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Achievements of the Medical Society of New Jersey & BergenCounty Medical Society


October 31, 2008  MSNJ Letter to ValleyHospital Medical Staff:


The Medical Society of New Jersey (MSNJ) advocates on behalf of all physicians and medical staffs in New Jersey. As you are well aware, the current economic, managed care and legislative climate in the state continues to have a severe impact on the ability to practice medicine. MSNJ has evolved significantly over the past several years. We are trying to be the voice of medicine in New Jersey, but we can’t do it without the support of your staff. We are very hopeful that your staff will consider contributing to the MSNJ Advocacy Fund which finances our legal and legislative battles. This past year we funded and accomplished many victories with medical staff support. Our efforts include:


  • Funding a public relations campaign which exposes the dangers of a Horizon conversion and incorporates an economic analysis of the true value of Horizon. The Commissioner of Banking and Insurance can only approve the application to become a for-profit insurer stockholder owned company if he determines that the conversion plan promotes the public interest, adequately protects consumers, and is fair and equitable. Most importantly Horizon must include an acceptable plan for the creation of a foundation to which the entire fair market value of the converted company must be transferred. The foundation must be used solely for purposes of expanding access to affordable, quality healthcare for underserved individuals and promoting improved health status for all New Jersey residents. MSNJ is leading the rally exposing the risk at hand. For-profit entities do not promote the public interest. This conversion will lead to premium increases and lower payments to providers and beneficiaries, reducing competition.

  • A judicial victory when the Superior Court of New Jersey-Appellate Division granted MSNJ’s request to stay the implementation of the new personal injury protection (PIP) payment schedule adopted by the New Jersey Department of Banking & Insurance (DOB1), which would have been effective on October 1, 2007. The proposed fee schedule would have reduced payments to physicians for the treatment of patients injured in automobile accidents. Behind the scenes, our two-prong attack strategy was implemented. Legislation has been introduced in both the Senate and the Assembly to also stop the schedule, but we believe we have a court victory. DOBI has reopened negotiations on the issue anticipating a judicial loss and the mandate to write a correct schedule. At this time, over a year later, the court date has not yet been set which means a silent victory for MSNJ.

  • A public relations effort reminding DOBI that Aetna wrote that it would be paying out-of- network providers 125% of Medicare, rather than the providers billed charges. As a result, DOBI fined Aetna $9.5 million and ordered Aetna to directly pay the affected providers’ billed charges.

  • Judicial intervention regarding the Superior Court ruling in the case of Garcia v. Health Net of New Jersey held that the WayneSurgicalCenter violated the Codey Act and therefore committed fraud that entitled the insurer to $15 million in reimbursement of patients’ claims, plus damages. MSNJ responded working with BME, attorneys, and the legislature to clarify the law. Legislation to correct the erroneous decision is on second reading in the Senate. It will reestablish the safe harbor for surgeons who refer patients to ambulatory surgery centers in which they have an ownership interest. The Senate will consider the bill on November 24th. In the mean time, MSNJ and the American Medical Association filed a brief last month before the Superior Court of New Jersey — Appellate Division on the case. We have requested the court make a finding. As the law stands, thousands of physicians in New Jersey are exposed to fraud claims under IFPA. For a copy of MSNJ’s filing please see

  • Meetings this month to diversified audiences demonstrating the dangers of exposing the patients of New Jersey to physician tier rating programs. MSNJ is fighting the practice with legislation because any mandated physician profiling program must use accurate, meaningful, statistically valid measures, methodologies and data. Cost efficiency alone cannot be measured without consideration of patient-specific characteristics and health care outcomes.

  • Joining and becoming a founding member of the new coalition called the NJ Lawsuit Reform Alliance. This is the coalition that formed in Texas and led the successful tort reform battle. Membership is vast and includes insurance companies, pharmaceutical companies, the business community, and other powerful lobbying groups.

  • As we work towards mutual goals, MSNJ needs your financial support to continue our fight to protect physicians and the patients they serve. The Advocacy Fund is used to finance public relations activities, including hiring economists, communicating with policy makers and the media, and rallying physicians and patients in grassroots lobbying efforts. The Advocacy Fund also supports our many lawsuits against managed care companies, state regulators, and others who infringe on physician rights. The Advocacy Fund is supported entirely by the medical staffs of New Jersey’s hospitals and individual physician contributions.


Other Medical Staffs have made the following contributions in 2008:

Englewood - $25,000

Overlook - $25,000

Holy Name - $50,000

CommunityMedicalCenterTomsRiver - $27,000

RiverviewMedicalCenter — $25,000



Institute of Medicine and Public Health of New Jersey Initiatives


NJDHSS Comprehensive Tobacco Control Program (CTCP) Physicians Outreach
Provide Physicians and other health care providers with the 2A+R tools to use during office visits to encourage patients to quit smoking—Assess, Advise and Refer


Alpha - Physicians Committed to Excellence

The IOMPHNJ and MSNJ, in collaboration with Thomson Reuters and STI Computer Services Inc., are providing New Jersey physicians with a unique opportunity to engage in an electronic data exchange that facilitates improved understanding of the patient populations they treat and the services they deliver.


Through the Alpha Project, small- and mid-sized practices are able to electronically submit the data already stored in their practice management systems (e.g., STI’s Perfect Care® system) directly to Thomson Reuters for analytic purposes. From these data, Physician and Practice Profile Reports are generated, which provide participants with in-depth information about their patients’ demographics, the most common conditions they treat, and the procedures they perform the most.


Alpha Project participants have the option to receive additional information about their quality of care and improvement over time. The project’s Performance Assessment Reports make use of quality measures endorsed by the Centers for Medicare and Medicaid (CMS) and used in its Physician Quality Reporting Initiative (PQRI) measures. These reports identify the quality measures that are most applicable to a physician’s patient population, and can help guide physicians in their quest to fulfill quality improvement goals for re-certification purposes.


The Alpha Project is also facilitating physicians’ management of care for chronically ill patients through online disease registries that document the care provided to their patient populations. DocSite, a disease registry vendor, is providing all project participants with direct access to their Web-based reporting tools. The Alpha Project is working with DocSite to use the data from physicians’ practice management systems to build and populate those physicians’ disease registries. This minimizes effort on the part of the practice or physician, and provides them with Web-based access to information about their patients.


Please contact the Alpha Project at for more information.


Physician's Disaster Preparedness
Provide MSNJ member physicians and other healthcare providers with information and implementation strategies to be used in the event of a natural or terrorist disaster.


Tri-county - Camden, Gloucester, and Burlington - Cancer Coalition Men's Health Conference: Taking Care of Business
Serve as fiscal agent, facilitator, and provide program management for the Men’s Health Conference. The Conference focus is the top four men’s cancers in the three counties, screening guideline, and barrier to men getting cancer screening.


Childhood Cancer Work Group Conference
Serve as fiscal agent, facilitator, and provide program management for the Childhood Cancer Work Group bi-annual conference. The conference focus is the youth and adolescent cancer survivor.


Smokefree Air Act Implementation Funded by the Robert Wood Johnson
Coordinate the efforts of the NJ Breathes tobacco control coalition to provide assistance to businesses in New Jersey during the early phase of implementation of the New Jersey Smokefree Air Act. Conduct public opinion polls and distribute signage and other ancillary materials to NJ bars and restaurants, meet with various editorial boards and media outlets to inform the public and assist New Jersey businesses.


CME Lectures on-line CME subscription service is available to MSNJ members. Members who subscribe to the service get the convenience of on-line CME at a reasonable month fee. Subscriptions support the charitable work of IOMPHNJ.


CME Accreditation
To increase the effectiveness and efficiencies of offering educational credits to the public health community.  IOMPHNJ will sponsor Continuing Medical Education (CME) (AMA Category 1 Credit(s)) activities accredited for physicians in New Jersey.