Final Days of the 2016-2017 Legislative Session
SURPRISE COVERAGE/OON BILLING BILL STALLS
NJ MEDICAL SCRIBES AS PMP DELEGATES
NJPMP DATA TO BE SHARED WITH EDIE
ED EXEMPTION TO CHECK THE PMP PRESERVED –
MANDATE DELAYED
New
Jersey has a new Governor. Governor Phil Murphy was sworn into office
with Lieutenant Governor Sheila Oliver at the War Memorial in Trenton
today, January 16, 2018. The Executive and Legislative Branches are
now all majority held by democrats.
OUT OF NETWORK REFORM: The Out of Network Legislation, for the fourth
time (8 years), was not approved by the Legislature prior to the end of the
2 year legislative session. NJ-ACEP has actively opposed the arbitration
models that have been proposed by Senator Vitale and Assemblyman (now
Speaker) Coughlin and will continue its support of Senator Sarlo’s and
Assemblyman Mukherji’s legislation promoting transparency and disclosure
when providing an out of network benefit to patients. Both measures will be
reintroduced for the new 2-year session with one of the OON bill’s
sponsors, Speaker Craig Coughlin, taking on a new leadership position the
Assembly. Governor Murphy still believes there may be budget savings
for state plans with out of network reforms, so this will definitely be
debated early on in the new legislative session.
Gov. Chris Christie did sign 108
bills and pocket vetoed at least 50 others in his final days in
office. The following bills of interest to NJ-ACEP were active upon:
BILLS SIGNED
EDIE/PMP INTEGRATION AND MEDICAL
SCRIBES AS PMP DELEGATES AUTHORIZED
New Jersey is now one of only a
handful of states to authorize its state PMP to share prescription data
with an emergency department information exchange (EDIE) and authorize
medical scribes as PMP delegates. Facilitating the adoption of a fully
integrated EDIE system in emergency departments and allowing medical
scribes as PMP delegates was a top priority of the NJ-ACEP Board and Dr.
Margie Langer, NJ-ACEP President this year.
This new opioid package of bills
came to be as a result of several recommendations from the Governor’s Task
Force on Opioid Abuse, one of which was to eliminate the current exemption
for EDs to check the PMP when prescribing 5 days or less of a Scheduled II
CDS prescribed for pain. While the press may be covering this as
eliminating the ED PMP exemption, that is not technically accurate.
· NJ-ACEP was successful getting a delay in the
implementation to eliminate the exemption. So, emergency departments
are still exempt from checking the PMP when prescribing a Scheduled II CDS
prescribed for pain when prescribing 5 day supply or less UNTIL SUCH TIME
the state PMP is sharing its PMP prescription data with an emergency
department’s information exchange. When the PMP is shared
through an EDIE, the PMP information will be accessible without logging
into the PMP system and available through the EHR/EDIE system utilized in
the ED. NJ-ACEP is working with the state PMP, NJHA, and
PreManage/EDIE provider to encourage adoption at hospital EDs statewide.
More to come on this at the Membership Dinner on January 25, 2018. Click here to register.
· In anticipation of the mandate to check in the ED,
NJ-ACEP was also successful expanding the class of delegates who can access
the PMP to include “medical scribes in the emergency department.” So,
effective immediately (or as soon as the state has their systems ready),
medical scribes can apply to access the PMP as a delegate to an existing
prescriber in the ED. A delegate’s account can be created at: http://www.njconsumeraffairs.gov/pmp/Pages/register.aspx
· Pain Agreements – 3rd Prescription
Issue Fixed: Another important issue
NJ-ACEP worked on was to clarify the confusion surrounding pain agreements
and when they were required in the original 5-day supply law passed in the
spring. There is no requirement to enter into a pain agreement
with a patient unless they are being treated for chronic pain - defined as
3 months or more of consecutive treatment written by the same prescriber. The
original law incorrectly stated that a pain contract was required when a
patient received a third prescription for a Schedule II CDS prescribed for
pain – regardless of prescriber, condition or whether it was consecutive
months of treatment. This was interpreted by some of your legal
departments as requiring a pain agreement to be entered into in the ED when
you happen to be writing the patient’s 3rd Schedule II CDS
prescription for pain in that year.
OVERDOSE TREATMENT INFORMATION
This law requires anyone
administered opioid antidote to treat drug overdose be provided with
information concerning substance treatment programs and
resources. However:
· NJ-ACEP successfully advocated for amendments that
states when an overdose victim receives treatment in a health care
facility, information concerning substance abuse treatment programs and
resources is to be provided by an appropriate staff member designated
by the facility, rather than by the health
care professional with primary responsibility for the person’s care as
originally proposed. The amendments further provide that the
designated staff member may develop a substance abuse treatment plan for
the overdose victim in conjunction with an appropriate health care
professional.
The Commissioner of Human
Services will be required to develop informational materials concerning
substance abuse treatment programs and resources, including information on
the availability of opioid antidotes to facilitate the provision of
information to patients pursuant to the bill.
BILLS POCKET VETOED
WANDERING RISK BILL VETOED
Legislation that would have
required hospital patient's medical record to include notation if patient
is at increased risk of confusion, agitation, behavioral problems, and
wandering due to dementia related disorder was pocket vetoed by the
Governor. This legislation originally required an ED or hospital
to make an Alzheimer’s diagnosis and make a notation of that patient’s
wandering risk.
· NJ-ACEP successfully advocated for amendments to the
bill that require a notation, if such notation is requested by the
patient's caregiver, be prominently displayed in a patient’s medical record
indicating that the patient is at increased risk of confusion, agitation,
behavioral problems, and wandering due to a dementia related
disorder. The notation is to be made by a health care professional or
appropriate staff member in the patient’s medical record at the time the
patient is admitted to the hospital or to the hospital emergency department
and may not be made except at the request of the patient’s
caregiver.
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