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A special thanks to our 2018 contributors!
Kate Aberger, MD, FACEP
Victor Almeida, DO, FACEP
Tanisha Arora, MD, FACEP
Michael Bernstein, MD, FACEP
Thomas Brabson, DO, FACEP
Joseph Calabro, DO, FACEP
David Castillo, MD, FACEP
Marc Dreier, MD, FACEP
Robert Eisenstein, MD, FACEP
Barnet Eskin, MD, FACEP
William Felegi, DO, FACEP
Jenice Forde-Baker, MD, FACEP
Michael Gerardi, MD, FACEP
Shelley Greenman, MD, FACEP
Patrick Hinfey, MD, FACEP
Steven Hochman, MD, FACEP
Marjorie Langer, MD, FACEP
James Martin, MD, FACEP
Dennis McGill, MD, FACEP
Valerie McLaughlin, MD
J. Mark Meredith, MD, FACEP
Amy Ondeyka, DO, FACEP
Nilesh Patel, DO, FACEP
Mark Rosenberg, DO, MBA, FACEP
Michael Ruzek, MD
Jessica Smolar, MD
Last year, we worked with the legislature and the NJ Hospital Association to improve care to our psychiatric patients in hopes of reducing psychiatric holds in our overcrowded ED’s with the passage of three important bills. We also worked along with the Medical Society of NJ to secure legislation which mandates that a carrier which issues a managed care plan with an out-of-network benefit, remit payment for reimbursement of a health care service directly to an out-of-network provider. We are also continuing our work with the legislature to avoid unreasonable mandated training for coverage of ED’s in designated children’s’ hospitals and working with a coalition to aggressively work against the insurance industry’s attempts to halt out-of-network reimbursement.
As a New Jersey emergency physician, this is the most important letter you have ever received. New Jersey is at a critical crossroads – and the physician community is smack in the middle!
The insurance industry is working hard to convince important State decision makers that …
…the rising health insurance premiums are directly related to physician (and hospital) billing
…the #1 reason that we are in the middle of a health care crisis is physician (and hospital) billing and
… the decision makers must force all physicians (and hospitals) into insurance networks in order to reign in insurance costs and bring down premiums.
The insurance industry has absolved itself from any aspect of this problem. Insurance CEO salaries aren’t the problem….nor are exorbitant premium increases that create high profit margins. The industry explains away how even “non-profit” carriers, such as Horizon BC/BS, can retain a CEO who earns over $8 million.
The industry is quick to testify before legislators, waving out-of-network bills, with no mention of what amount was finally paid, nor any mention of how long it took to receive the monies. The industry fails to report on difficulties physicians have to even negotiate fair rates for in network services; especially since there’s no negotiation power afforded physicians.
New Jersey finds itself embroiled in a heated battle – the physicians vs. the industry – all focused on out-of-network reimbursement.
Legislators are beginning to host work groups and hearings. The insurance industry is, as you would expect, very well organized and well funded. Now it’s time for the physician’s voice to be heard!
A large of coalition of 20+ organizations – including all the State’s physician organizations, hospitals and ASCs – have come together and developed a sound, workable strategy to push back on the industry’s attempts to halt out-of-network reimbursement. But we need your help! As you can imagine, this is a large undertaking and it will be expensive.
But, there really is no bigger issue facing medicine in New Jersey. STATPAC is soliciting to help fund the work of this important OON coalition. Please give now (suggested amount is $300.00 per physician representing approximately 3 hours of pay). Your NJ-ACEP Board of Directors is overseeing the efforts, and has a strong voice at the table.
Simply click on our new STATPAC website – www.njstatpac.org -- that allows you to contribute on line. Your help is needed and appreciated.
Steve Hochman, MD, FACEP