal.

Once the new implementation date is determined, we will post a new Notification on our Medical Policy Portal. We will also communicate this information in a future Partners in Health UpdateSM article.
If you have any questions, email us at consultcodes@amerihealth.com. Be sure to include your name, contact number, and provider ID number in your email.

CPT Copyright 2016 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.

Highlights of the 2018 Medicare Physician Fee Schedule (MPFS) Final Rule 

Click here to download the MPFS 

 
2018 Quality Payment Program Final Rule Highlights 

Click here to download the quality payment program document